Mary Butler (Waterford, Fianna Fail) | Oireachtas source

It is clear from the debate this morning that Members across the House share the gratitude to, and have paid extraordinary tribute to, student nurses and midwives and all their healthcare colleagues who have provided, and continue to provide, care across the entire service. The Government will not be opposing this motion.

I wish to offer my deepest sympathies to everyone who has lost a loved one. In particular my thoughts are with the families of the 93 people whose deaths were notified yesterday.

We all know that Irish nurse and midwife graduates are in great demand worldwide. As we have heard today, the main reason for this is our four-year degree programme. As the Minister for Health, Deputy Stephen Donnelly, stated earlier, the graduate education approach these programmes offer to our student nurses and midwives is a hands-on learning approach as students. An essential part of their learning and the approach to building their skills is actively taking part in patient care. Clinical placement learning is on a supernumerary basis for years 1 to 3 and the first part of year 4. The placements of between eight and 15 weeks in each year of the programme cover the wide variety of clinical environments students need to learn in. The clinical placement in the fourth and final year of study is through an internship paid placement. This unique learning period focuses on the assimilation of skills, knowledge and professional behaviours learned over the programme to enable the critical thinking and decision-making required to be a nurse or midwife. In addition, an important element of this clinical placement is the built-in four-hour period of reflective learning per week for the student to reflect on the placement. Clinical placement for all student nurses and midwives is the clinical learning environment in which they gain, incrementally, the practical experience, necessary skills and professional behaviours required to become members of the nursing and midwifery professions.

Members will be aware that this clinical placement education time comprises 50% of the student nurse and midwife undergraduate programme. This significant proportion of learning time is prescribed by an EU directive and translated into the education and training standards and requirements by the Nursing and Midwifery Board of Ireland. Maintaining a student's supernumerary status and offering the full student experience to achieve these standards is a proven success factor of all the nursing and midwifery programmes.

Members will be aware that due to the current pressures on the health service as a result of the latest surge of Covid-19, in particular on critical care, a decision was made to suspend all supernumerary clinical placements for first to third year nursing and midwifery students. This suspension is for a period of at least two weeks from 18 January 2021. This was a necessary decision and, as with so many decisions in managing care through a pandemic, it was in immediate response to the particular clinical care demands at the time and the requirement for qualified staff.

It is regrettable that placements had to be suspended. We are aware it will cause an unavoidable temporary delay and inconvenience for many nursing and midwifery students. The staff who support student placements are experienced and have the skills and knowledge to support the current surge requirements. The Department is currently working with the HSE, the higher education institutes, the Nursing and Midwifery Board of Ireland and clinical partners to ensure students affected by the decision to suspend clinical placements will not be disadvantaged in the completion of their educational programmes on time.

The clinical oversight group in place since the beginning of the pandemic will continue to review the impacts of Covid-19 on the provision of clinical placements. This group will be an important part of supporting the safe reintroduction of supernumerary placements as soon as possible.

In September 2020, following the first surge, when all placements for all healthcare students, not only nurses and midwives, were suspended, clinical placements for all nursing and midwifery students were fully reinstated. As the Minister for Health explained earlier, while Covid-19 continues to impact our communities and health services, each surge has impacted on the students' clinical placement education differently.

Prior to this current surge, additional supports had been put in place for students to assist them in maintaining their clinical placements and continuing this key part of their learning. The additional supports are in recognition that there are additional demands on students due to Covid-19 and the need to comply with public health requirements. Such demands may include getting additional and alternative modes of travel to and from placement locations, finding alternative accommodation in some instances and making changes to living arrangements.

I will outline the relevant supports in a moment.

All healthcare workers have access to PPE, training and occupational health supports. Students are also fully supervised on placement by qualified staff with the skills and knowledge to support their safety in the clinical environment. There has been ongoing engagement between health sector management, the student nurses and midwives and their representatives unions, and this continues, including with the oversight group. Maintaining student nurses and midwives on their education programmes and protecting their student status remains a priority. I wish to reiterate the supports currently available to student nurses and midwives. They include access to the pandemic unemployment payment for those students who may have lost part-time employment due to Covid-19. This is a specific exemption the Minister, Deputy Donnelly, secured for our student nurses and midwives. The supports also include enhanced illness benefit for those students who work part-time but who have fallen ill due to Covid-19. The accommodation allowance of €50 per week towards alternative accommodation while on placement in clinical sites away from the base hospital is maintained. Additional travel expenses associated with clinical placements are also reimbursed. Other welfare schemes to assist with financial hardship due to illness, subject to qualifying criteria, include the supplementary welfare allowance and the urgent needs payment. There is also access for eligible students to the national access plan and the student assistance fund. There is a €250 top-up for those in receipt of the SUSI grant or a €250 contribution to fees for eligible students.

We have heard the Minister tell us that in order to ensure supports were in place for student nurses and midwives while on clinical placement during this time, he appointed Professor Tom Collins to carry out a short-term independent review of clinical placement allowances. He received this report on 31 December 2020. The key recommendation in the report is to implement a pandemic placement grant of €100 per week for each supernumerary placement week during the pandemic. This is on top of the supports in place for all clinical placements and the additional supports referred to a moment ago. The Minister has accepted the recommendations and is keen to progress the implementation of this additional support. In addition, the Minister has committed to a longer-term review of allowances for student nurse and midwife placements and work on this is due to commence.

The collective feedback we have heard from the students, the clinical placement support staff, the group directors of nursing and the heads of school in the higher institutes of education reflect the investment by the profession in educating their students and the importance to them all of supporting the education programme. We have also heard the challenges outlined, the difficulties and, in particular, the impact the pandemic is having on students and their education. The variety of supports in place, financial and non-financial, to continue to support students at this time remain under review to ensure safety and maintenance of the learning environment.

I again commend the student nurses and midwives on their commitment to continuing their education to becoming nurses and midwives. The pandemic has shown us all the importance of having a highly trained, highly skilled and adaptable health workforce. Supporting our students to continue their education, protecting the graduate programme and maintaining their student status to do so remains a priority for the Government, the Minister and the professions.

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