Gino Kenny on non-EEA doctors and student nurse exploitation

Thanks Sean and thanks everybody for their contributions. I just have two sets of questions and the first question is to Susan in relation to non-EE doctors and at the moment they make up 53% of all doctors and more than one third are trained abroad in the health service and obviously they're highly motivated and highly trained but there seems to be kind of a glass ceiling in relation to career paths and getting you know better prospects in the Irish health system. My question to Susan is do you think the change in the legislation which has gone through the Oireachtas at the moment that will be implemented in June 21 will this make a difference to that set of doctors and also obviously in your submission is that there's obviously a major shortage of consultancy places in the consultancy places in the RCL system and we have this cohort of doctors which are highly, as I said, highly educated, highly motivated but they seem to be discriminated against so could you make a comment on that? Yeah, first of all I would make a general comment that it's actually unethical for Ireland to be recruiting in so many doctors from countries who need their own doctors to look after their own population. Well the better system is where doctors move around countries to get enhanced training but come back to their home country in the majority of cases to practice. So the WHO and the WMA would say this is a non-ethical practice anyway that we are actually depriving other systems of much needed health professionals in their own system. But for that group of doctors who come here they don't really want to stay here because they haven't been able to access the training posts. So yes while the recent legislation is helpful in so far as it gives them some access they are merely competing with the same number of doctors now for the same number of training posts. So that move is not going to help our medical manpower shortage in any way at all. It's not going to make one jot of a difference to an additional post. So I think that the non-EEA doctors and the non-EU doctors they have been treated very poorly. They also emigrate quite quickly in the main from Ireland after a number of years because they are treated badly. So to say that they will be an answer to the consultant shortage it would not be a correct interpretation of the situation. If we look at what we could have done apart from all the normal planning based on previous reports but even since COVID in July of this year a number of SPRs who had finished their training and were ready to do consultant posts. We asked the HSE to offer each and every one of them a temporary consultant contract. We were told no they couldn't have a temporary consultant contract. We now have a situation where highly qualified and trained SPRs are working as regis in the system or are doing locum work around the system. It is an absolute disgrace. We just don't value our doctors. We don't value any of our doctors. We don't value the Irish trained doctors or the non-EEA doctors. But our over reliance and we are very appreciative of all the work that these doctors have done and in them coming to prop up our health services. But it is wholly wrong and completely unethical to have such an over reliance of non-EEA doctors in the country. Thanks. Just one more comment here, if you could make it. There was a survey done by the INMO. Actually, I should put that to Phil. Phil, just in relation to student nurses at the moment, they are working as de facto care assistants. Obviously, with that around COVID, they are not allowed to take a second job, which is a huge financial burden. How do you feel about what you have stipulated on earlier on in relation to the exploitation almost of student nurses in the health system at this particular time? The second question is in relation to infection rates around healthcare workers. I think you said in your submission that 50 nurses per week are out of work. Now, if that continues, the Irish health system is in serious trouble if that continues. And what, you know, what provision can be put in place to prevent that happening? Because there is a tip of bite and all that. Thanks Deputy Kenny for your questions. I think in respect to the student nurses, I think we've made our comments earlier on in this proceeding. But it is important to state that we believe strongly that they are being exploited at the moment. There is a shortage of healthcare, in healthcare, in the grades of nursing and midwifery. And the student nurses who are unpaid and are now rostered for the clinical placement part of their training are being used to fill gaps. It's as simple as that. And we believe strongly that payment is the very least. We have not and we do not advocate unpaid work. We do not advocate that anybody who is in our health service in the middle of a pandemic, when every other student in the country is being told, stay at home, stay and join your classes online. And you have student nurses being told, come in here and work in these wards. And we will we will not pay you for that period of time. Not only will we not pay you, but it'll cost you because they have. Remember, these are the same as any other students. They usually have part time jobs to supplement the requirements. And that part time job. Once you hear that it's a nurse, a student nurse working in an acute hospital, they say, no, don't. No, thanks. We don't want you coming in here. And that is a secondary problem that they're now facing. So we do not want nursing to become such that these students have to leave because they simply can't afford to reside in cities where most of the training places are in Dublin and Cork, pay their accommodation, go in and do their clinical placement. 12 hour shifts in many instances, shifts expanding beyond the normal shift pattern. So I can find no other word but exploitation right now. We met the Department of Health last Friday. We set this out to them. We have appealed to the minister. We have appealed to the public to support the student nurses in their campaign to get proper remuneration for what is work. There is no other way to describe it. In respect of the infection rates. Yes, the absence rates, 50 nurses a week are what the HSE figures illustrate. That requires a period of absence of 14 days at a minimum. And we know that many nurses are telling us that the infection, the post COVID infection period is extending in some cases into 16, 17, 18. And unfortunately, longer in some cases. So that is a huge gap in the roster. And what we need to do is we need to make sure that we have proper facilities from an occupational health point of view in place. And I'm not talking about a counselling free helpline or a text message to say, are you okay? Because what's happening is we are allowing health service staff who are in close contact to return to work if they're asymptomatic. We know too much about this virus right now to risk that because that does then create a risk for others who come in contact with that person. When we do not have a routine testing regime to sit at the same time alongside that policy. So we have to test in acute hospitals. We have to make sure we're picking up asymptomatic cases. And we have to make sure there are greater protections for those that work in our acute hospitals from a testing point of view.