Micheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

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 versawhere 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.

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