Bríd Smith (Dublin South Central, People Before Profit Alliance)
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82. To ask the Minister for Health the reason students in the healthcare sector who are working in public hospitals and on the front line of services during the Covid-19 pandemic are being told they must get the flu vaccination shot and must pay the full cost themselves; if he will arrange for such students to be reimbursed the costs; and if he will make a statement on the matter. [42324/20]

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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We have heard a lot about student nurses and the work they are doing on the front line at the moment. I want to ask specifically why they are being asked to pay for the flu jab. It is perfectly understandable that they would receive the flu jab given that they are front-line workers and working very hard with patients in Covid wards etc. Why, particularly when they are not being paid for the work they do, are they expected to pay for a simple thing like the flu jab? A number of nurses have come to us about this issue. I would like a comprehensive answer from the Minister.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank Deputy Bríd Smith for her question. When I received the question, it alarmed me because it suggested something that should not be happening. As a result, I asked for it be looked into.

The flu vaccine is free for all healthcare workers working in our public and voluntary hospitals and to all healthcare workers delivering front-line services. It is also available free of charge to all students on clinical placement. Students can access it in local occupational health clinics, vaccination clinics staffed by their peers or at their local GP or pharmacy. My Department and the HSE are not aware of a situation where students on clinical placements have been charged to receive the vaccine. If the Deputy is aware of individual cases where this has occurred, I want to tell her categorically that it should not have happened. If she would like to revert to me with any individual cases, I guarantee her that they will be followed up.

This year, given the potential for the winter flu season to coincide with a resurgence of Covid infections, and the importance of minimising hospital attendance, the Government expanded the provision of vaccination without charge to all of those in the HSE defined as being at-risk groups, including healthcare workers. The amount of vaccine made available for this winter is almost double the amount of vaccine administered last winter. Healthcare workers are at an increased risk of getting flu. They also have the potential to spread the flu by virtue of their contact with patients. Likewise, they can prevent the spread of flu by getting the vaccine. It is recommended, therefore, that everyone working in a healthcare setting should get the flu vaccine. This includes medical, nursing and allied health students, including those working in residential disability services.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I thank the Minister for his answer. I will provide him with the information I have. Again, we are hearing, in regard to student nurses, that something should not be happening. It should not be happening that they are not getting paid for work they are doing. It should not be happening that they are working instead of studying. It should not be happening that they are not supervised. It should not be happening that they are working instead of learning. However, all of those things are happening. I totally get that workers who work on the front line need to be protected from the flu, but the problem is that they are being asked to pay for it. I will send the Minister the information on that.

Maybe the problem is that they are not defined as workers when they are working. The Minister's reply referred, at the end, to all students, but it also referred to those working in the health sector. At the very least, we need to recognise that student nurses are actually working and we need an assurance that this will not happen in the future. I ask the Minister to clarify that it will not happen. I will give him the information I have.

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy. The two issues are separate. There is the question of vaccinations and the question of students and the allowances they should be paid. I know the Deputy and others are advocating that they become part of the paid workforce. The colleges are strongly opposed to that and are very worried about it. They believe the comparisons with the apprenticeship model could set the profession back decades. Comparisons have been made in this House with Australia, where they run an apprenticeship model and a graduate degree model. The opportunities available to the degree programme graduates are significantly better than those available to the apprenticeship graduates. A lot of the really exciting and important developments in the nursing and midwifery professions happening right now are because they are degree graduate students, including enhanced nurse practitioner specialist roles and so forth.

Specific to the issue at hand, it is clear policy of the HSE that all students get the vaccination for free. I would be very happy to look into cases of individuals who are coming to the Deputy. As Minister for Health, I very much want to know if any of our students, on their clinical placements, are being charged. I will act on it if that is the case.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I appreciate the Minister's answer but the fact is that it is almost like the Government is blinkered to the fact that we are still in a pandemic. That is ignored and we are told that they should be students and they should be training. In fact, they are students and they are working. It is not that we are demanding that they become part of the workforce. We recognise that they are students but we also recognise that they should be paid for every hour they work. It is work that a normal care worker would do, including emptying bed pans, washing patients, taking their vitals and sometimes administering liquids and fluids to them. It is not that they are not working. When one is not being paid for one's work on the front line, being asked to pay for the flu jab is adding insult to injury and it really needs to stop.

The Minister wants me to draw attention to specifics but a lot of things happen in the HSE that should not happen. I know care workers in the HSE who have basically been witch-hunted for making any criticism of their employment or their employer. It really is not acceptable that it is like the politburo for workers who work within it. Some of these nurses are nervous about giving their names for that very reason. There is a bad culture there and this is only another example of it. The culture we have to stamp out is the exploitation of student nurses.

Stephen Donnelly (Wicklow, Fianna Fail)
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We are talking about a different issue now but I am very happy to talk about it. There are two separate issues. One is whether students are being asked to do inappropriate activities while on their clinical placements. Various testimonies have been read out in the Dáil and various students have given testimony in the media and online. As Minister for Health, I take those allegations deadly seriously. I have initiated a full review of all of the allegations. I am meeting with all of the directors of nursing on these allegations. There cannot be a situation where these students are being treated as workers. It is imperative, as part of their degree education, that they are full-time students. In first, second and third year, they spend the majority of their time on campus. The HSE provides clinical placements where they can link theory and practice. I can tell the Deputy that their educators are strongly opposed to the idea that they would become part of the paid workforce in the HSE. In essence, their argument is that they want to protect them as students and protect their learning, and if we start paying them as workers in a system, they could be treated as such.

As the Deputy will be aware, I am seeking a short review, to be finished by the end of this month, in co-operation with the representative bodies, to look at the allowances for student nurses. We want to see if we can increase the allowances during the Covid period to reflect what is a very difficult time. If such a recommendation is made, then I have committed to the students and I have committed to their representative organisations, in writing, that those increases in allowances would happen from January.