I propose to take Questions Nos. 177 to 179, inclusive, together.
Though the HSE has the capacity to recruit where it is necessary to do so in order to ensure patient safety and to support service delivery, there is evidence that there are, at present, some difficulties in recruiting certain frontline staff including consultants, NCHDs and specialist nurses. I am currently progressing measures to ensure that we will have an adequate supply of highly skilled consultants, doctors and nurses.
There has been a significant increase in the number of consultants (Whole Time Equivalents) since the establishment of the HSE, the number increased by 723 from 1,947 in January 2005 to 2,670 in December 2013. However there are some specialties in which there are international shortages and which have been traditionally difficult to fill, regardless of the salary scale. There are also some hospitals to which it has historically been difficult to attract applicants, in particular smaller hospitals. The establishment of Hospital Groups will help to address this issue, as this will allow doctors to be appointed as group resources.
The ability of the public service to attract and retain high quality frontline staff shapes the extent to which the HSE can maintain and develop the range of health services required. I set up a group under the chairmanship of Professor Brian McCraith last July to carry out a strategic review of medical training and career structures. The Group will make recommendations aimed at improving the retention of medical graduates in the public health system, planning for future service needs and realising maximum benefit from investment in medical education and training. It provided an Interim Report in December 2013 focusing on training. In April 2014 the Group submitted its second report to me and this dealt with medical career structures and pathways following completion of specialist training. The final report of the Group will deal with a number of issues including workforce planning and this is due to be submitted to me by the end of this month. The work of the Group is key to ensuring that we have attractive propositions for consultants and doctors in training, NCHDs, in the years ahead.
Additional nursing support is being made available throughout the system. Measures include the increase in nursing hours available under the HRA and the appointment of nearly 500 nurses and midwives under the graduate scheme, with over 200 others currently going through the recruitment process. This innovative model combines a contract of employment (with clinical rotation) with a fully funded interdependent education programme. I have just approved the establishment of a taskforce to develop a framework that will determine the staffing and skill mix requirements for the nursing workforce in a range of major specialities. The focus will be on the development of staffing and skill mix ranges which take account of a number of influencing factors. The taskforce is being chaired by the Chief Nursing Officer.
Where frontline staffing shortages exist, the HSE makes alternative arrangements to ensure service provision, including recourse to agency and locum cover. However, it is preferable that sufficient numbers of doctors, nurses and NCHDs are recruited to permanent posts to support the most efficient and effective delivery of services. The details of availability and development of staff are a matter for the HSE and I have forwarded this aspect of the Deputy's questions to the HSE for direct reply.