Wednesday, 11 November 2020
Saincheisteanna Tráthúla - Topical Issue Debate
I thank the Minister of State for the opportunity to raise this issue today. I appreciate it relates to the Department of Further and Higher Education, Research, Innovation and Science and possibly the Department of Health. The issue is with supernumerary student nurses in first, second and third year for whom 50% of the course is based on clinical placements. In general, but particularly during the Covid-19 period, these nurses are under extraordinary financial pressure to take up placements, which often mean substantial travel, accommodation, additional laundry costs, living away and, indeed, having to stay away during the Covid-19 period. As matters stand, if they must travel to their placement, which many do, they are given just €50 per week to cover these costs. That is simply not practical. If one takes my constituency of Sligo-Leitrim in the north west and counties Donegal and Roscommon, for example, placements might be 100 miles away. These nurses have to find accommodation, feed themselves and make sure their uniforms are laundered regularly, particularly during Covid.
An allowance of €50 per week does not come anywhere near meeting those costs.
This situation is being experienced by student nurses all over the country. There are difficulties for everybody during the Covid pandemic but that is particularly the case for student nurses in their first, second and third year of training. Some of them are doing weekend work as healthcare assistants but the reality is that they may, as a result, miss out on a clinical placement because the relevant authorities in those placements do not want the increased risk from a Covid perspective that taking those student nurses on would bring. The solution to this, at a minimum, is the introduction of a bursary for bachelor of nursing students in their first, second and third year to assist them at this time and cover the significant expenses they are being forced to endure during this period.
I received a response on 30 September to a question I tabled in respect of payments to student nurses in the first-year to third-year cohort. The response states:
Supernumerary clinical practice placements were temporarily suspended during the initial Covid-19 pandemic response and a temporary scheme was put in place whereby these students were offered employment by the HSE as healthcare assistants. These supernumerary clinical practice placements will resume as expected, based on the requirement for undergraduate nursing and midwifery programmes.
Based on a trawl through the figures that were provided to me, more than 554 people are affected by this issue among the first-year to third-year cohort.
I reiterate the call from the Irish Medical Organisation, INMO, for a scheme to be put in place, similar to the one that was previously in operation, under which student nurses were paid healthcare assistant salaries. That was done in recognition of the fact that many student nurses are working well beyond their experience. We know there are serious capacity issues within the system. According to the INMO, the reality of current service provision is that "inadequate registered nursing staffing levels are requiring students throughout their clinical placements to undertake work over and above that expected of their undergraduate status". The INMO states that the failure to remunerate them "amounts to exploitation".We all accept the bona fides of the organisation in this matter. We are merely calling on the Government to recognise that student nurses are workers and that they should be paid for their work.
I thank the Deputies for raising this important issue. I am conscious of the difficulties being experienced by students and their families as a result of the Covid-19 pandemic and the importance of the student grant scheme and related supports such as the student assistance fund and the fund for students with disabilities. These supports have a fundamental role in assisting students and parents who are putting their children through further and higher education. I will outline in my reply the various supports available through my Department to assist higher education students, including student nurses. They encompass a range of additional supports that have been put in place for students as part of budget 2021 and under the Government's Covid response earlier this year.
The principal support provided by the Department in financial terms is the student grant scheme. Under the terms of the scheme, grant assistance is awarded to students attending an approved course in an approved institution if they meet the prescribed conditions of funding, including those relating to nationality, residency, previous academic attainment and means. The decision on eligibility for a student grant is a matter, in the first instance, for the awarding authority, which is Student Universal Support Ireland, SUSI. For the 2020-21 academic year, grant applications will be based on gross income from all sources for the year from 1 January to 31 December 2019. However, if a student has experienced a change in circumstances since then, that can be notified and flagged to SUSI and will be taken into account. In such cases, applicants may qualify for a revised grant. Details of this process are available on the SUSI website, susi.ie. All students in third level institutions who are experiencing exceptional financial need can apply for support under the student assistance fund. This fund assists students, in a sensitive and compassionate manner, who might otherwise be unable to continue their third level studies due to financial circumstances.
In 2020, my Department will spend approximately €450 million on access measures for further and higher education. This includes €400 million on student grants and related activities, which is expected to benefit 74,000 further and higher education students. As part of budget 2021, the Minister, Deputy Harris, and I secured an additional €20 million to provide for additional applicants to SUSI, €6 million to expand supports to postgraduate students and an additional €1.5 million to support the most disadvantaged students through the 1916 bursary scheme. We have also secured a €50 million fund to support full-time third level students this year.
A range of additional supports have also been provided to reflect the particular circumstances of learners affected by the pandemic. We have doubled the level of funding available under the student assistance fund from €8 million to €16 million. We have increased the level of funding for the 1916 bursary bund to €5 million per annum, which will provide an additional 200 bursaries and bring the total for 2021 to 1,000 bursaries for the most disadvantaged students in the country. As I outlined, we have secured an additional €20 million for SUSI, allocated €6 million to enhance SUSI supports for postgraduate students and provided a €50 million third-level support fund. We have also introduced a €15 million scheme to assist students in purchasing laptops. Finally, we have put in place a €3 million well-being and mental health fund.
Many students undertake placements as part of the process of attaining their qualification. They include a wide range of health professionals undertaking placements in the HSE and the wider health service. Bursaries, stipends, payments and other forms of remuneration are entirely a matter for the health service rather than the course provider or my Department. I very much appreciate the points raised by the Deputies regarding the situation of student nurses. I have set out the relevant supports available to students, including student nurses, within the remit of my Department. I have no doubt that the Deputies may wish to pursue the matter further with the Department of Health.
I thank the Minister of State for his response. I appreciate and welcome all the supports that are available to the wider student body. However, we need a targeted bursary for student nurses, who have additional incidental costs that would not ordinarily apply to other students. It is not a case of one or the other. The supports that are in place are, of course, welcome and necessary, but we should always be open to adjusting or increasing them. This is one such instance in which we must accept and embrace the fact that student nurses in first, second and third year have additional costs and that existing supports do not cover them. These students will become the medical professionals we need in the future. While they are attaining their clinical experience and expertise as part of their studies, we cannot expect them, on €50 per week, to meet the travel and associated expenses arising out of the requirements of their placement.
The Minister of State suggested that we might bring this matter to the attention of the Department of Health but I ask him to explore, on an interdepartmental basis with the Department of Health, the introduction of a bursary in the interests of all the student nurses nationwide in their first, second and third year of training.
I appreciate that the Minister of State is coming at this issue from a higher education point of view. I acknowledge his indication that there is the possibility of taking it up with the HSE, the Department of Health and the relevant line Minister. The fact of the matter is that nurses are productive from the minute they go onto a ward or into an acute hospital setting. That is the point we are making. Student nurses are taking up the slack due to the lack of capacity at this time. There is a precedent in the fact that, at the start of the pandemic in March, a payment was made to student nurses akin to the healthcare assistant payment. I call on the Government to revisit that payment scheme. It could go a long way towards staving off the possibility that some of these student nurses will be lost from the system. If people get good pay and conditions at an early stage in their career, the chances are better that they can be retained within the service instead of being lost to Australia, Dubai or the UK.
We must be more lateral in our thinking in respect of the day-to-day supports that nurses should have because we need to retain them.
I thank both Deputies. I recognise the validity of the case and the argument they are making. There is absolute merit it what they are saying. This is an issue I will flag to the Minister for Health, Deputy Stephen Donnelly, his Department and the HSE. I am also cognisant of the point relating to the IMO has stated on the record in respect of this matter.
I note the point made by Deputy MacSharry regarding a targeted bursary for student nurses. I will certainly communicate with the Minister in that regard also.
There is an opportunity for the stakeholders and all who have an interest in this issue to raise and pursue it through the upcoming social partnership talks relating to the next round of the national wage agreement. That negotiating process is possibly a forum by means of which matters could be fleshed out further.
I want to flag that when a student in a third level institution makes an application to the student assistance fund, which is there to assist students who are in need, final decisions on awards from the fund are decided by a small group appointed by each higher education institution, the membership of which may include the registrar of the particular college, the access officer, the student welfare officer, the students union representative, the head of student services, the head of lifelong and flexible learning or the finance officer. The student assistance fund is available to help with a range of costs, including those relating to books and class materials, rent and other utilities, food, essential travel, childcare, medical issues and connectivity. That gives the Deputies a flavour of the criteria of the fund, the allocation for which amounts to €16 million. Obviously, many of the criteria meet the demands and needs which were articulated by the two Deputies.