Dáil Éireann Debate, Tuesday - 23 October 2018
64. Deputy Louise O'Reilly asked the Minister for Health the reason in spite of his commitment to address the recruitment and retention crisis affecting the nursing and midwifery professions, the HSE has stated that there is only one nursing application for every four nursing vacancies; and if he will make a statement on the matter. [43842/18]
View answerMy question, like all my questions, is relatively simple. It relates to the recruitment and retention crisis, in light of the fact that nurses and midwives in the Irish Nurses and Midwives Organisation, INMO, have rejected the results of the Public Service Pay Commission, PSPC. It strikes me that nothing concrete is being done to address this that works. I am sure the Minister will list whatever it is that he is doing, but it does not appear to have the desired impact.
As Minister for Health, the recruitment and retention of nurses and midwives has been and is a consistent priority for me. Challenges exist in recruitment and retention of these professions, which is not news to the Deputy, as she knows and shares my view. We operate against a backdrop of a global shortage of nurses and midwives. Despite these challenges, however, the data show that we have managed to increase the number of nurses and midwives employed, which should not be ignored in this debate.
When the number of nurses and midwives employed by the HSE is compared between September 2017 and September 2018, it shows there has been an increase of 1,050 whole-time equivalents, including student nurses. Without student nurses, the increase is 1,039 whole-time equivalents. The Deputy refers to a statement made by the HSE in its annual report for 2017 which in many ways confirms what we already know - that we are operating within a competitive recruitment market when it comes to filling positions involving health professionals, not least nurses and midwives.
The recent pay proposals put forward were a positive step towards making the public health service a more attractive place to work for nurses and midwives. The PSPC recommended an increase of 20% to the specialist qualification and location allowances for nurses. The allowances are also to be extended to maternity services. In addition, the commission recommended the eligibility requirements for a senior staff nurse or midwife be reduced from 20 years to 17 years.
The Government also proposed to address the issue of new entrant pay, not just for nurses but across the public service, which will benefit approximately 10,000 nurses to the value of approximately €3,000 each.
I am sorry the INMO rejected these proposals but I respect the outcome of its ballot. On foot of the public service stability agreement, PSSA, Government is making considerable resources available to increase public service pay, including in respect of nurses. This is on the basis that this agreement is honoured by all the parties involved. I understand the INMO will consider its next steps when its executive meets on 5 November but I would like to see all parties, including my Department, come together during the intervening period to see if there is a way forward. Industrial action is not something which any side wants to see. Patients do not wish to see it, and I know nurses do not wish to see it either. I hope that engagement will take place between nurses and their employer in advance of 5 November.
I have some small knowledge of industrial relations between nurses and the State. If the Minister does not acknowledge and address the issue of pay, he will leave nurses and midwives with no choice. The Minister has said, and we all know, the last thing nurses wish to do is contemplate industrial action, but that involves them being given another option. He described the recent pay proposals from the PSPC as a "positive step". Some 94% of those balloted in the INMO have rejected it and, therefore, it is not viewed by them as a positive step.
Will the Minister acknowledge that pay is a factor? I do not mean allowances or any specific element of pay but rather actual pay, that is, what the Minister or I would call pay, which one might have in one's pocket after payday and not any one specific bit thereof that might apply to one person but not to his or her colleagues. Will he acknowledge that pay is central and will he take any steps to address it?
What the Government will do is respect the PSSA to which we asked public service unions to sign up, which they did, and to which the Irish Congress of Trade Unions, ICTU, signed up. I understand the INMO is a member of ICTU and I understand all parties to the PSSA have signed up and have agreed there would be no cost-increasing claims for improvement in pay for the duration of the agreement. The agreement, which was signed up to by the unions says, namely, that there will be no increase in pay above and beyond what is spelled out in the agreement.
This is a new agreement and if we start unpicking it at such an early stage it does not say much for honouring agreements that have just been agreed. We asked the PSPC to do a body of work on an expert basis, to come together, analyse data, hear from all sides, receive submissions and make recommendations. It made recommendations which would have put more money in the pockets of many of our nurses and midwives and, on top of that, it recommended pay rises for new entrants, which is an issue which needs to be addressed. I respect the INMO ballot; it has made its decision in that regard. I would like there to be engagement with it in advance of 5 November to see if a way forward can be found which respects the PSSA.
The Minister missed an important point in the PSSA which was also in other agreements, including the one on which Fianna Fáil reneged. The point is that the parties reserve the right to go back to the table and renegotiate if the circumstances change. When I was "back in my twos", as my dad would say, when circumstances changed we were quickly dragged back to the table in order that there would be negotiations on the subject of pay cuts.
Circumstances have now changed and we face a recruitment and retention crisis. All of our talk about Sláintecare, reform and everything else will come to nothing unless we have the staff to deliver. Nurses and midwives are the single biggest cohort in our health service. Other trade unions aside from the INMO now call for a renegotiation of that agreement, just as Fianna Fáil did when it felt the circumstances were right for another agreement. There is scope, therefore, to renegotiate, and I would like to hear something more positive from the Minister about nurses' and midwives' pay. We passed a resolution here where we all agreed pay had to be central, not for a small group, a section or a single cohort but for all nurses and midwives.
I do not wish to engage in a back and forth about industrial relations matters on the floor of the Dáil because I want there to be serious engagement between my Department and the Department of Public Expenditure and Reform, where appropriate, and the INMO in advance of its executive meeting on 5 November to see if there is a way forward. I must respect an agreement that the vast majority of public servants have signed up to, namely, the PSSA, to which ICTU has signed up, which is only a new agreement but which sees many benefits for people across the public service.
I accept there are recruitment and retention challenges, especially the latter in the case of people working in the health service. There are a number of measures in place to try to assist with this in the PSPC. I had hoped they would be accepted in order that we could have further engagement along the lines the PSPC references already in its reports. The Deputy is right when she says we need more nurses working in our health services. They are key to the delivery of Sláintecare and I hope a resolution can be found. It will require engagement, however, that takes place in the context of respecting the PSSA.
