Jim Mitchell
Question:7 Mr. J. Mitchell asked the Minister for Health and Children if he will introduce a Dublin allowance for certain health care workers. [28799/00]
Other Questions. - Health Care Workers.
Question:
78 Dr. Upton asked the Minister for Health and Children the main elements of his package of proposals to attract nurses back into the medical workplace; if, in view of the particular shortage of nurses in the Dublin area, he will consider the introduction of a special allowance to compensate nurses for the costs of living in the greater Dublin area; and if he will make a statement on the matter. [28918/00]
John Perry
Question:95 Mr. Perry asked the Minister for Health and Children if he has considered the provision of accommodation to attract key health workers back into the health services in areas such as Dublin. [28759/00]
I propose to take Questions Nos. 7, 78 and 95 together.
Clearly, the issue of a Dublin allowance is a matter that has wider implications for the public sector and would have to be considered in the context of the Programme for Prosperity and Fairness. I can, however, inform the House that a working group is being set up in relation to the recruitment and retention of nursing staff in the Dublin area. The working group will comprise representatives of health service employers, Eastern Regional Health Authority, the Department of Health and Children and the Health Service Employers Agency, and of the four nursing unions. It will have the following terms of reference: to examine factors affecting the recruitment and retention of nursing and midwifery staff in the Dublin area and to recommend innovative ways in which the situation might be improved. However, the remit of this working group will not include an examination of a Dublin weighting allowance for nurses. The only forum in which nurses' pay rates, including all allowances, can be dealt with is the benchmarking body established under the Programme for Prosperity and Fairness.
With reference to the question from Deputy Perry, while I have no wish to pre-empt the deliberations of the working group, the provision of accommodation may well be considered by it. In reply to Deputy Upton, on 29 November 2000 I announced details of a £5 million package of incentives aimed at attracting nurses and midwives back to work, retaining nurses and midwives in the public health service and addressing shortages in specialist areas. The initiative includes a new scheme of flexible working arrangements for nurses and midwives in the public health service which will come into operation on 1 February next and the abolition of fees for "back to nursing" courses with immediate effect. In addition, nurses and midwives undertaking such courses will, for the first time, be paid a salary. The intention is to remove all financial obstacles in the path of nurses and midwives who wish to return to practice.
From the current academic year, all nurses studying for the post-registration higher diploma in sick children's nursing will have their fees refunded. They will also receive an enhanced salary while in training. The number of available places on specialist nursing courses is being expanded. In order to encourage more nurses into specialised areas of clinical practice, nurses undertaking specific courses will now receive full pay while doing so. They will also have their course fees paid in return for a commitment to continue working in the specialist area for a specified period following completion of the course. Funding is being provided to the HSEA to employ a nurse manager to co-ordinate the provision of supervised clinical placements for nurses recruited from abroad.
A major advertising campaign aimed at attracting qualified nurses and midwives back to work is under way. This campaign is making use of radio and print media advertising to market nursing as a career with the specific objective of encouraging nurses and midwives back into the system. I am sure the House will agree that these initiatives represent a very significant effort on the part of my Department to facilitate the recruitment and retention of nurses.
If this question related to a Cork weighting would we have such bureaucratic long-fingering? Does the Minister agree that, according to one eminent matron of a Dublin hospital writing recently in a newspaper, 60,000 nurses pay their registration fees annually but only half of them are working in hospitals? Of the shortage of 1,800 nurses, two-thirds is in Dublin where there is a shortage of 1,200. Does the Minister agree that Dublin hospitals are sometimes located in areas where there is a danger to nurses who must leave at unsociable hours? Car-parking and living accommodation near the hospital are relevant issues to making the job attractive. Will the Minister indicate when he will be in a position to report on his findings for a Dublin weighting for nurses and other health care specialists?
I made it clear that a Dublin weighting allowance can only be considered in the context of the benchmarking review and the process under the PPF. That said, the working group I have established will examine a range of areas which could facilitate nurses working in Dublin and may identify areas where hospitals can introduce innovative local solutions. Some hospitals have already begun doing this. For example, the issue of accommodation is being addressed by a number of hospitals in Dublin in order to facilitate nurses. We are also examining the provision of more nurse training places in Dublin to develop a more indigenous base in the Dublin region. Traditionally, nurses have come to Dublin from around the country. Because of the development of new and more specialised services in the regions, they are beginning to flow back out again. To this end we have recently concluded an agreement with St. Michael's in Dún Laoghaire where we will create an additional 40 nurse training places, in addition to the record increase this year, and we will examine the provision of more places across the Dublin region.
It is obvious that many nurses are of child bearing age and the lack of child care is a real block to nurses who want to continue working either part time or full time. Will the working group address this issue? What timeframe is the Minister talking about? This is a critical situation and there is always a danger in setting up a working group or task force that it may delay resolving the problem rather than meeting it. This is not a new problem – we have been aware of it for a number of years. About two years ago the joint committee invited the Department to advise it on the shortage of nurses. The only change which has occurred since is that the shortages have become worse.
That is not true; things are improving. The figures for 30 November—
Will the Minister explain how that is so as my figures do not show that?
The figures which the Deputy has relate to a survey carried out on 30 September. That survey, carried out by the HSEA, acknowledged that the impact of the recruitment campaign which was ongoing by hospitals was not fully reflected in the figures because a number of nurses recruited from overseas had not completed their orientation programme or come into the service. Already there is a significant difference, which will be more evident by January. In Beaumont Hospital we have halved the shortage of nurses.
It is wrong to say there has been no change. I have been extremely pro-active on the shortage of nurses since coming into office and there has been a series of initiatives in terms of new specialist courses and abolition of fees for part-time degree courses in return for public service commitments. I have met An Bord Altranais to try to accelerate the registration process and to remove further obstacles in paediatric nurse training, etc. Not a week goes by when we do not continue to re-examine the issue of nursing shortages as it is critical to the operation of our hospitals. Even though we are setting up a working group, that in itself will not be the basis for deferring action. If further action is necessary we will take it and will continue to keep the situation under ongoing review. We are working with all the agencies and have witnessed a far better degree of co-ordination among them latterly than before, not only in terms of overseas recruitment but also in terms of training, etc.
Because there is a serious crisis, why not give nurses an accommodation allowance? Accommodation is a big problem for nurses. As the Minister said, most nurses come from rural areas, and parents are sending them money so that they can pay for their accommodation. Providing such an allowance would not interfere with the national pay agreement. I know of nurses who are thinking of returning to the regions and giving up nursing as they cannot afford to live in Dublin City with the allowances they are getting from the Department of Health and Children. An allowance would resolve the problem.
I made it clear we are examining that specific issue in the context of the benchmarking review body. It would be naive to suggest the implications of an allowance would not be more widespread. If we can ring-fence it—
I do not think so as there is a serious problem.
I acknowledge there is a problem, but we must be aware that there are shortages across many areas in the public sector.
We are talking about a vital service.
Yes, and I am examining the issue. We have set up a working party and I want to resolve the issue in the context of the PPF.
An Ceann Comhairle: I am calling Question No. 8 in the name of Deputy Michael D. Higgins.
I answered a similar question in the time for priority questions, Question No. 2. Does the Chair wish me to repeat the reply?
The Deputy concerned has indicated that it is not necessary to repeat the reply.