As I have indicated previously, responsibility for the management of the workforce in a given region lies exclusively with the chief executive officer of relevant health board-authority. However, in order to improve recruitment and retention prospects my Department has put in place a number of important initiatives to meet the human resource needs of the health services.
Specific human resources initiatives in key areas such as pay rates, improvements in career structure and enhanced opportunities for professional and career development have and will play a part in increasing staffing levels. Overseas recruitment by health agencies has, over recent years, also contributed significantly to meeting the workforce needs of the health services, particularly in the medical, surgical and nursing professions.
The Department of Health and Children has made substantial investment in consultant numbers in recent years. In the past five years the number of consultant posts in Ireland has increased by 31% to 1,824 posts at 1 January 2004. The current number of permanent consultant posts approved by Comhairle na nOspidéal is 1,912. Between 1993 and 1 January 2004 there was a 56% increase in consultant posts. This has included significant investment in consultant staffing in regional hospitals. I expect this increase to continue.
In the nursing area, the recruitment and retention of adequate numbers of staff has been a concern of the Government. A number of substantial measures have been introduced in recent years. The number of nurse training places has been increased by 70% since 1998 to 1,640 from 2002 onwards. The promotional structure within nursing has been substantially improved. Some 1,600 clinical nurse specialist and advanced nurse practitioner posts have been created. The Department of Health and Children has also introduced a scheme of flexible working arrangements for nurses and midwives. In addition, a comprehensive range of financial supports have been introduced to support nurses in pursuing part-time degrees and specialist courses, including "back to practice" courses.
My Department gave approval in late 2003 to the rollout, on a national basis, of the health care assistant training programme. The main objective of the programme is to upskill health care assistants to enable them to take on a wider range of duties. This frees up nursing resources to concentrate on exclusively nursing tasks.
Given the large numbers of staff employed and the unique nature of the services being delivered, a coherent, strategic approach to workforce and human resource planning needs to be developed further. This should be 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. Enhanced skills mix by matching skills to service needs benefits patients and empowers health personnel to reach their full potential. This optimises their contribution to quality care. The continued implementation of the action plan for people management has a crucial role to play in improving retention and reducing the turnover of skilled staff. The Health Service Executive will have a central role to play in the development of an integrated workforce planning strategy for the health sector.