Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance) | Oireachtas source

The Minister of State has met the society. To me it is a slam dunk that we should do this. I am coming across a considerable number of young people who are very interested in the area of mental health, they want to go into this area and we are putting obstacles in their way which makes no sense. The society says that the figures for extending the salary and the assistance with fees for education and counselling psychology is a derisory €1.7 million. It is nothing. It says that an additional 50 trainee psychological posts across the professional doctoral programmes for a five-year period would be an extra €2.45 million. That is €12 million over five years. That, again, is buttons compared to the wider health budget but would have a very serious impact. It is also saying that in order co-ordinate the management and placement of current and increased numbers of trainees, the Government should fund with immediate effect the establishment of a national psychology placement office, as the HSE has recommended, which would require the funding of just a measly €770,000 per year. Again, this is buttons but could have a very real impact.

Incidentally, when one thinks about the sort of mental health issues, and so on, that we have in our schools, I believe that we should have psychology departments in every single school in this country. It would be a great assistance to our young people. who are significantly impacted by all kinds of mental health issues and need support. There are many young people out there who want to do this kind of work, to work with other young people, but we need to make it easy for those who want to do this, to get the qualifications and placements they need, and then to move into working in our health services.

One other group which I will quickly give a shout out for is the graduate entry level medical students, that is the people who have previous degrees, graduate entry level students. I believe there is a particular name for this group which the Minister of State’s officials, I am sure, will know the name of. These are people who have done other degrees and now want to move on to medicine. They have not done a primary medical degree, have done another degree, and then go on to do medicine. There is a pathway for them to move from whatever other degree they have done into medicine but, again, they are faced with completely shocking fees. This is crazy. When we have such a shortage of doctors, why are we putting obstacles in the way of people who want to study medicine and who want to work in our health service?

The other broad point I would make on recruitment and retention, which came up with regard to the student nurses, could apply to a lot of healthcare professional areas where there are real difficulties in people just surviving day to day, whether they are studying nursing, midwifery or in other areas. The people I have mentioned often have real day-to-day cost of living and accommodation issues. Because they are studying, they are not paid properly and they cannot afford accommodation so they drop out. There are all sorts of pressures on them. We should introduce bursary schemes to incentivise people, essentially to fund them in these areas of healthcare where we have a dire shortage of people, whether it is in nursing, midwifery, psychology or elsewhere.

The quid pro quocould for such bursary schemes is that if people get a decent bursary, they would then commit to working for a few years in the health service after they qualify. We assist them in getting through their qualifications so they are not struggling, they are not paying shocking fees and they get some sort of proper stipend to sustain them and allow them to pay their accommodation costs and, as a quid pro quo, they commit to giving a few years in the health service, rather than leave the country, as so many do because the situation is so difficult for them. Those are a few practical suggestions.

We are theoretically committed to this under Sláintecare. We have a lot of the capacity we need in the health service but the problem is that a significant section of that capacity is privatised because we have a two-tier system. That is just crazy. I am infuriated when I hear the ads for private emergency departments and private hospitals. The implication of these ads that we hear on the radio every day is that if people go to the public emergency department, they will be waiting for half a day, a day or two days in a war zone, but “Come to us, if you can afford to pay, and you will get treated straight away.” The capacity is there but it is only there if people can pay. There is significant additional capacity in the private system but only available to people who can afford to pay very expensive private health insurance. That speaks to the obvious need to integrate and to have a single-tier, universal, publicly-run system, rather than the two-tier system that we have. We were forced to recognise the need to do that during Covid so surely we should make that a permanent state of affairs by having an integrated, single-tier, universal public health system.

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