Dáil Éireann debate -
Thursday, 22 Apr 1999

Vol. 503 No. 5

Written Answers. - Nursing Staff.

Brendan Howlin

Question:

38 Mr. Howlin asked the Minister for Health and Children the plans, if any, he has to deal with the serious shortage of nurses in the Dublin area; the specific proposals, if any, he is considering; the progress in terms of negotiations with the nursing organisations; and if he will make a statement on the matter. [10475/99]

Ivor Callely

Question:

88 Mr. Callely asked the Minister for Health and Children if there is a shortage of nurses in the health services; if he will quantify the identified shortages; the measures, if any, being taken to address this; and if he will make a statement on the matter. [10608/99]

Minister for Health and Children (Mr. Cowen)

I propose to take Questions Nos. 38 and 88 together.

While the recruitment of nurses is primarily a matter for individual employers, the overall issue of the availability of nurses is being kept under review by the Health Service Employers' Agency. The HSEA established a task force in 1998 to examine the full nature of the difficulties in recruiting nursing staff and to make recommendations on appropriate action.

A HSEA survey of Dublin hospitals showed 448 vacant staff nurse posts on 15 January 1999. However, a survey of the same hospitals carried out one week later by the Department revealed a significant reduction in the number of vacant posts – down to 384 on 22 January 1999. A further survey carried out during the week ending 5 February 1999 provided an almost identical result, 384.9 vacancies.

This downward trend is consistent with the increase in the number of nurses applying to An Bord Altranais for registration. The returns indicate that there is a particular difficulty in recruiting nurses for specialist areas such as theatre, intensive care, coronary care, accident and emergency and paediatrics.

Health board and voluntary hospitals outside of the Dublin area have indicated that they have no difficulty in filling permanent nursing posts, but occasional problems arise in recruiting temporary or locum staff to cover sick leave, annual leave and maternity leave. The survey returns reinforce the indications given to the HSEA by hospital management that nurses are leaving Dublin and taking up positions in rural areas. The cost of housing and traffic gridlock are seen as disincentives to taking up nursing posts in Dublin.

The strength of the economy is also having an impact on the availability of nurses. Nurses have enhanced mobility by virtue of their education, training and skills. In the current economic boom, they are much sought after by pharmaceutical and related companies in the private health sector, as well as by commercial concerns in other sectors. Ireland is not in a unique position in relation to the shortage of nurses. The reality is that the United States, the United Kingdom and most other European countries are also experiencing a shortage of nursing personnel. Pay rates for staff nurses are higher here than in the UK and a number of other European countries, including Germany and the Netherlands.

It is worth noting that An Bord Altranais report an increase in the number of nurses applying for registration which would suggest that nurses are returning from abroad. In 1998, the Board received 1,400 applications for registration from nurses abroad, compared with 939 in 1996. Conversely, the number of Irish nurses going abroad dropped from 1,079 in 1996 to 850 in 1998. Arising from the work of the task group, the HSEA outlined to the nursing unions in November 1998 a number of initiatives to address the shortage, including the standardisation of overtime rates and full incremental credit on permanent appointment for relevant previous nursing experience both at home and abroad.

In addition, the HSEA is committed to the introduction of more flexible working arrangements for nursing staff. At present, the only options for permanent employment are full-time work or jobsharing. The absence of more flexible attendance patterns has been identified as a major obstacle to attracting nurses and midwives with family responsibilities back to work. The HSEA circulated a discussion document on a revised scheme of working arrangements to the nursing unions earlier this week. This initiative is being undertaken under the programme for partnership.

My Department has engaged a nurse researcher to specifically study nursing needs for the coming years and to carry out research on the reasons why nurses are leaving their profession. When this research has been completed, my Department will be in a better position to further address the issue of nursing shortages.

In relation to negotiations with the nursing organisations, the Deputy will be aware that the Labour Court recently recommended significant improvements in existing allowances for nurses working in specialised areas and who hold special qualifications. The court also accepted that there are grounds for improvements in the pay of Ward Sisters and higher grades to reflect the new roles proposed for those grades in the Report of the Commission on Nursing. It recommended that the parties enter into immediate discussions on implementation of that report, with those discussions to be completed by 1 May 1999 at which stage the parties were to report back to the court.

I announced on 10 February that the Government was prepared to accept these Labour Court recommendations. Discussions between the HSEA and the nursing unions began on 16 February and an intensive programme of talks was agreed. Difficulties arose when the direct discussions got under way on 25 February 1999 and the Labour Court decided to appoint a chairman to preside over the negotiations. Intensive discussions between the parties have since taken place. Although a certain amount of progress was made in the discussions, agreement was not reached on the pay issues. The chairman of the talks reported back to the Labour Court and I understand that the Court has arranged to meet the parties again on 29 April 1999.