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Explainer: What is the current situation with unpaid student nurse placements?

The government last week voted against a motion to pay student nurses on placement.

STUDENT NURSES HAVE been in the headlines recently after the government voted against a motion to pay them for clinical placement during the pandemic. 

The motion was rejected by the three parties in government, which was described as “cold-hearted” and a ‘betrayal that won’t be forgotten’ by People Before Profit TD Richard Boyd Barrett.

The Irish Nurses and Midwives Organisation (INMO) is currently in talks with the government in relation to student nurses’ pay.

Speaking in the Dáil yesterday afternoon, the Taoiseach Micheál Martin said there should be “no exploitation of any student nurse in any hospital setting”. 

Let’s take a look back at the details of student nurse payments and what exactly student nurses do while on clinical placement during their degree.

Are student nurses ever paid?

During their time in college, student nurses are required to work unpaid to get the necessary number of ‘working hours’ needed to become fully qualified.

From fourth year onwards, these nurses receive some payment but a large chunk of their clinical placements are unpaid during the rest of their degree. 

Clinical placement takes place in healthcare or related settings such as hospitals.

The placements usually last for 12 weeks in the first three years and take place at different times of the year depending on the college and setting.

The INMO said in March that students nurses and midwives completing unpaid work placements during the pandemic should be paid and protected as employees. 

On 26 March, it was confirmed by then-Health Minister Simon Harris that student nurses and midwives completing placements during the pandemic would be paid. 

Harris said all student nurses and midwives would be offered contracts as a healthcare assistants (HCAs) and be paid accordingly. 

This scheme is no longer in operation. It ceased in August, leading to the Opposition motion that was rejected by Fine Gael, Fianna Fáil and the Green Party.

Here’s what happened with various groups over the past nine months: 

First, second and third year 

The placements during these years in college are usually unpaid. However, this changed during the pandemic. 

After union negotiations, students in these years on clinical placements were offered temporary contracts and paid on a HCA salary between April and August.

Anyone who completed a placement during this time on these contracts was paid on the scale which starts at €13.82 per hour. 

These temporary HCA contracts for first, second and third year students were extended until 31 August. This measure ended at that point and has not since been reinstated so people on placement since then have been unpaid. 

Fourth year 

In the fourth and final year of their degree, nursing students undertake a 36-week roster of continuous placement and are paid as health service employees.

This internship has traditionally been paid but the payment was reduced during the recession.

Again, the pandemic changed the situation with this payment. The government said fourth-year students on their continuous placement should also be paid on the HCA scale.

This was originally due to be for a three-month period from April to July but was later extended to the end of the students’ internship. 

As of 1 October this year, the salary for a student nurse on 36 weeks placement stood at €15,056, according to the INMO. This works out at almost €11 per hour. 

Allowances

First to third year students doing nursing or midwifery are entitled to an accommodation allowance of up to €50.79 per week for the duration of their placement.

This is only paid in the instance where it’s necessary for the student to live away from their normal place of residence during the placement.

A review of the student nurses’ allowance is under way and a report will be available in September 2021, Tánaiste Leo Varadkar has said.

What happened last week? 

Last week, the government voted against a motion to pay student nurses.

The Solidarity-People Before Profit (PBP) motion put forward by TD Mick Barry was defeated by 77 votes to 72.

Fianna Fáil, Fine Gael and the Green Party all voted against the motion, while opposition parties and groups supported it.

The motion called for the immediate reinstatement of the payment at HCA rate for student nurses and midwives who either were or are on placement during the Covid-19 pandemic, among other measures.

These include: 

  • Setting up a bursary or payment system to cover costs of travel and accommodation for the length of placements. 
  • Abolish college education fees of €3,000+ per year for students “training to work on the frontline of the health service”
  • Ensure parity of pay for nurses and midwives with all other paramedical graduates

A similar motion was defeated in a vote earlier this year.

The Taoiseach yesterday described this motion as “simplistic” and designed to be put on social media. 

“I understand what you were at last week, in terms of putting up a motion, put up the dashboard, go on social media and say ‘they don’t want to pay we want to pay’, that’s overly simplistic and you know it,” he said to Sinn Féin leader Mary Lou McDonald in the Dáil.

The government put down a counter motion outlining the current provisions in place regarding the €50.79 weekly accommodation allowance for some on placement among other measures.

Green Party TD Marc Ó Cathasaigh said on Twitter: “Everyone wants to do their best by student nurses, myself included, but this motion wasn’t the way to do it.”

What is the job of a student nurse? 

Student nurses complete their placements in a variety of different clinical settings. 

A second-year student nurse, Chloe Slevin, wrote a piece for TheJournal.ie last weekend saying: 

We are not just students, we are fully integrated into our placements and despite being a student, every patient I have ever met has called me “nurse”. I am sure you can imagine how strange that was to hear at 18, and it is still weird to me now. To my patients, I am more than just a student.

Last month, Richard Boyd Barrett spoke in the Dáil about student nurses who had reached out to him.

“One second year nurse worked six weeks on placement. She worked four days a week in the Rotunda Hospital from 7.30am to 4pm,” he said. 

“She also had a job in retail at the weekend where she was being paid absolutely nothing. She worked two weeks in a gynaecology ward from 7.30am to 8.30pm and was not paid a penny.”

It is understood that student nurses in their fourth year 36-week placement are often included in staff rosters. This occasionally happens in other years of placement too. 

The INMO said earlier this year: “The purpose of a placement is to train the student, not provide extra resources to the health service.”

The union added that if the health service cannot provide proper training during the Covid-19 crisis, “then they need to change the status of students on placement”. 

The Taoiseach made reference to the status of students too, saying that nursing education has been designed so the nursing students receive a degree. 

He argued that it would be a backward step for it to return to an apprenticeship scenario where nurses would be in effect working in hospitals. 

“At the heart of this, it seems to me now is, do we want to protect the learning experience of nurses on the degree programme or not,” he said

I introduced it myself as Minister for Health and it was important in terms of giving a higher degree of respect in terms of the nursing profession within the overall hierarchy health itself.

“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,” he added.

What has the INMO said recently? 

The INMO is in talks with the government on the issue of student nurses not being paid while on placement.

In a statement this week, the union said: “The INMO and our student members are engaged in intensive discussion with government on the issues for student nurses and midwives. We will issue a further statement in the coming days once the next steps have been agreed with our members.” 

- With reporting by Rónán Duffy

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    Mute Ashley Rowland
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    Dec 9th 2020, 12:15 AM

    Student Nurses are just amazing. Working in a hospital is as tough a career as you can get and to think young people choose to work in them for free during a pandemic is just unreal. I hope every one of them graduates and move abroad to work in a career in the sun paying over 100k plus a year because they will deserve every single penny of it.

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    Mute Sarah-J. Mc Hugh
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    Dec 9th 2020, 12:23 AM

    This happens in other healthcare settings for example, social care. CORU registration creates requirements has these students do 800+ hours which must be unpaid, they have to find different blocks of work themselves within academic deadlines, and even if they work in the sector already, they can’t do work experience with their existing employer. I think the government is scared of the impact outside of nursing, as well as the cost in nursing. Doing free work often requires significant additional travel at cost to students, and clashes with student paying jobs which keeps roofs over their heads. The government needs to review and cost this work across the board and make minimum payment rules so that people don’t suffer.

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    Mute Dean
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    Dec 9th 2020, 8:32 AM

    @Sarah-J. Mc Hugh:
    Yes and the fact that they even have to top-up a certain amount of ‘working hours’ before they can become a worker is the most capitalist thing I’ve heard. It’s worker poverty.

    M. Martin said there should be “no exploitation of any student nurse”, while not paying them. Is that not exploitation

    A wealth limit and a poverty limit could help fix such exploitation, inequality and suffering.

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    Mute James Ward
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    Dec 9th 2020, 9:07 AM

    @Sarah-J. Mc Hugh: everyone needs to stop calling it free work, or unpaid. It’s training – 1st to 3rd years do this as a replacement for sitting in a classroom or a lab, but it is still training. They also get remuneration for transport in first 3 years, and after 1st, they are eligible for HCA/nurse on call instead of working retail.

    It’s a different ecosystem, and while there was exceptional circumstances this year (which the inmo let down the 4th years in terms of sharing protective gear), as a parent of graduates in nursing and others, they are all hard, with no exception to nursing – but it is still college, it is still training.

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    Mute James Ward
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    Dec 9th 2020, 9:21 AM

    @Dean: you are almost there – a means tested poverty limit would help, but for all students.

    And student nurses are students. If you are learning to fly a plane, you have to put in hours in a plane with someone at your cost before you can fly yourself. While nurses, particularly yrs 1 to 3, feel they are flying solo (no matter how matter photos of girls looking shattered they throw out), they are not. Even in 4th year, they get the wheel, but are still extra, monitored and students. The same in teaching, engineering, even civil servants. You want fairness, then remove SUSI and add 250k students to means tested dole. It would cost over €2b that would be taken from other areas, but it would be “fair”

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    Mute C.
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    Dec 9th 2020, 11:24 AM

    @James Ward: Social care workers don’t get any remuneration for transport during their placement, and most social care jobs will throw you straight into doing the full job during the placement for free.

    In other industries, you get paid as you train. What makes healthcare different?

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    Mute Mary Nugent
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    Dec 9th 2020, 2:08 AM

    They should get paid for working covid. Not normal placement. Leo stand up now.

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    Mute Angelika Passet
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    Dec 9th 2020, 5:00 AM

    @Mary Nugent: why not for normal placements. My sister trained as a nurse 50 years ago in Germany and she was payed from the first day. Not the same as a qualified nurse, but who works for free these days?

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    Mute Joe Kennedy
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    Dec 9th 2020, 5:58 AM

    @Angelika Passet: other students doing work experience as part of their training no?

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    Mute Ciaran bolger
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    Dec 9th 2020, 9:49 AM

    @Angelika Passet: because all nurse paid then when it was an apprenticeship. Now it’s a professional degree course which the nurses themselves agitated for!!

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    Mute Ciaran bolger
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    Dec 9th 2020, 9:52 AM

    @Mary Nugent: should student doctors and other healthcare students be paid also?

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    Mute Kieran
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    Dec 9th 2020, 5:33 AM

    Cabinet approves increase in pay for judges and party whips https://jrnl.ie/5292378

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    Mute James Ward
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    Dec 9th 2020, 10:35 AM

    @Kieran: it’s unrelated – all qualified nurses and nearly half a million public servants also received this. If govt don’t do this, they will breach constitution.

    This article is about first to third year university students getting paid to train.

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    Mute Maurice Frazer
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    Dec 9th 2020, 12:45 PM

    @James Ward: wrong, it is pay restoration for many junior public servants, but this is a increase Government Whips and the Judiciary as their pay was not reduced in the last recession.

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    Mute Paul Mc
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    Dec 9th 2020, 2:29 AM

    Leo stand up ha ha ha dont make me laugh!

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    Mute sue
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    Dec 9th 2020, 8:13 AM

    If you don’t want to pay them, then they should be treated as students without any sole responsibility. They should not be working in their own and most definitely shouldn’t work 10 or 12 hour shifts.

    I get that they are looking at placements as kind of practical learning. But if that is what they want, then this should be carried out as such and students should at all times have a fully qualified nurse with them. You can’t have it both ways, claim they are students and not pay them and then make them do the work of a fully qualified nurse.

    And the transport/ accommodation allowance of €50? In which century are these guys living to think that this is enough?

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    Mute DK
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    Dec 9th 2020, 8:51 AM

    @sue: This is it in a nutshell. Either they do the work and get paid for it or they don’t do the work and are there to shadow and learn and in that case shouldn’t get paid. I understand the government’s point in not wanting to pay as this gives the impression of an apprenticeship so work would be expected from the student nurses but no point saying no it’s not an apprenticeship and they shouldnt be doing the work and then have nurses so understaffed that they do have to do normal nursing duties. Can’t have it both ways. Either way it’s an own goal by government. Paying them a wage until the end of this crisis would cost a pittance in the grand scheme of things and after that go back to normal situation.

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    Mute James Ward
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    Dec 9th 2020, 10:41 AM

    @DK: so were all be fine if they didn’t receive pay if it turned out they didn’t do front line work, but instead shadowed film time staff. Because that exactly what it is – instead of lectures for their clinical, the go to hospitals, they learn what the nurses do, and gradually get to do it themselves in 4th year, where they get paid (a small amount). While the reference student claims “but, they call me nurse me” doesn’t actually make you one – it’s college, just in a hospital. This year was exceptional, but we don’t want 1st year student nurses being shafted to ICU responsibility every year because they’re paid.

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    Mute DK
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    Dec 9th 2020, 11:05 AM

    @James Ward: Agree 100% with you. People love outrage though, especially during this pandemic it seems.

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    Mute Dan
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    Dec 9th 2020, 7:48 AM

    50 a week accommodation! Do FFG not live in this country?

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    Mute Hundredth Idiot
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    Dec 9th 2020, 5:04 AM

    I know people love to celebrate nursing, but the real issue here is exploitation in “training” positions across our economy.

    “She also had a job in retail at the weekend where she was being paid absolutely nothing”.

    The answer is: minimum wage, no exemptions.

    I appreciate there will be unintended consequences, but let’s deal with those as they arise.

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    Mute Dean
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    Dec 9th 2020, 7:48 AM

    Searched RTE to find news about student nurses and judges’ wage increase but the last article is from March 2019? Conveniently where Simon Harris says student nurses will be paid:

    https://www.rte.ie/search/query/student%20nurses

    They make it next to impossible to find news about real issues. They need to be defunded and privatised, and taxes only used for essential necessities like shelter, water, and “no explanation” of all workers (not just students) Taoiseach — perhaps a wealth limit and a poverty limit for workers/employers

    22
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    Mute Gavin Tobin
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    Dec 9th 2020, 8:43 AM

    @Dean: Ha find information on the #IrishAirCorps chemical exposure scandal on Indo, RTE or Times

    Raised 21 times in Oireachtas including Leo’s confidence vote…nada, zip, not a dicky bird.

    https://www.youtube.com/channel/UCZaOJiRVFqQRHk8y0mrVSrA

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    Mute Victoria
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    Dec 9th 2020, 9:09 AM

    All the money is probably gone now anyway, back into topping up former taoisigh pensions. The same story in this country as the politicians get richer we get nowhere

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    Mute Dangling Damo
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    Dec 9th 2020, 2:18 PM

    @Victoria: ah victoria in relation to politicians weren’t we get told that if we pay peanuts you get monkeys. It seens we got them anyway despite paying for expensive peanuts but we do reelect them time after time irrespective of the numerous bleeding hearts calling for change and to vote them out. We got what we deserve for being so stu pid.

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    Mute Brendan Deasy
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    Dec 9th 2020, 8:46 AM

    Student nurses have to wait for reports and reviews which will no doubt be never ending.
    The mother and baby home report could take years to be released, most likely it will get buried like anything embarrassing to FFFG, *cough tribunals.
    This got put through rapidly though – when they’re looking after themselves they’re very quick to do it.
    Dáil approves €16,000 top-up payments for ‘super junior’ ministers amid criticism https://jrnl.ie/5158882

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    Mute Charles Shelly
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    Dec 9th 2020, 7:35 AM

    Disgusting

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    Mute adrian j aungier
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    Dec 9th 2020, 8:40 AM

    Unethical,immoral TD’s allow these trainees be exposed to very high risk of being infected as they are young and not work experienced and therefore at very high risk of being infected, yet they see no need to pay them for this risk. How do these vermin of TD’s sleep at night

    22
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    Mute Irish big fellow
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    Dec 9th 2020, 9:24 AM

    This is the contrast scenario. Apprentices are paid a training allowance from €230 to €450 a week while in “off the job training” depending on their apprentice experience in terms of time served. The employer pays the recommended wage to them when “on the job training”.
    Do nurses expect something similar or are they under graduates like most of their colleges in third level.?

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    Mute Larry Roe
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    Dec 9th 2020, 8:28 AM

    do a poll and let the people speak on this situation

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    Mute FlopFlipU
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    Dec 9th 2020, 5:16 AM

    Work out the cost and add it to the tax bill that’s the only answer

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    Mute James Ward
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    Dec 9th 2020, 10:43 AM

    @FlopFlipU: it’s €2b for all students to get minimum wage, regardless of means.

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    Mute Damon16
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    Dec 9th 2020, 9:47 AM

    I’m not sure the situation on the ground is whats being portrayed in the media and by INMO.

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    Mute adrian j aungier
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    Dec 9th 2020, 8:37 AM

    How this unelected Government of complete wasters allow this to happen when men and women put their lives on the line is truly disgusting. Pay them a salary and man up.

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    Mute Tennyson
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    Dec 9th 2020, 11:14 AM

    €11 per hour is less than your average warehouse operative…the level of responsibility I would argue, is a teency bit more for a newly qualified nurse. Anyone think this is just a bit wrong…?

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    Mute Damon16
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    Dec 9th 2020, 12:31 PM

    @Tennyson: 11E an hour refers to a student nurse, not yet qualified. Most graduates in other fields required to do mandatory workplace training as part of a college degree don’t get paid anything (in fact it actually costs money in most instances).

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    Mute Simp Cuckington
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    Dec 9th 2020, 11:07 AM

    Should have learned a trade if they wanted to be paid!!!

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    Mute Tennyson
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    Dec 9th 2020, 11:15 AM

    @Simp Cuckington: a&sehole

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    Mute Dangling Damo
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    Dec 9th 2020, 2:32 PM

    @Simp Cuckington: Trades men do earn a larger hourly rate than most public sector employees and all the table thumping and gushing praise wont fix this anomaly since the state decides remuneration for public sector employees who provide their services in good and bad times

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    Mute Wade Wilson
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    Dec 10th 2020, 7:29 AM

    FFGG have no problem handing out taxpayer money to their friends but will fight tooth and nail to make sure no one else outside their golden circle ever gets anything.

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