Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I very much welcome the opportunity to address the House on the motion. I thank the Deputies for tabling the motion, which the Government will not oppose. I would like to take this opportunity, as I am sure we all do, to thank nurses and midwives, including students, and all healthcare workers for their ongoing dedication, commitment and professionalism as we continue to deal with Covid-19. I meet many nurses, midwives and students, and many other healthcare workers throughout our healthcare system, on a regular basis. Many of them are tired. Many of them have had a difficult time. We have to do everything we can to support our healthcare workers. At the same time, while many are tired, they also discuss a sense of immense pride in the work they have done and the work their colleagues have done, and in how our healthcare community has stepped up in the face of the biggest healthcare crisis and challenge we have faced in living memory. The Government is committed to recognising the dedication that front-line healthcare workers have shown during the pandemic. Work is ongoing to determine how best this can be done.

The contribution of our nurses and midwives, and our student nurses and midwives while on clinical placements, has been, and continues to be, exceptional. Student placements in hospitals are a feature of training and education across a range of disciplines in the health sector. The placements give students practical experience to meet the educational and regulatory requirements of the programmes and ensure they are in a better position to get jobs after graduation. Clinical placements are a necessary part of the degree programme for nurses and midwives who gain invaluable practical experience and develop their clinical skills. Of course, part of the result of this is that our graduates are sought all over the world because of the quality of the training they have had and the degree programmes they have come through.

As many of the Members here will know, we have introduced a number of measures to help support our student nurses and midwives during the pandemic. First, we ensured they could access the pandemic unemployment payment if they ceased part-time work in, for example, a nursing home or another healthcare facility because of infection prevention and control considerations. This was a special exemption for student nurses and midwives.

I commissioned a report from Professor Tom Collins who recommended a specific pandemic payment grant of €100 per week of supernumerary placement. There was an option put in place also to backdate that to the start of last year's academic term in September.

Following the completion of the Short-Term Review of Clinical Placement Allowances for Student Nurses and Midwives by Professor Tom Collins, the Collins Report, in December 2020, a longer-term independent review was commissioned to examine multiple issues as follows: first, the existing clinical placement allowances payable to student nurses and midwives on supernumerary clinical placement for first, second and third years; second, the pandemic placement grant as specified in Professor Collins’s report; and third, pay for fourth year nurses and midwives on the paid internship placement. Mr. Seán McHugh was appointed to carry out this independent review. He invited submissions from a number of stakeholders, including the HSE, higher education institutes and students. I was pleased to receive a report on this matter from Mr. McHugh and my officials and I have completed our review of his report. I agree with his recommendation to increase the pay of interns. I intend to extend payment of the pandemic placement grant. I will also be supporting additional recommendations that were made in the report and will be requesting Cabinet approval for increased financial supports to this end.

Covid-19 brought a range of serious challenges to our nation and to our health service in respect of capacity and staffing. We have worked hard to increase both in order to respond to the pandemic and to deliver a better resourced health service for the future. Both budgets 2021 and 2022 provide very significant amounts of funding for a large, permanent expansion of the health service workforce.

This year, we have recruited an additional 4,462 staff so far, including many more nurses and midwives. The year-to-date whole-time-equivalent growth for 2021 is the second largest increase since the foundation of the HSE, the largest increase being last year. The Department and the HSE deserve great credit for achieving this during a pandemic. Budget 2022 continues the significant investment in the health sector workforce, with funding for an estimated 141,491 full-time staff to be in place at the end of 2022. This would be a further increase of 10,855 from the current staffing numbers, equating to an increase of 8%.

I am acutely aware of the impact that the recent Covid-19 surge is having on our health service, on our patients and, of course, on our healthcare workers. I know that many of our healthcare workers were increasingly concerned about the waning immunity of the vaccines. I was very pleased to authorise yesterday evening the roll-out of booster vaccines to approximately 300,000 healthcare workers. I received updated recommendations from the National Immunisation Advisory Committee, which recommended that a booster dose of an mRNA vaccine is offered to healthcare workers who have completed a primary vaccination course of any Covid-19 vaccine. The additional vaccination of healthcare workers will further protect them and, in turn, the vulnerable patients under their care. Reducing the level of breakthrough infections among healthcare workers will help ensure the continuity of healthcare services particularly during the winter, which have been seriously curtailed by higher rates of transmission of this virus and the pressure that Covid-19 is putting on our entire healthcare system.

My Department, the HSE and the National Treatment Purchase Fund are focusing on improving access to elective care in order to reduce waiting times for patients. These plans include funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, providing virtual clinics, increasing capacity in the public hospital system, as well as increased use of the private system.

We have a budget of €350 million available to support vital initiatives to help us to address the waiting lists. These have disimproved during the pandemic but, let us be clear, they were unacceptably high for a long time before Covid-19 arrived here. This causes great stress and anxiety for patients and their families, as well as the healthcare staff who are trying to care for them in what are sometimes suboptimal conditions.

I also acknowledge the distress overcrowded emergency departments are also causing to patients, to their families and to frontline staff who are working in very challenging conditions in hospitals throughout the country. I thank all of our frontline workers for their ongoing work and professionalism. I recognise that this winter will be a difficult one for patients, for their families, for our health system and for our healthcare workers.

The Government has funded significant initiatives across the health service in the acute, community care and primary care sectors to reduce demand on emergency care by providing alternative care pathways outside the acute sector, additional capacity within the acute sector and additional discharge options in the community sector for patients who were admitted through emergency.

The winter plan will provide for the appropriate, safe and timely care of patients by ensuring, insofar as possible, that effective levels of capacity and resources are in place to meet the expected growth in activity levels.

In conclusion, I want to state that I do not underestimate the difficulty that nurses and midwives and their healthcare colleagues have experienced throughout the course of the pandemic. Without question it has been a difficult and often brutal time. In conjunction with the HSE, the higher education institutes, the Nursing and Midwifery Board of Ireland, NMBI, and clinical partners, my Department and I will continue to focus on keeping our nurses, midwives and their colleagues safe.

I will have to leave before the end of the debate for a meeting on epidemiology and the Minister of State, Deputy Butler, will be here for the wrap-up on behalf of the Government. Gabhaim buíochas.

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