My Department has responsibility for the formulation and development of health policy. The management of health services, including the direct employment of staff and the utilisation of agency staff, is a matter for the individual health agencies. The use of agency nurses is, to a significant degree, related to the unanticipated absence of nursing staff which, of itself, impacts on the continuity of care. While each hospital is required to stay within its employment control ceiling, my Department does not apply ceilings on the use of agency nurses nor are there any plans to do so since such a measure could adversely affect management's flexibility of response in arranging nursing cover for unanticipated absences. There is no bar to any nurse, should he or she wish, working for a nursing agency during off-duty periods. It is up to every nurse to ensure that he or she maintains a high level of service and do not work for excessive periods. Agency nurses must be suitably qualified and registered with An Bord Altranais, and may be employed in any hospital or health agency.