Dáil Éireann Debate, Wednesday - 3 March 2004
128 Mr. Sherlock asked the Minister for Health and Children the steps being taken to address the continuing serious shortage of nurses; the steps being taken to ensure that qualified nurses remain in the hospital service; and if he will make a statement on the matter. [7066/04]
View answer134 Mr. Naughten asked the Minister for Health and Children the efforts he has made to attract and retain nurses within the health service; and if he will make a statement on the matter. [6904/04]
View answer163 Mr. Durkan asked the Minister for Health and Children the steps he has taken or proposes to take to ensure that adequate medical, surgical and nursing staff are available to meet current and future requirements having particular regard to overseas agencies recruiting here; and if he will make a statement on the matter. [6998/04]
View answer236 Mr. Durkan asked the Minister for Health and Children the current requirements in terms of medical, nursing and surgical staff to ensure the operation of all hospitals and health institutions throughout the country; the degree to which this requirement is currently being met; his plans to address the shortfall in the foreseeable future; and if he will make a statement on the matter. [7262/04]
View answer238 Mr. Durkan asked the Minister for Health and Children the plans he has to ensure the provision of the required levels of nursing staff at all hospitals and health boards throughout the country; and if he will make a statement on the matter. [7264/04]
View answerI propose to take Questions Nos. 128, 134, 163, 236 and 238 together.
The chief executive officer of each individual health board has responsibility for the management of the workforce, including the appropriate staffing mix and the precise grades of staff employed within that board, in line with service plan priorities, subject to overall employment levels remaining within the authorised ceiling. Hence, the recruitment of health service staff in 2004 will take place in the context of the implementation of each health board's service plan. The Deputy may wish to note the increase in the approved employment level from 1997 to end 2003 was 27,985, 41%, bringing the approved employment ceiling to 95,800 in whole-time equivalent terms, excluding home helps. In the context of this extension, the implementation of some important initiatives are making an important contribution to strengthening the capacity of the health services to recruit and retain the high calibre professionals required in all disciplines to fill challenging and demanding roles central to the delivery of quality health and social care services to the public.
The Deputy will be aware of developments such as pay increases, improvements in career structure and enhanced opportunities for professional and career development, which have all played a part in increasing staffing levels. The implementation of the pay recommendations of the public service benchmarking body will make a further contribution to recruitment and improved retention. Overseas recruitment by health agencies has, over recent years, also contributed significantly to meeting the workforce needs of the health services, particularly in professions where qualified staff are scarce. The implementation of these, and similar, developments will make an important contribution to strengthening the capacity of the health services to recruit and retain the high calibre professionals required in all disciplines to fill challenging and demanding roles central to the delivery of quality health and social care services to the public. It is, however, important to emphasise that staffing requirements overall must be viewed in the context of the very substantial increases in employment levels achieved in the health services over the past several years.
With regard to overseas agencies recruiting in Ireland, it must be acknowledged that freedom of movement of workers is protected and encouraged under existing EU policies to which Ireland fully subscribes. I would also point out that the number of overseas health professionals employed in the Irish health service is ample evidence of our ability to recruit from abroad and that overseas staff find Ireland an attractive location in which to pursue their careers. For many years, the Irish health service has benefited hugely from the international mobility of health professionals, and our educational and regulatory regimes are well adapted to ensuring the portability of professional qualifications.
I would also point out that comparing the latest available employment levels, September 2003, to those in 1997, there are 32.5%, an extra 8,200, more nurses, 36.8% more medical and dental personnel, an extra 1,832, and over double,112%, the number of health and social care professionals, an extra 6,971, employed in the health services. This is a considerable achievement which reflects the success of the steps taken to increase the attractiveness of employment in the health services and also the ongoing measures being taken in areas experiencing shortages of fully trained and qualified staff.
The Health Service Employers Agency, HSEA, undertakes quarterly surveys of nursing vacancies, the latest of which is for the year ending 31 December 2003. The main points of the survey are: there were 994 extra nurses employed in the health service in the year ending 31 December 2003; 788 nurses were recruited from abroad in the year ending 31 December 2003; 329 nurses work every day in the hospitals as agency nurses; and the vacancy rate now stands at 1.73% nationally.
While all sectors reported that recruitment was well ahead of resignations and retirements, employers reported that 675 vacancies existed at 31 December 2003, a decrease from 1,021 vacancies in December 2002. However, the combination of utilising agency nurses and overtime adequately compensates for this shortfall.
Since the surveys began, the number of vacancies as at 31 December 2003 is the lowest recorded. The highest number was at the end of September 2000, when employers reported 1,388 vacancies. The latest figure represents a reduction of 51% on September 2000.
The current vacancy rate of 1.73% has been declining steadily in recent years, and could be considered to be a normal frictional rate, given that there will always be some level of movement due to resignations, retirements and nurses availing of opportunities to change employment and locations.
I introduced a scheme of flexible working arrangements for nurses and midwives in February 2001. Under the scheme, individual nurses and midwives may apply to work between eight and 39 hours per week on a permanent part-time basis. The figure 33,442 whole-time equivalent nurses working in the health service translates into 39,119 individual nurses. Of these, some 28,366 work full-time, and 10,753 work job-sharing or other atypical patterns. Thus, over one quarter of the nursing workforce avails of family-friendly work patterns.
There have been substantial improvements in nursing pay since 1997. For example, a staff nurse on the maximum point of the scale has seen a 51% increase in basic pay up to 1 January 2004. Since 1998 nurses have been paid for overtime. Previously they had been given time off in lieu and the introduction of payment represents a further significant financial incentive for nurses.
Last year, 1,640 nursing training places were available, and this is 70% higher than the number available in 1998. In addition, there are now in excess of 800 places available on specialist postgraduate courses including accident and emergency, coronary care and oncology. A comprehensive package of incentives, including payment of fees and other financial supports, are available to nurses undertaking these courses.
The latest survey of numbers from the Health Services Employers Agency, HSEA, shows that, out of a total complement of 3,973 filled non-consultant hospital doctor posts as at 28 September 2004, there are 33 vacancies, giving a vacancy rate of just 0.83%. These statistics clearly show that we have a very low vacancy rate among the NCHD cohort this year. Comhairle na nOspidéal is the statutory body set up under the Health Act 1970 to regulate the number and type of appointments of hospital consultants in the Irish public health service. According to the recently published Comhairle na nOspidéal consultant staffing report, during 2003, 93 additional consultant posts, a 5.4% increase on last year, were approved by the body. In the past five years 436 additional consultant posts have been approved by Comhairle na nOspidéal. This compares with 202 in the previous five years. The current consultant establishment at 1 January 2004 in the public sector was 1,824 which constitutes an average distribution of 2,148 of population per consultant throughout the country.
I am also conscious that, in view of the large numbers of staff employed and the unique nature of the services being delivered, it is imperative that a coherent, strategic approach to workforce and human resource planning be developed further and aligned closely with strategic objectives and the service planning process. Planning for the development of new and existing services in the future must be soundly based on a robust and realistic assessment of the skill and human resource needs to deliver these services. The issue of skill mix is also of paramount importance in meeting human resource needs. Enhanced skills, by matching skills to service needs, benefit patients and empower health personnel to reach their full potential and optimise their contribution to quality care.
I am, however, well aware that, in addition to effective planning to ensure the continued availability of a qualified, competent workforce, it is also necessary for the health service to become an employer of choice to further improve potential for recruitment and retention. While the record number of staff recruited into the health service in the past number of years shows the progress that has been made in this regard, even more can be achieved. Having recruited and developed such a large number of staff over recent years, it is a priority to retain them by offering a challenging and rewarding career path. In the human capital and skills intensive health sector, retention has been identified as a key issue in better people management. The continuing implementation of the Action Plan for People Management plays a crucial role in improving retention and reducing turnover of skilled staff, while providing the opportunity for each member of the workforce in the health sector, to maximise their contribution to the creation of a quality and patient-centred health service in line with the objectives of the health strategy.
