I welcome the Minister of State to the House. This Bill presents welcome amendments to the Health and Social Care Professionals Act 2005, the Medical Practitioners Act 2007 and the Regulated Professions (Health and Social Care) (Amendment) Act 2020. I and my party will support the Bill. These amendments will address barriers which prevent holders of British medical degrees from taking up interim training posts in this State. This is essential for attracting more internationally-trained doctors into the HSE and for increasing and deepening all-island co-operation in training medical professionals.
However, we are currently experiencing a shortage of interim posts despite the increase in recent years from 727 in 2016 to 854 intern posts this year. While all-hours graduates are entitled to one, many international students who want to stay and work in Ireland cannot get one and we also need to increase the number of medical graduates in the coming years.
The Bill also makes other registration-related amendments required to ensure the continued provision of a route to registration on the general division of the Medical Council's register for certain cohorts of internationally-trained doctors. These amendments are vital to ensure that internationally-trained doctors can continue to register and practice in this State. Many issues of unfairness are also faced by international doctors in assessing medical specialist training posts which this will not resolve. That is an issue of capacity.
The Bill will also ensure that social care workers who must register with CORU are subject to the same relevant standards as other regulated health and social care professions. This Bill, while welcome, speaks to a weakness in Government policy when it comes to the medical profession. For a number of years, the HSE has been overreliant on international recruitment to fill posts. The Medical Council's medical workforce report 2021 published over the summer illustrates this significant reliance, with more than twice as many international graduates as Irish graduates first registering with the Medical Council in 2021. Likewise, we have a significant overreliance on international recruitment to fill nursing posts. In 2021, 62% of first-time registrants with the nursing and midwifery board were non-EU workers. Migrant workers contribute vitally to the Irish health service and are the only reason that staffing levels have not collapsed. However, we must develop a sustainable supply of domestic graduates and retain those we train. The problem we face is illustrated in the fact that by the end of May, Australia alone has already issued 402 visas to Irish doctors, compared to 272 in 2019.
Not only must we train more Irish doctors and make it easier for internationally-trained doctors to come to work here, but we need to stem the bleed of Irish graduates abroad. It is a disgrace that again, we are seeing considerable numbers of doctors and nurses leave, not because they want to - many do want to go to develop skills and some will come back and some will not - but, unfortunately, my experience of dealing with some junior doctors and people who would want to come to work in the Irish healthcare system are opting to emigrate out of necessity and because they feel that the public system is not delivering for them in the way that they would like.
To address all of that will take serious work, to address working conditions as well as the housing disaster and the cost-of-living crisis which is driving talented graduates from our shores. The ongoing dispute with non-consultant hospital doctors is not growing confidence in the ability of this Government to deliver on health. Speaking at the medical professionalism conference 2022, the CEO of the Medical Council, Leo Kearns, stated that the council's 2021 medical workforce intelligence report, "will definitely highlight the need for a workforce strategy for healthcare".
I have been talking about this for some time. We need a comprehensive workforce strategy that gets real about training more graduates and about retaining and recruiting more and dealing with the myriad industrial relations issues, contract issues, capacity issues in the system which make it difficult for medical professionals to work on the frontline in healthcare and, of course, the cost-of-living and the housing crisis do not make it any easier.
I will also discuss a matter which this Bill does not address; the regulation of homecare workers. This is important from a safeguarding point of view, as well as for employment standards and pay. There is a dire need for greater regulation across the homecare sector, which has been highlighted by HIQA time and again. The non-regulation of homecare as a profession does a disservice to care workers in my view, as it means the State does not truly value the work that they do as a professional career. It is also a disservice to those in receipt of homecare and their families who should have confidence that the care worker delivering their care is a fully-regulated professional.
Homecare workers are, more often than not, caring for people who are at a higher risk of abuse or neglect. Anyone who is working so closely with people in a vulnerable position should be a regulated professional. This lack of recognition for homecare is at the root of the shortage of homecare workers. There are many different reasons, but I think we will all accept that working conditions and pay in this sector are among the main reasons we cannot recruit the numbers that we need to fill the million of hours that are made available every year under the Estimates process.
It is not recognised, unfortunately, as a valuable, meaningful career by the State, which is evidenced in the HSE's outsourcing of homecare to private providers. They are not given the secure, well-paid employment which they deserve and their employment conditions often leave them with little or no pension, unreliable hours and insecure employment.
I welcomed, a number of years ago, as I imagine most Deputies in the House did, the considerable number of additional home-help hours that were made available in the budget a number of years ago. Unfortunately, many of those hours were not delivered, simply because we could not recruit the staff. I also know that we have the same problem with children's disability networks teams. We have the same problem in many different areas of healthcare. On paper, people are entitled to a service. We are being told the funding and the money are there but we cannot get the staff.
There was a big announcement in the budget again last year and big numbers from the Minister. The Government said it would recruit 10,000 staff. Five and a half thousand were recruited but it is way behind what we should have recruited. Critically, they are in those areas of primary care and community care which are very important for staffing and the network teams which are supposed to working on the ground to provide for people in the community, care for people in the community to take pressures off our acute hospitals.
It really is about time that we got serious about workforce planning and healthcare. It really is about time that we looked at fully implement the safe staffing and skills mix framework. It is about time we deal with all of the contractual issues which have bogged down recruitment and retention in the health service for so long.
It is about time we treated healthcare professionals and people who work in the public or private sector delivering healthcare better. One clear example I can give, which I raised directly with the Taoiseach earlier, is the pandemic bonus payment. It affects people under the Minister of State's brief given she has responsibility for older people. I listened intently to Tadhg Daly of Nursing Homes Ireland this week. He quite rightly challenged the Government on the failure of the HSE to deliver the pandemic bonus to all the staff in nursing homes. We talk about Covid and the huge pressures staff were under, which was absolutely the case in acute hospitals, but nursing homes bore the brunt in the first couple of months. It was traumatic for people working in nursing homes. It was beyond belief what they had to go through to ensure people were kept safe. Despite this, they are the very workers who still have not got the pandemic bonus payment. Bizarrely, and in a failure of governance on the part of the Government, we hear now that the State is going to employ a consultancy firm to find out or figure out how to pay non-HSE staff. Some consultancy firm is going to be hired and it will be paid well, as these firms are. I do not know how long this will take but it is beyond a joke that this is where we are at nine months after this bonus was first announced. Members of the Defence Forces, fire service workers, cleaners, security staff and, as I said, people who work in nursing homes and agency staff still have not been paid. That is unacceptable.
This Bill does a number of good things, which I welcome. We must properly regulate the healthcare sector. Regulation in staffing is important and professionalising healthcare is something we should always strive to do. The removal of barriers, as provided for in the Bill, is welcome but the bigger challenge is convincing the people who are training to come and work in the public system. This Government has much to do if it is to win over graduates to come and work in the public system. That is deeply unfortunate.