Alice-Mary Higgins (Independent) | Oireachtas source

I welcome the Minister of State to the House.

I will begin by commending the more than 200 graduate entry medical students who wrote to the Minister in October to highlight the extremely urgent issues and problems with the current fee model for graduate medical studies in this State. In their letter they highlighted that: "GEM students are not eligible for SUSI (or any other similar student financial support schemes), and since 2022 have had no access to any private medicine-specic loan services." This is following the end of the Bank of Ireland loan which previously filled that role. The yearly cost of tuition for these students can range "between €14,580 and €17,760 (with no option of payment deferral)" in terms of tuition fees. These costs do not include transport, equipment costs and, fundamentally, do not include the exorbitant cost of accommodation. These students have highlighted that entire sections of society are therefore precluded or effectively blocked "from obtaining a medical education – regardless of their drive, passion or academic achievements," or any desire they have to contribute in that area.

The issue of "pricing people out" from education is one of fundamental importance. It is education of a fundamental public good. Fees that diminish equal access to that are, indeed, a public bad and something we need to address. Crucially, in terms of medical education only being provided, we know that general education medical students may use the 1916 bursary, which the Minister of State may speak to in his response, but the maximum amount of bursary payable is €5,000 per year, which does not even cover 50% of the fees.

The Minister has previously referenced the availing of the student assistance fund. Again, that fund is not a systemic answer to ensuring access to a whole strand of medical education. The fund is something that was meant to be there on a needs basis and decided case by case. The level of funding available to students is not sufficient to live on. Also, the level of work required for a GEM course means that students do not really have the time or capacity to engage in sufficient paid employment to earn a living thus meaning they can pay for their tuition.

Exorbitant fees and "pricing out" taken together is completely unacceptable and, indeed, foolish at a time when the Department of Health's national task force has identified the need for an additional 2,000 hospital consultants and 1,000 junior doctor posts by the end of the decade, and that the working experience of junior doctors needs to be improved. We need to ensure that we retain doctors and have a pipeline that means medical education is accessible. It is also important to have a medical profession that reflects wider society because not only is education a public good but health is a public good.Having doctors who reflect wider society is part of ensuring that we have health systems that genuinely work for all communities. We saw how important that was during the pandemic.

It is important and interesting to note that one of the most impactful persons ever to enter the medical profession in Ireland, Dr. Noël Browne himself, was only able to do so because he received a scholarship for his medical education. His lived experience in respect of the destructive effect of tuberculous on Irish families and poor communities across Ireland was hugely important in inspiring him to take the actions to become the person who eradicated it. This is just an example of why we need diversity in our education system and in medicine.

I would like to know what steps are being taken to ensure equitable access in medicine.