Mick Barry (Cork North Central, Solidarity)
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I do not need to wax lyrical about the role of migrant nurses in our health service, and I do not need to wax lyrical about the role of migrant workers more generally in our health service. We all know their role is critical and that, without their contribution, some say the service would collapse within a matter of days. I suspect it would actually collapse within a matter of hours. Irish society owes these workers a real debt of gratitude, and like all workers, they deserve to be treated with courtesy and respect.

According to reports in the Irish Independenttoday, migrant nurses may have been treated with anything but courtesy and respect at one of our largest hospitals, namely, Cork University Hospital, CUH. One nurse with more than a decade's experience in nursing claimed that a manager said to a group of nurses there:

You only move here to steal our benefits; you get pregnant as soon as you land, have three or four babies and take everything from us; you smell, don’t wash your hands after using the toilet and spread Covid in our country; you kill Irish patients.

Another nurse from Pakistan told the newspaper:

The very first day of adaptation, when we were expecting welcoming words from the coordinator, a senior member of management entered the room and started saying horrible things [...] No welcome, absolutely no respect. There was a lot of racism. This person was always screaming and shouting at us. It was such a stressful environment to work in.

That one nurse would make such an allegation would be a matter of concern to me. That two nurses would make such allegations would only heighten my concerns. However, that 29 nurses signed a petition addressed to the Irish Nurses and Midwives Organisation outlining what the Irish Independentdescribed as similar allegations should lead to alarm bells ringing here.

I understand that there are cases before the Workplace Relations Commission, with the complainants supported, by the way, by both Migrant Nurses Ireland and the Irish Nurses and Midwives Organisation. However, I am going to move on from the particular to the general. A representative of Migrant Nurses Ireland told the newspaper:

Our concern is that this is not an isolated case in the Irish healthcare system. The most concerning aspect is that, despite previous complaints, the same manager continued the excessive hate speech and racist attitude by abusing their position of authority.

I am concerned that a worker facing abuse of this kind is automatically placed in a very vulnerable position by the State's visa policy. Most migrant nurses move to Ireland through the atypical working scheme. A visa only allows a person to live legally in this country for a period of six months. After this, a nurse receives a personal identification number, PIN, which they take to immigration to secure a work permit that lasts for a year. How vulnerable does this make a worker who has been trained by a manager who might be racist, and who in effect has the power not only to fail them but to force them to go home? How vulnerable does this make other such workers who witnessed such treatment and who tremble at the idea of speaking out for fear that they will be forced to go home? Does the Minister of State accept that this is potentially an extremely important case at CUH, and does he also accept that the State's visa policy may well be a contributory factor in this whole sorry situation?

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I thank the Deputy for raising this matter. Before I hand over to the Minister of State, I want to say that it has been my direct experience, and that of my family, to have a lot of contact with migrant nurses and care workers. What has distinguished them has been their utter professionalism, their deep sense of care and integrity, and their fundamental kindness that has made them outstanding in their field.

Joe O'Brien (Dublin Fingal, Green Party)
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I thank the Ceann Comhairle. I agree with that and with Deputy Barry's sentiments on how crucial migrant nurses are not only to our hospital system but also to our care system, more broadly speaking. Before I read my answer, which is important, I want to say I heard the media report this morning and it stopped me in my tracks. The small clip I heard was shocking, and I have since read the article. It is important that I read in this formal answer, and I genuinely thank Deputy Barry for raising the issue today.

The HSE CEO and the Minister for Health have both been very clear that no employee of the public health service should ever have to endure racism while carrying out their duties. It is intolerable and completely unacceptable. Everybody is welcome in the health service in Ireland, regardless of race, creed or ethnicity. More than two in every five doctors and nurses employed in the HSE were not trained in Ireland. Without these employees, essential healthcare could not be provided to our most vulnerable citizens, and Government wishes to thank them for all they do for patients and their families.

The HSE is committed to fostering an organisational culture where every employee is valued and celebrated, where employees are treated with dignity and respect, and where discrimination in any form is not tolerated. The HSE has a diversity, equality and inclusion policy in place which reflects the protections provided to its employees on the grounds of ethnicity, race and culture in line with equality legislation. The HSE is committed by that legislation to taking proactive steps to eliminate the potential for discrimination from its day-to-day operations, and training is mandatory for staff in respect of this policy.

Racist behaviour in the workplace is illegal under the Employment Equality Acts 1998 to 2015, and is explicitly proscribed by the HSE’s dignity at work policy. That policy puts an onus on health service employees and managers to create an environment in which staff are treated with dignity and respect. The policy also sets out informal and formal procedures to deal with complaints. Health service managers have a key role in communicating the policy to all staff, ensuring they understand its contents. A number of national training programmes are available to support the policy, and racist behaviour is specifically addressed in the HSE’s three e-learning modules on diversity, equality and inclusion at work, which are available to all staff online.

The HSE is working with partners such as the Nursing and Midwifery Board of Ireland to strengthen supports for staff coming from outside Ireland to ensure a soft landing, an effective orientation and induction, and to enhance local supports available to staff, particularly in the first weeks of their employment in the HSE.

With regard to the article that the Deputy is referencing, Cork University Hospital has confirmed to the Department of Health that an independent external investigation is under way into a series of allegations. I understand that HSE management at Cork University Hospital are treating the allegations very seriously. In these circumstances, it would be inappropriate to comment any further on the details of this investigation while it is ongoing.

I would like to finish my first contribution by thanking the nurses for coming forward with their story. I ask any worker in any sector of the economy who faces situations like this, where their position is exploited and where they are victims of very clear racial abuse, to please come forward and report it, and look at the procedures that are within their organisation as well. I fear this is not the only situation where occurrences like this are happening. Well done to the nurses for coming forward and telling their story.

Mick Barry (Cork North Central, Solidarity)
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I, too, fear this is not an isolated case. I have to wonder, if allegations such as this can be brought forward by more than a score of nurses in a public sector workplace, which is a unionised workplace, what is going on in some private sector workplaces with vulnerable workers who do not have trade union protection and who are in fact employed in places that are not just non-union but anti-union.

With regard to some of the wider questions that are raised by this case, Migrant Nurses Ireland stated, "We strongly seek the implementation of mandatory training in the areas of equality, diversity and inclusion." That is mandatory training. It also stated: "We’re bringing people from other parts of the world to support the health system – but we do nothing to support them in return."

I point out that the Minister of State did not address one of the questions I asked him. Does he not think that the State's visa policy creates a situation where there is a huge power imbalance between, say, a manager on one hand and a vulnerable worker on the other and that where such a massive power imbalance exists, these types of situations are more likely to occur?

I will conclude on this. I know it is not the exact same case and the Minister of State will not have prepared a response, but I would like if he could come back to me in writing in the next few days with an answer on the 1,000 Indian nurses who were brought to this State to work as healthcare assistants at the start of the year and whose exploitation has been highlighted in the media. Both the Department of Enterprise, Trade and Employment and Department of Justice were working over the summer on various changes to the rules and regulations and visa systems which might be of benefit to these workers. Have we any update on the deliberations of those two Departments?

Joe O'Brien (Dublin Fingal, Green Party)
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I do not have the specifics on that. I will bring it back to the Minister to follow up on that as well. I indicated in my initial contribution that mandatory training was part of what was required in the HSE. I have an additional interest here. I am responsible for the national action plan against racism, so I will be delving into that a little bit further to see how thorough that is and to see who is captured by that mandatory training because it is not always everyone who does it. One of the weaknesses of the training that is provided or at least offered across different Government Departments, and I have been asking about this as well, is that generally it tends to be optional. What we find is that the people who are most interested in doing the job right and are more open-----

Mick Barry (Cork North Central, Solidarity)
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Are they mandatory?

Joe O'Brien (Dublin Fingal, Green Party)
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-----to diversity are the ones who go to it. Therefore, when it is not mandatory, it is a problem. When it is stated as mandatory, I would like to see how comprehensive that is. I am committing to the Deputy that I will find out more about that. Of course, training does not solve it either. Racism is deeper than that for many people. We have much work to do in that regard.

With regard to the Deputy's question about the employment permit system, I worked with many people on a one-to-one casework basis who, in one way or another, came here through the permit system. Certainly, the employer-employee relationship is an imbalanced one in terms of where the power lies. It is fair to say the permit system exacerbates that to some extent as well, which is why we need to pay particular regard to the vulnerabilities of people who are here on temporary permissions that have to be renewed on a regular basis and who are in these situations where they can be subjected to these kinds of prejudices. It does require additional care and additional cognisance of what people need in terms of protections when they are coming here from another country.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I would not have thought that professionals in the caring sector would need mandatory training in what is effectively common human decency-----

Joe O'Brien (Dublin Fingal, Green Party)
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Yes.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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-----and heaven help us all if that is the juncture at which we have arrived. One can only wonder how such people, if they were to treat their professional colleagues in a racist fashion, might treat their vulnerable patients.