Catherine Connolly (Galway West, Independent) | Oireachtas source

I thank People Before Profit, Solidarity and RISE for moving this motion. We have not discussed this matter since the beginning of the Covid-19 pandemic, although we have all raised it through oral and written parliamentary questions and Topical Issue debates. It was an urgent issue from day one. I thank the parties I have mentioned for using their Private Members' time to bring this motion when there were other things they wished to raise.

The Ministers of State, Deputies Butler and Rabbitte, have been sent into the fray when the senior Minister should be here to discuss this issue and many others. His absence is not acceptable. I have said this before. The Minister of State, Deputy Rabbitte, sat here all morning, and the Minister of State, Deputy Butler, is here now. I welcome their presence, but in view of the importance of this issue and its background, the senior Minister should be here.

Speaking of background, I spent ten years of my life on a regional health forum. I saw the public health system systematically undermined while every effort was made to further the private system. There is a background to this situation. Time does not allow me to deal with all of that and it is not necessary to do so. I will mention some snapshots of the situation in 2019, just before we went into Covid-19 with a health system that was not fit for purpose. As a result of this situation, the Government took actions which made things worse for people on waiting lists for operations. Our public system was utterly unfit for purpose following actions taken by various governments.

Irish hospitals were already working at almost full capacity. According to figures from the OECD, Ireland had a hospital occupancy rate of 95%, one of the highest in the OECD. This was about 20 percentage points above the OECD average of 75.2%. In other words we had very little spare capacity. As a consequence, dreadful decisions had to be made to keep hospital beds free and an agreement was made with private hospitals to leave their beds empty.

I can pick any statistics but I will pick only a few. By the end of November of 2019, just a few months before Covid, we had seen the highest number of patients on trolleys in any year since records began, with more than 100,000 people having gone without beds in the year to 29 November. According to the INMO, in 2019 there were 1,157 fewer nurses and midwives working in the HSE than in 2007. Some 40,000 nurses went on strike in 2019 over pay and staff shortages. According to the INMO at the time, and indeed some clinical directors of various hospitals, the dangers of overcrowding and chronic understaffing put patients at grave risk.

That was the background leading into Covid. Today we have a speech that I doubt the Minister of State, Deputy Butler, or the Minister of State, Deputy Rabbitte, wrote. It is five pages long and disingenuous in the extreme. It does not deal with the issues or the very brief request set out in the motion. The first page of the motion text is long but the second page has simply three very basic requests. The Minister of State's speech refers to excitement. It states: "Our four year degree level programme is one of the main reasons that Irish nurses and midwives are in great demand throughout the world." It refers to the "exciting" career of nursing and midwifery. I agree with that and I agree that nurses and midwives are in demand, but these five pages fail to explain why our nurses and midwives are in such demand throughout the world but not in demand in their own country. Surely at least a page of this speech might have focused on what we need to do to pay our nurses adequately while they are training and following their training, how we might retain them, and what package of actions are necessary for us to be able to cherish them.

I felt embarrassed about the clapping. I clapped for the nurses on two occasions. I did so with some shame. The hollowness of my clapping and all our clapping was deafening because at the same time we were in receipt of constant representations from nurses and student nurses who were not really being protected. There was the whole debacle over the protective gear and so on. They carried a huge burden without any payment. Then for a little while we brought in some payment for them and then took it away again, ostensibly because the situation had changed. The situation has not changed. It has changed to the extent that we are not using as many intensive care beds and there are not as many in hospitals, but we will face, as the Minister of State well knows, another surge in January or February.

What is being asked for here is a temporary Covid-related measure, as I understand it, and Covid is still very much with us. We talked about €18 billion in extra funding going to businesses and other organisations, and rightly so, but not to the student nurses and nurses on whom we depend. Any study in psychology that I ever read or looked at in a previous life showed that people got better more quickly as a result of interaction between nurses and the patient. I might add the porters and cleaners as well, whom we should treasure much better. That was the greatest predictor of a patient getting better, not the actual doctors. I pay tribute to them as well but they were not a predictor of patients getting better.

There are a number of practical problems here. The nurses could not work outside because they could not risk the spread of Covid when they went back into the hospital so they were deprived of that source of income. "Sorry" is the wrong word. Deputy Butler is a Minister of State. It is the senior Minister who should be in here looking at this and not giving us a five-and-a-half-page speech telling us how exciting this career is. We have listened today to all the contributors. Excitement is not something at the forefront of nurses' minds. They are trying to cope with Covid, struggling with mortgages and trying to raise children in a career that is not valued, despite the fact that they have degree status. I am not putting that forward as something that gives them status, but they wanted those degrees and worked for them themselves. We are not giving the right recognition to nurses at any level but today we are looking at giving them, during Covid, the payment they deserve.

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