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Covid-19 Pandemic

Dáil Éireann Debate, Tuesday - 8 December 2020

Tuesday, 8 December 2020

Questions (4, 5)

Neale Richmond

Question:

4. Deputy Neale Richmond asked the Taoiseach the engagements he has had with the First Minister and deputy First Minister of Northern Ireland in respect of lifting Covid-19 restrictions. [39968/20]

View answer

Richard Boyd Barrett

Question:

5. Deputy Richard Boyd Barrett asked the Taoiseach the engagements he has had with the First and deputy First Ministers of Northern Ireland in relation to lifting Covid-19 restrictions. [41633/20]

View answer

Oral answers (20 contributions) (Question to Taoiseach)

Dealing with Covid-19 on the island of Ireland is a priority for the Government and I have had regular contact with the First Minister and deputy First Minister on the matter. Furthermore, there is ongoing engagement on Covid-19 between the Minister for Health, Deputy Stephen Donnelly, and the Minister for Health in Northern Ireland, Robin Swann; between the Chief Medical Officers, North and South; and between the two health services. I have discussed Covid with the First Minister and deputy First Minister by phone and by videoconference on a number of occasions, including Friday, 16 October; Monday, 15 October, and Thursday, 24 September. I have spoken by phone separately with the First Minister on two occasions, 7 November and 8 October.

There is ongoing engagement at official level on a wide range of matters, including Covid. There has been particularly close contact between Irish and Northern Ireland officials in recent weeks in the context of respective restrictions and other measures as a consequence of Covid. While we each have our own medical and scientific advisers and decision-making processes, there is good co-ordination between us. I am pleased to note that there is a high level of commonality in our current overall approach, including in respect of the ongoing public health advice and to the lifting of restrictions as we approach the Christmas period.

I thank the Taoiseach for his response. I raise this issue, as Deputy Boyd Barrett has, in order to look at a couple of areas. The end of a period of restrictions is, supposedly, approaching in Northern Ireland and most of us in this jurisdiction have been enjoying in the past week or so being back at level 3 restrictions. We hope to stay there or go down to level 2 or 1 in due course. It should be noted that the restrictions are still sterner and the impact of the virus is much more worrying in Northern Ireland. We see reports of capacity issues at a number of Northern Irish hospitals. Of particular concern is the situation at Altnagelvin Area Hospital, which services much of Donegal as well.

Looking at the co-ordination between the Taoiseach and the First Minister and deputy First Minister, we need not only to discuss restrictions and the potential lifting of them but also the co-ordination needed in that regard. Two weeks ago, I raised with the Tánaiste my serious concerns regarding the issue of bus tours being organised by Northern Irish companies to bring shoppers down to the Republic, be it to somewhere like Dundrum Town Centre in my constituency or to the city centre. Those were flagrant breaches of the restrictions and, when the matter was taken up with the operator, there was a sheer lack of understanding that crossing any county boundary should even be considered.

I raise the serious issue of co-ordination of the vaccine roll-out. Every one of us was cheered by the scenes in Coventry, featuring a Fermanagh native, and in Belfast, when individuals were given the first vaccines. We look forward to seeing that coming into the Republic. We need to be aware that many people, going through the strands of priority that the Government has laid out for vaccines, may be working in the Republic and living in the North or vice versa, be they in an at-risk group or not. There is much more co-ordination to be done. I hope the Taoiseach will continue his conversations with the First Minister and deputy First Minister throughout this important period.

Since the Government voted down the Solidarity-People Before Profit motion calling for the payment of student nurses and midwives, I and student nurses and midwives have listened with fury to the Taoiseach's lame, dishonest and unacceptable excuses in respect of the decision the Government made. There is an interesting all-Ireland dimension to the hypocrisy around treatment of our front-line workers, such as student nurses and midwives. The following is from an elected representative on this island:

It’s only fair and right that our student nurses are properly recognised and recompensed for the service to our communities during this pandemic.  Right across the city we have Covid patients being tended to by NHS staff and their student nurse colleagues.  The Health Minister must recognise their efforts at the most challenging of times with fair and proper wages.

That is a quote from a Green Party councillor, who would have voted in the election for the Greens to enter Government down here and in the party's leadership election. That is stunning hypocrisy. A party with which the Taoiseach is allied marched into the Dáil last week and voted against paying student nurses and midwives; the same party, in the North, is calling for their payment and saying it is due recognition for the work they have done on the Covid front line. What does the Taoiseach think about that? Even people who are aligned to the Government call for the payment of student nurses and midwives in the North. Yet the Taoiseach comes out with lame, dishonest and unacceptable excuses for doing the exact opposite down here and covering over the disgraceful decision not to pay student nurses and midwives. We will rebut these excuses one by one in the next question in this session.

We welcome that there has been agreement on how the Covid vaccine will be administered. There needs to be the tightest possible contact between the Northern Executive and the Government. That will be critical in the roll-out of the vaccine, particularly in Border counties. I welcome the level of co-ordination that the Taoiseach has stated remains in place between him and the First Minister and deputy First Minister. We need to see how the vaccine will be rolled out. We must also ensure that there are proper staffing levels and proper consultation with GPs so that, when the vaccine is ready, we are prepared to roll it out.

I thank all of the Deputies for raising these issues. To Deputy Richmond, the first overall point I will make is that we have made every effort to try to align our positions, North and South, on Covid-19. Early on, there was the memorandum of understanding between the Chief Medical Officer, CMO, in the Republic and the CMO of Northern Ireland. There have been sensitivities and differences of opinion within the North and the Northern Ireland Executive. In advance of some of the restrictions that were introduced, we could see transparently those sensitivities playing out as well as the difficulties and challenges in terms of getting agreement in the multi-party Executive. It is an Executive that is made up of quite a number of parties. That has proved challenging.

We have engaged and we have made suggestions from the summer onwards. Unfortunately, there have been periods when our period of severe restrictions under level 5 did not align with Northern Ireland, which was at a lesser level, and when we emerged from level 5, Northern Ireland went to a more severe level. That said, I draw some comfort from the fact that numbers have been going down in both jurisdictions, although I think they are still relatively high in the North, worryingly so. We are coming out of level 5 in the Republic at a level that we must be careful about because it is far higher than when we eased restrictions in the summertime. There is a real need for vigilance in terms of stopping the spread of the virus.

In the Border counties, there is an ongoing need for co-ordination on a range of fronts such as those the Deputy has suggested in terms of shopping trips down. For example, in the Republic right now, there is a restriction on going outside one's county. That applies to all of our Border counties. It should be enforced and will have to be monitored. Likewise, Northern Ireland should monitor its regulations and enforce them as well so that we have the minimum risk to the general public in terms of the spread of the virus.

Regarding co-ordination on the vaccine, people living in the Republic but working in the health service in Northern Ireland will get the vaccine in Northern Ireland. We look forward to ongoing co-operation on the island of Ireland in terms of the roll-out of the vaccine. Both jurisdictions have similar prioritisations in terms of the groups that will get the vaccine first. In my view, that is the way it should be. I think there will be close co-ordination and co-operation from the respective CMOs and, indeed, public health specialists of both sides. Regarding hospitals, in case there are requirements for us to provide support or vice versa where a particular hospital is over capacity or there are pressures on a hospital at a given time because of the level of ICU or bed occupancy by Covid patients, particularly over the Christmas period and into January, we are mindful of that situation and will monitor it very carefully.

Deputy Boyd Barrett raised an issue - he described my presentation as "lame, dishonest and unacceptable" - with the normal high-pitched melodrama. I have to say in response that we are committed to student nurses. The countermotion last week from the Government facilitated the payment of the pandemic unemployment payment to student nurses, who cannot work part time. Fourth year nursing students are paid - I think the Deputy will acknowledge that - as part of the 36-week placement. First year students, second year students and third year students are on clinical placements. I do not believe they should be working during their clinical placements because those clinical placements are meant to be protected under the nursing degree programme by the hospitals. People are being paid by the HSE to be in the hospitals with the express purpose of protecting the learning environment and protecting the degree programme for the students. There should be no exploitation of students in that regard and none should be tolerated. I mean that.

I have spoken to the heads of a number of colleges and to the Chief Nursing Officer, who are concerned that we are now moving back to an apprenticeship model. What the Deputy seems to be advocating, whether he means it or not, is to go back to the apprenticeship model, which would be a retrograde step and an undermining of nursing ultimately. The whole idea of moving to the degree programme was to modernise, transform and professionalise nursing education and to give students the opportunity to go to third level to study a nursing degree programme like other students in medicine, pharmacology, physiotherapy or occupational therapy. Why should student nurses be any different? Why should they not have been in a position a long time ago to participate in a degree programme? That was the whole motivation behind the degree programme. It seems to me that that model is now being challenged. I am open to debate on that and I believe there should be a more fundamental review of the degree programme now in light of this debate. We should make up our minds once again about what we actually want for the future of nursing as a key part of our healthcare service. The whole idea was to advance nursing in the hospital hierarchy. In pay claims and so on, the advancement of the nursing degree was often used as a rationale.

This is a very core issue. I was involved in bringing in the nursing degree programme - I know what I am talking about. Heads of colleges have received stories of people being exploited or allegations of exploitation. That should not occur. The HSE is saying that that is not happening. We need to verify that. I do not think that any first year student on a clinical placement for six weeks should be treating a Covid patient. I do not think anyone in this House would suggest that should be the case. It should not be the case. The student should be there to learn.

But it should not be the case and the Deputy should not be saying it should be the case. If he is saying that everyone should be paid, then he is saying that we should go along with it.

I am not saying that.

We should not go along with it. To go along with that is to undermine the whole programme and go back to an older and, in my view, less advantageous model for nursing in general. That is the point.

Start with the reality.

I am starting with reality. In my view, we need to deal with that core issue. I have said to the Minister and others that there should now be an overarching review of nursing education in general. Australia, which often gets mentioned, has the two models running in parallel - a nursing degree model where the students do not get paid and an apprenticeship model. That is my understanding. They are two different models entirely.

It is far too simplistic to come forward with a Private Members' motion and say "They are all against us" or "They are all for us" because they voted for a motion. A motion achieves nothing in terms of public service pay. It achieves nothing in terms of a degree programme. It is about political manoeuvring. That is what it is about in essence. The Deputy knows that as well I as know that.

The Government could have amended the motion to pay them in a different way.

It is wonderful that the Deputy can boil it down to one slogan, to one hashtag, but public policy never gets developed on a hashtag. It is time people realised that.

#RepealThe8th.

That is the point. That is the bottom line.

It is legislation, it is public service pay talks-----

-----it is working out entitlements. That is hard work. Negotiations have been ongoing with the union and the INMO in relation to a review of allowances. There is a review of allowances for first year, second year and third year students. It will end by the end of December and result in an increase in those allowances. There will also be a review of the fourth year payment and the nature of that. In addition to verification procedures and so on and the need to protect that learning environment that I spoke about, we need to do a more fundamental review of what we want out of nursing education and what we think is the best model of nursing education into the future.

I thank the Taoiseach, but we are eating into the time for the next series of questions. We have just under 15 minutes left and there will be six Deputies contributing on the next group.

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