Gabhaim buíochas leis an gCeann Comhairle. At 8 o’clock this morning Joanna Sloan, a young nurse in Belfast, was the first person in Ireland to receive a vaccine for Covid-19. A little earlier a 90-year-old Fermanagh woman, Margaret Keenan, was the first person in Britain to receive the jab. We now await the vaccine roll-out plan for this part of the island. There is at last light at the end of the tunnel. Hopefully, this marks a turning of the tide in our fight against this virus and the beginning of the end.

Last Wednesday, the Government voted against paying student nurses and midwives. It then justified this decision by saying that they do not get paid because they do not do real work. It has broken its promises. Promises made by the Minister for Health, Deputy Stephen Donnelly, his predecessor, Deputy Simon Harris, Fine Gael and Fianna Fáil amount to nothing.

We are standing here today talking about the student nurses working without pay on the same day that the Government will increase pay for super junior Ministers and judges. These are not normal times. The ask of student nurses is always incredible but it is extraordinary during a pandemic.

I will share with the Taoiseach some of the messages I have been sent by student nurses and midwives in reaction to his decision. Alison writes:

We start our shifts at 7:30 am. By 8, we are rushing around carrying out observations, helping patients with toileting and washes. This will bring us up to 10:30/11. Twelve o'clock comes and we do medications, blood sugars, feeds and toileting. After lunch we try and get some documentation done, call doctors, check blood results and other tasks. Teatime comes and we are back assisting with feeds, toileting and medication.

It is outrageous that the Government is saying that they don't do real work.

Rebecca says that she lives at home, unable to afford student housing and she comes home every night from work fearful that she has contracted the virus and could pass it to her immunocompromised dad.

Ella says that every student who was on placement was forced to give up their part-time work, the work that pays their bills. She is immunocompromised and felt in danger. She was on the ward with the highest number of Covid-19 patients in the hospital and she had to isolate.

Marie writes:

In third year, I dealt with a patient who had a major haemorrhage. The patient went into cardiac arrest. I ran for the crash cart, I alerted the nurses station to call the cardiac team, and I did chest compressions to try and keep that patient alive. The patient died. I drove home in silence and couldn't talk to my mother.

Sinead, a student midwife, says:

I have sat with women who are crying because their baby has been feeding all night. We are the ones who hold their hands and tell them everything will be ok. We are the ones who cry with them.

Roisin says:

Our college years are spent working thirteen hour shifts in understaffed hospitals where you are counted as a member of staff. This year is more exceptional. Students now can't work a paid job due to [fear of cross-contamination]. This creates enormous strain when it comes to paying rent, fees, transport and possibly supporting [a family].

These statements illustrate the real work, real lives and real struggles of student nurses and midwives. The Taoiseach should please tell them they will be paid, and paid properly.

Twenty years ago, we moved from an apprenticeship model of nurse education to a degree model. It was a fundamental shift and transformation in nurse education, sought by the nursing profession, particularly the nurses' unions. I introduced it myself as Minister for Health and Children. It was important in giving a higher degree of respect to the nursing profession within the overall health service hierarchy. This debate has been very much politicised and characterised by short-termism. It has been designed to put one group of politicians into one corner and another group in another via a simplistic motion that seeks to resolve the issue of public service pay and the critical issue of how best to educate medical and nursing students right across the health area. Essentially, what the Deputy is saying is that we should return to the apprenticeship model, which I do not think is a good idea. No student nurse should be exploited. First-year students are not meant to be treating Covid patients, and they are not meant to be treating patients, full stop. Their education in clinical placements should be protected. If it is not protected, it is unacceptable. As far as I am concerned, no exploitation of student nurses should or will be accepted by the Government.

At the heart of this is the question of whether we now want to protect the learning experience of nurses on the degree programme or allow ourselves to drift back to yesteryear, to 20 odd years ago and preceding decades, to the apprenticeship model, which was not ideal at all for student nurses at that particular time and which led to repeated calls for modernisation. We were asked to bring nurse education into the 21st century. I have spoken to the heads of nursing in some of the colleges, and I have spoken to the Chief Nursing Officer. This is an important point. I have absolutely no issue with reviewing, at a macro level, the question of whether we want to retain or evaluate the nursing degree programme in terms of protecting learning for students into the future. I am up for that. I believe we should do so because it is 18 years since the programme was created. In the interim, fourth-year nursing students get paid for the 36 weeks of their internship. First, second and third-year students do not; they get allowances and so on. The Minister has indicated that there is a review whose authors will report by the end of December 2020, which will deal with an increase in allowances for first, second and third-year students. The fourth-year student wage, which is up to €21,000 or €22,000 per annum, is also up for review. This is an immediate review with an independent chairperson who will verify the findings. Negotiations with the INMO have been ongoing, even prior to last week's vote. Prior to that vote, as the Deputy knows, the Government took a decision that the pandemic unemployment payment would be available to student nurses who could not do the part-time work in which they would have been engaged because of Covid-19 and the fear of cross-contamination and so on.

The payment is now available, as agreed between the Minister for Health, Deputy Stephen Donnelly, and the Minister for Social Protection, Deputy Humphreys. That was decided at last week's Cabinet meeting and is available to student nurses.

One nurse educator, the head of a particular college, said to me that this is critical from our perspective. Everything we fought for over the past 20 years is now at risk if we go back to thinking it is okay for nurse students to do every type of job in the hospital when they are meant to be learning. We have advanced nurse education in this country and brought it into the 21st century. That is the case not only at undergraduate level, but also at postgraduate level. That is important in terms of the professionalisation of women in the health service and the professionalisation of nursing. Nursing is no longer a poor relation to other professions within the health arena. That is ultimately at the core of this debate, if we want to go down a particular road.

Nobody is suggesting that we should drift backwards; far from it. We are absolutely insisting that students nurses and midwives must be acknowledged and paid for the critical tasks they carry out. We are insisting in this year and in these times above all other times, as we face into a pandemic, that we recognise and reward the real work of student nurses and midwives. Those students are among those who have kept our under-resourced and understaffed hospital system afloat. Those are the facts.

It is ironic of the Taoiseach to advance as a reason for not paying student nurses and midwives an argument about the professionalisation of nursing. Professionalisation of nursing cannot result in the pauperisation of student nurses and midwives. I have read their testimonies to the Taoiseach. Those are real, lived experiences and cannot simply be ignored, particularly this year, when the Minister for Health and his predecessor, Deputy Simon Harris, made concrete promises that student nurses and midwives would be recognised, rewarded and paid. That needs to happen.

The Deputy and everyone else knows that there have been ongoing discussions about this issue between the INMO and the Minister over the past number of weeks. Those discussions are continuing and will result in a review before the end of December on the allowances applying to student nurses.

I am trying to say to the Deputy that the days are over for saying it is all right for student nurses to be given the menial tasks, or whatever tasks, while they are supposed to be learning and going through an educational programme. An expensive infrastructure has been put in place in hospitals across the length and breadth of the country to protect the learning environment. We need to face up to that. It needs to be protected and it is wrong to exploit it. Any nurse who works and is asked to do certain tasks on particular rosters should be paid, but they should not be asked to do it in the first instance. That is the point. Why do we have preceptors, clinical nurse placement officers and second level clinical nurse managers, CNM2? Those management positions were created specifically to look after the degree programme in clinical placement. That is what I mean by the professionalisation of health education, to move away from where it was.

Nurse education and nursing have advanced a lot. I say again that there should be no exploitation of any student nurse in any hospital setting. It will not be accepted and that has been made clear to the HSE and to all and sundry. That is an important point that the Deputy is ignoring. She is playing politics and that is fine. I understand what she was at last week by tabling a motion, putting up the dashboard, going on social media and saying that the Government does not want to pay these students but Sinn Féin does. That is overly simplistic and the Deputy knows it. Public service pay and issues relating to education programmes of this kind were never dealt with via one simplistic motion in Dáil Éireann. The Deputy knows that as well as anybody else and it is time now to be honest about it too, in terms of how it is presented as a story.

Today is a truly historic day. Joanna Sloan, 28, from Belfast, a nurse working in her field, and Margaret Keenan, 90, originally from County Fermanagh and now in Coventry, received the first doses of the Covid-19 vaccine. They are obviously not the first people to receive it, but they are the first to receive it post trial. It is an historic day because science has delivered.

Science works. We now have vaccines. The scientists have done their work and have delivered. Now we, as public representatives, need to support the scientists who have delivered these vaccines. We must be very pro-vaccine.

Historically, I and my party have been very pro-vaccine, as the Taoiseach knows. We pushed in the last Dáil for the human papillomavirus, HPV, vaccine to be given to boys. I am delighted that has commenced. We fought in relation to other vaccines as well. I attended the global vaccination conference last year in Brussels. The deputy chief medical officer, CMO, was there as well.

I am concerned about utterances by some public representatives in the past and about the impact it is having on our citizens. I am concerned that many citizens are being fed lies and deliberate misinformation about vaccines at a critical time. I ask the Taoiseach publicly to deal with it. We all have a role here. Today, the Labour Party has written to all Deputies, Senators and MEPs, that is, to every national public representative, and has asked them whether they will sign up to and promote the vaccine and promote the public awareness behind the vaccine and its full roll-out. We hope it will be 100%. I ask the Taoiseach to lead and I ask everyone else to sign it and return it within a week. We need a public awareness campaign now, ahead of the vaccine roll-out, which hopefully will be early in the new year.

I ask the Taoiseach to consider one other factor. Much of the misinformation is spread on social media platforms. In this city, we have Twitter, Facebook, TikTok, Google and Instagram. We need to talk to them and deal with misinformation that is deliberately put out on those platforms. They all changed their algorithms and their rules in respect of the recent US election. They need to do so again with regard to the roll-out of this vaccine. It is important for people's lives. We in Ireland can lead on that if the Taoiseach uses his role to talk to these social media companies, which are now so powerful in relation to how messaging gets out. Will the Taoiseach consider that?

I thank the Deputy for raising the issue of the vaccine. It is a historic day and a vindication of science as the ultimate route to follow in dealing with this terrible virus that has wreaked such havoc across the world in terms of lives lost, of people becoming ill with long-term consequences and of economic and social upheaval. It has changed our way of living. I applaud the Deputy's initiative and I would have no difficulty in signing such a petition. We need to be strong and positive in support of vaccination to eliminate a virus which has caused devastation, ill health and death across the world.

The objective of vaccination, historically, has been to eliminate such diseases and viruses. The history of vaccination was an extraordinary one in the 20th century, in terms of healthcare and health outcomes. This is often forgotten as time moves on and that which was horrendous in one era becomes commonplace and of no consequence in the next era because of vaccines and medicines more generally. We need to make sure fake news does not get prevalence and does not get promoted on the digital platforms the Deputy referred to. That is a fair point.

I can recall all of the issues around the MMR vaccine when I was Minister for Health and Children and the huge damage that was done at the time. We had to put up with a measles outbreak for two or three years and children became very ill and, in some cases, lost their lives as a result of that campaign.

We await the outcome of the European Medicines Agency in respect of the Pfizer-BioNTech vaccine and then the Moderna vaccine on 11 January. The Government has announced today the provisional vaccine allocation strategy and the groups that will receive the vaccines in sequence, particularly the aged, those in our nursing homes and our healthcare workers as key priority groups. That is particularly important.

I will receive the blueprint from the task force on Friday. That will be the culmination of a lot of work undertaken by various work streams involving a lot of bodies. To be fair regarding the vaccine allocation strategy, the national immunisation committee, which has been responsible for many immunisation programmes, made a provisional recommendation, which NPHET has endorsed, in terms of the sequencing. All I will say is that individual Deputies may have issues around that and may have their own queries but fundamentally, we should allow the public health experts and science inform that as well. I think that if we allowed a situation where Deputies and Senators were going to decide who got what in sequence, we would be here for quite a long time in itself.

I take the Deputy's proposal on board as one that is designed to try to increase participation rates in terms of the vaccines to make sure that we get herd immunity and can eliminate this virus once and for all.

I thank the Taoiseach for his positive response. I ask that every Deputy, Senator and MEP do the same. I would appreciate it if the Taoiseach or another member of the Government spoke to those social media companies. It would be helpful in Ireland and further afield.

I have a query about next Friday and the task force, which has a set amount of work to do. What database will we use to gather the information? Since I have a background in this area, I think about this matter a great deal. This country's unique identification code is the personal public service, PPS, number. How will we gather all of the information relating to people's health, where will it be stored and do we need emergency legislation on this matter before Christmas? The House addressed many issues with the public services card, as the Ceann Comhairle remembers. I agreed with some of those issues but not others. The information on individuals to be stored in this situation will be deep and personal and will relate to their health. Do we need legislation? I presume the Government has been in touch with the Data Protection Commission in advance of this issue. What has it advised?

First, I think we should point out that about 2 million people receive the flu vaccine. We are not strangers to national immunisation programmes, although this will be of a far greater scale than we have had so far. There has been a very significant roll-out of the flu vaccination programme in itself. That worked very well, notwithstanding all of the complaints and criticisms.

Clearly, one of the task force's work streams is around an IT infrastructure to capture the data on those who have been vaccinated but also in terms of monitoring the vaccine's effectiveness, monitoring the uptake of the vaccination and supporting post-vaccination evaluation.

The common good has to prevail. This is a public health initiative designed to help the entire population in terms of the elimination of this virus, which has been so devastating for so many. Legal advice is ongoing in relation to whether legislation is required or not on a number of fronts but it is our view that as things stand at present, we are in a position to move ahead. Suffice it to say, the IT infrastructure is a key part of this situation, as are quite a number of other work streams.