Táim ag cur ceiste inniu ar an Tánaiste i dtaobh an phá d'altraí atá ag traenáil agus iad ag obair ar an líne thosaigh sna hotharlanna ar fud an Stáit seo. Is iad seo altraí atá ag cur a saol i mbaol ar ár son - fuair cuid mhór acu an víreas Covid-19 agus d'fhulaing siad agus rinne siad íobairtí móra ar ár son. Is iad seo altraí freisin nach gcreideann an Rialtas gur fiú pá a thabhairt dóibh. Nuair a amharcaimid ar an dóigh a dhéileálann an Rialtas seo le pá d'altraí atá ag traenáil, cífimid nach bhfuil dílseacht ar bith ag an Rialtas dóibh sin atá ag obair ar an líne thosaigh. Throughout this pandemic and long before it, our nurses and midwives have been our heroes and the heroes of our health service. Since the outbreak of the virus they have put their own health and the health of their families at risk. That has not deterred them from serving the Irish people. A number of healthcare workers have tragically lost their lives in doing so. With more than 3,000 health workers having contracted the virus during this period, and with our hospitals and health services put under pressure like never before, student nurses and midwives have stepped up and into the breach. They have served their patients, worked alongside hospital staff and provided excellent care in difficult circumstances. The Irish people are proud of them and of their service. They have been taken for granted by the Government.

Last night, the Government voted against a motion to pay student nurses and midwives for the work they do. Many of these student nurses and midwives are asked to work for no pay. That is not good enough. Nobody other than the Government believes it is good enough. It will not be lost on the public that at the same time that these workers are being asked to go without pay as they work on the front line, Deputies in this House have been offered two pay rises in the last year on top of their very generous salaries. What message does that send out to front-line workers, to our student nurses and midwives and to the Irish people? Student nurses and midwives, like all those on the front line, have kept our health services together. The patients in our hospitals who receive care from our student nurses do not see them as student nurses but rightly see them as the people at the end or side of their beds who are caring for them, helping them to recuperate and providing them with the essential services. Hospital managers, consultants and specialists would not have been able to do their jobs if they had not been supported by these student nurses.

Student nurses and midwives are not being paid and no one can stand over this. The reality is that these student nurses and midwives are being taken advantage of, exploited and taken for granted. They deserve so much more. They do not need claps, slogans or platitudes but they deserve to be paid. We asked them to go to the front line to put their lives and their families’ health at risk, and to step up, so the least that can be done is that they are rewarded with decent and fair pay. The Irish people cannot understand why the Tánaiste and his Government are against pay for student nurses at the time of a pandemic and a time when they have stepped up to serve the Irish people and their patients. The payment of the student nurses is a litmus test for this Government and of this Government’s commitment to fairness for front-line workers. It tells us so much about what this Government stands for and whose side it is on.

My question for the Tánaiste is simple. Will he revisit the issue and change the Government’s decision to ensure that student nurses in their first, second and third years should be paid and that other nurses should be paid fairly?

I thank the Deputy for raising this issue. Throughout the course of 2020 and this pandemic we have seen nurses and midwives doing an extraordinary job in our health service, as indeed have all healthcare workers, including doctors, therapists, cleaners, porters, people working in our laboratories and people working in administration, without whom no front-line worker could do his or her job. It has been an excellent and professional job. It is not fair to say that they have been taken for granted. We have seen a very significant increase in staffing levels across our health service to respond to the pandemic. There have also been two pay rises this year, albeit modest ones, in March and in October. In most cases, workers in the public health service would have received a third pay rise in 2020 in the form of an increment.

There are many students in Ireland. The vast majority of students in Ireland do not get paid, including teaching students. Exceptions are made, for example for gardaí in training and for apprentices. Indeed, nurses are among those exceptions and among the few students who are paid. They are paid for their preregistration year, in recognition of the fact that the work they do then is unsupervised and would have to be done and paid for if they did not do it. As the House will be aware, nursing and midwifery students are required to complete 45 weeks of training in total across years one, two and three and for a semester in year four. This is a supernumerary clinical placement that they do to meet the standards and to complete courses. Supernumerary clinical placement is the optimal clinical learning environment. This places students on the front line in a learning capacity as an addition to the workforce. It is fully supervised for certain periods of the year during each year of training. This ensures that students can safely learn, observe and take part in a wide variety of clinical skills acquisition required for qualification.

The Irish Nurses and Midwives Organisation and students have raised a number of issues around loss of income due to fewer opportunities for part-time work during the pandemic, particularly in nursing homes, together with HR issues in respect of difficulties with rosters, and issues also around overall student well-being, including the increased risk of getting Covid-19 which is a real concern for all of us.

The matter of student pay is also being considered. A review of student allowances is under way and will be completed shortly. It is intended that this outcome, once negotiated with the unions, will take effect from September 2021.

The Tánaiste has again spoken about the extraordinary work being done by our student nurses and indeed by our public health workers across the board and I agree with him. He talks about pay rises but the core of this issue is that student nurses do not get paid for their work. The Tánaiste talks about supervised work as if this is all normal times. This is not normal times. Doctors, consultants and care assistants can see what student nurses are doing. They have stepped up and into the breach and have put themselves and their families at risk. They are on the front line. They are our heroes; the Tánaiste's Government believes they should not be paid for their work. This is something that the Government should not be standing over. The public is angry at this because many people believed that our front-line workers were being paid and rightly so. The penny has dropped and it is now the case that this Government does not value the work that these student nurses are doing in the first number of years.

While the Tánaiste speaks of reviews, what is needed here is a commitment, one that was given by the previous Minister for Health and is now broken by this Government, which was that student nurses will be paid. Can the Tánaiste stand up and defend the position while those who are working in our hospitals as we speak-----

I thank the Deputy.

-----on the front line in Covid-19 wards should not be paid? Will he revisit the issue and do what the Irish people want which is to reward our front-line workers with more than platitudes or rounds of applause?

A Theachta, bheadh sé cabhrach dom dá bhféadfá cloí leis an am, más é do thoil é, mar tá ceannairí eile ag fanacht chun labhartha.

I thank the Deputy. Praise, applause and kind words do not pay any bills or butter any parsnips. I am very aware of that. I am as aware of it as the Deputy is. That is why we have ensured our healthcare workers in Ireland are better paid than is the case in many European countries, such as the United Kingdom and in Northern Ireland where they went on strike not very long ago and where the Deputy’s party is in office. That is why we ensured that all healthcare workers received two pay rises this year, albeit modest ones, one in March and one in October.

This was not the case in other countries. In many cases, there has been a third pay rise, in the form of an increment, for those on a salary scale. Even though most students are not paid in Ireland, we do pay student nurses and midwives in their preregistration year in recognition of the work they do and its value. That is why the matter is currently being considered, as I said in my earlier remarks. A full review of student allowances is under way and it will be completed shortly. There will be discussions with the representatives, and any changes will come into effect in September 2021.