Written Answers Nos. 76-100
76. Deputy Alan Kelly asked the Minister for Health the reason appointments for cancer patients in the Mater Hospital are consistently being cancelled; if beds for cancer patients are being reallocated to alleviate the trolley crisis in the hospital; and if he will make a statement on the matter. [50602/18]
View answerThe Mater Hospital runs a Symptomatic Breast Disease Clinic and Rapid Access Clinics for lung and prostate cancer. In October, the key performance indicators set out in the National Cancer Strategy 2017-2026 for access to the three clinics were reached as follows:
|
Clinic |
Target |
Performance - Oct.2018 |
|
Symptomatic Breast Disease Clinic |
95% of referrals triaged as urgent to be seen within 10 working days. |
95% |
|
Lung Rapid Access Clinic |
95% of referrals to be offered an appointment within 10 working days. |
100% |
|
Prostate Rapid Access Clinic |
90% of referrals to be offered an appointment within 20 working days. |
100% |
Unfortunately, appointments for some cancer patients can be cancelled from time to time.
77. Deputy Bríd Smith asked the Minister for Health his plans in the event of a strike by nurses in public hospitals to deal with extended waiting lists and access to emergency department services; and if he will make a statement on the matter. [50772/18]
View answerAs the Deputy will be aware, the INMO and the PNA have rejected recent pay proposals. The INMO are currently conducting a ballot of their members seeking a mandate for industrial action. While the Government will respect the outcome of this ballot, I would continue to urge the parties to continue to engage. Indeed, I understand that the parties have been invited to attend a meeting of the National Oversight Body next week. I would hope that this will provide an opportunity to progress matters. As I have said previously, while I understand that our health service faces serious challenges on recruitment and retention, I do not believe that industrial action is the solution.
However, I can assure the Deputy that, if a strike were to happen, HSE Management will put contingency plans in place to minimise any disruption that may arise, and to ensure that patient safety is not compromised. A framework for dispute resolution is in place for the health services and this set out procedures to be followed in order to make the required arrangements.
78. Deputy Lisa Chambers asked the Minister for Health the contingency action he and the HSE are taking in the context of the United Kingdom possibly leaving the European Union without a deal; and if he will make a statement on the matter. [50711/18]
View answerThe Government’s overriding priority at present is to work towards the finalisation of the draft Withdrawal Agreement and the political declaration on the EU-UK future relationship.
However, any Brexit scenario will mean considerable change and impact for Ireland. Government Departments and Agencies are undertaking extensive and detailed Brexit preparedness and contingency work. Co-ordination of this whole-of-Government response to the UK withdrawal from the European Union is being taken forward through the cross-Departmental coordination structures chaired by the Department of Foreign Affairs and Trade. Contingency planning for both a “central case” and for a “no-deal scenario” bringing together the detailed work being undertaken by individual Ministers and their Departments on issues within their policy remit is well advanced. Its focus is on the immediate economic, regulatory and operational challenges arising.
My Department, the HSE and other Health Agencies have been taking forward detailed Brexit preparedness and contingency work related to the impacts in the area of health of the United Kingdom leaving the European Union, with or without a deal. A number of issues are being examined and contingency planning for a range of eventualities is underway. A key issue will be to ensure that there is minimum disruption to health services and that essential services are maintained on a cross-Border, all-island and Ireland-UK basis.
Of particular relevance to citizens is the work on the Common Travel Area to ensure that the arrangements by which Irish and British citizens can live, work and access public services in each other’s countries will continue into the future in any Brexit scenario.
In a number of key areas the appropriate response and mitigation will be at EU level and the Government is continuing to engage actively with the Commission on areas of priority for Ireland. The Commission has flagged the particular impact of Brexit on Ireland in its recent contingency planning communications.
79. Deputy Catherine Connolly asked the Minister for Health the number of patients or staff or both who contracted latent tuberculosis in Galway University Hospital, by month, in 2017 and to date in 2018; and if he will make a statement on the matter. [50615/18]
View answerIn relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
81. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the position regarding the recent engagement with the representatives of a company (details supplied) in the context of securing an agreement for the provision of Spinraza for children and adults with spinal muscular atrophy and who would benefit from its properties; if the talks are ongoing; the timeframe in this regard; the outcome of same; and if he will make a statement on the matter. [50803/18]
View answer143. Deputy John Curran asked the Minister for Health if an access programme will be established to the drug Spinraza for children with spinal muscular atrophy; and if he will make a statement on the matter. [50616/18]
View answerI propose to take Questions Nos. 81 and 143 together.
The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies the criteria for decisions on the reimbursement of medicines. As Minister for Health, I do not have any statutory function in relation to reimbursement of medicines.
Nusinersen (Spinraza) is indicated for the treatment of 5q spinal muscular atrophy (SMA), a disorder characterised by progressive muscle atrophy and weakness.
In October 2017, the HSE received a reimbursement application for nusinersen. In December 2017, the National Centre for Pharmacoeconomics completed a health technology assessment of nusinersen and did not recommend reimbursement at the price submitted. The application is being considered by the HSE's Rare Diseases Medicinal Products/Technology Review Committee and the HSE Drugs Group and is due to be considered by the HSE Leadership Team shortly, following which a final decision will be notified.
82. Deputy Joan Collins asked the Minister for Health the way in which the HSE is responding to a situation (details supplied); and his plans to deal with same. [50644/18]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
83. Deputy Paul Murphy asked the Minister for Health if he will report on the State Claims Agency dealings with the survivors of those who have suffered adverse reactions from the Pandemrix swine influenza vaccine administered in December 2009; his views on whether it is best practice that court cases directly involving victims are avoided; and if he will make a statement on the matter. [50604/18]
View answerWhile I cannot comment on individual cases or matters that are the subject of litigation, one of which is a case managed by the High Court concerning the issue of Discovery, I can provide background information on this litigation and clarify matters that are already in the public domain.
As of 3 December 2018, the State Claims Agency (SCA) has been notified of potential claims being initiated against the Minister for Health, the Health Services Executive and GlaxoSmithKline Biological SA by eighty three (83) individuals and in 62 of these cases formal legal proceedings have been issued. The plaintiffs allege personal injury in which they claim the development of narcolepsy resulted from the administration of the H1N1 pandemic vaccine.
The management of these cases transferred to the State Claims Agency on 15 October 2013 when the Taoiseach signed the National Treasury Management Agency (Delegation of Claims Management Functions) (Amendment) Order 2013. It would not be appropriate for me as Minister to interfere in the management of these claims which were delegated to the State Claims Agency.
Up until 31st October 2018 the number of reports with clinical information confirming a diagnosis of narcolepsy in relation to individuals vaccinated with Pandemrix or Celvapan, received by the Health Products Regulatory Authority is 95 - Pandemrix (n=91) and Celvapan (n=3) and one report of narcolepsy in a patient where the brand of pandemic vaccine administered to the patient was unknown to the reporter (n=1).
My main priority as Minister for Health is that individuals and families affected receive appropriate health and social care supports. My Department continues to engage with the Health Service Executive, the Department of Education and Skills, and the Department of Employment Affairs and Social Protection to ensure the provision of a wide range of services and supports, on an ex-gratia basis for those who have received a diagnosis of narcolepsy following administration of the H1N1 pandemic vaccine. The HSE’s Advocacy Unit acts as liaison with other service providers and Government Departments to facilitate access to required services. It is in regular contact with the individuals affected and their families; and regional co-ordinators have been appointed to assist by providing advice, information and access to local services. These supports include discretionary medical cards, reimbursement of expenses associated with diagnosis and treatment, home tuition and learning supports.
The Programme for a Partnership Government includes a commitment to "put in place a scheme, on a no-fault basis, that will respond to the needs of people with disability arising from vaccination". The policy objectives in putting in place a scheme to meet the needs of people with disability arising from vaccination are to provide fair and just compensation for those who may have been injured by a vaccine, to reduce the costs to the State by providing an alternative to litigation and to maintaining public confidence in immunisation. This matter is under consideration by my Department with a view to developing a proposal regarding a vaccine damage scheme based on evidence concerning, vaccine damage schemes, legal advices and consultation with other Government bodies.
I continue to engage with the Minister for Justice and Equality, and the Minister for Finance on what further improvements can be made to the legal framework governing the management of, inter alia, certain vaccine damage cases.
I wish to acknowledge the impact on the lives of these people and families affected by narcolepsy and reiterate my commitment to the on-going provision of appropriate services and supports.
84. Deputy Bríd Smith asked the Minister for Health his plans to ensure that future CervicalCheck screening can be carried out in publicly run facilities here to the highest standards; if the requirements needed in terms of suitably qualified graduates and university programmes have been examined to ensure such a programme can operate effectively; and if he will make a statement on the matter. [50775/18]
View answerMy priority is and will remain the provision of services of the highest quality. It is important to be clear that the Report of the Scoping Inquiry into CervicalCheck, published on 12 September on the website of my Department, provides welcome reassurance on the quality of all laboratories currently contracted to provide services for CervicalCheck, including the private laboratories contracted both in Ireland and America (Medlab Pathology and Quest Diagnostics, respectively) and the Coombe Women and Infants University Hospital in Dublin.
As the Deputy will be aware, switching to HPV testing as the primary screening mechanism will require a reconfiguration of laboratory services. While it is likely that a tendering process will be needed to meet at least some of the HPV testing requirement, the potential to use public laboratories in Ireland to carry out testing for the programme is being carefully assessed as part of the planning of this major project.
As part of the project plan for the switch to HPV testing, I will ask CervicalCheck to liaise with the relevant training bodies to ensure that those bodies continue to produce suitably qualified graduates to meet the needs of the CervicalCheck programme.
86. Deputy Darragh O'Brien asked the Minister for Health the way in which he plans to reduce the long waiting times for children in need of an assessment from early intervention teams in north County Dublin; and if he will make a statement on the matter. [50717/18]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
87. Deputy Caoimhghín Ó Caoláin asked the Minister for Health the position regarding additional beds at Monaghan Hospital; his plans regarding these additional beds; and his further plans to expand the service delivery profile of the Monaghan Hospital site. [50594/18]
View answerIncreasing hospital bed capacity is a priority for this Government. Over the past 12 months an additional 240 beds have been opened nationally. A further 78 additional acute beds are expected to be opened in early 2019 across the country. In addition, my Department is currently in discussion with the HSE, in the context of the National Service Plan 2019, to identify the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019.
The selection and opening of beds on specific sites in 2019 and future years will be considered as part of the annual estimates and service planning process, and subject to financial, operation, human resource and policy considerations and priorities.
With regard to expanded services in Monaghan Hospital, the establishment of hospital groups has enabled a better configuration of hospital services with benefits relating to safety, quality, access, cost and sustainable medical staffing. Hospitals working together in a group can support each other, providing a stronger role for smaller hospitals in delivering less complex care, and ensuring that those who require emergency or complex planned care are managed safely in larger hospitals.
The Smaller Hospitals Framework focuses in particular on the future role of smaller hospitals and outlines the wide range of services that can be provided within these smaller hospitals. As a Model 2 hospital, in line with the Smaller Hospitals Framework, Monaghan Hospital has a Minor Injuries Unit located on site which provides an important service to the local community. I recently met with the RCSI Hospital Group, which includes Monaghan Hospital, to discuss how all hospitals within the group can develop and contribute to improvements in both scheduled and unscheduled care for patients.
I am committed to securing and further developing the role of our smaller hospitals with the expansion of services delivered in these hospitals, especially in services such as day surgery; ambulatory care; medical services and diagnostics.
The National Development Plan provides €10.9 billion for Health capital developments across the country, including both national programmes and individual projects, across acute, primary and social care. Health capital projects and programmes currently underway will continue. As to be expected with a ten year plan, many proposals are at an early stage and will require to progress through appraisal, planning design and tender before a firm timeline or funding required can be established.
88. Deputy John Lahart asked the Minister for Health the reason CHO 7 missed its target for home support hours during the first nine months of 2018; and if he will make a statement on the matter. [50697/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
89. Deputy Charlie McConalogue asked the Minister for Health when the short stay ward will open in Letterkenny University Hospital; the preparations the HSE has under way to ensure it is opened promptly; and if he will make a statement on the matter. [50590/18]
View answerAs the Deputy will be aware, hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months. It is against this background that the Health Service Capacity Review 2018 recommended an increase in acute hospitals beds of over 2,600 by 2031 to support the projected increase in demand for services in the years ahead.
Increasing capacity is therefore a priority for the Government. Over the past 12 months, an additional 240 beds have been opened and a further 78 additional beds are planned for early 2019.
The Winter Plan 2018/19, which is due to be published on 6 December, will also seek to increase capacity and my Department is currently in discussions with the HSE, in the context of the National Service Plan 2019, to identify the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019. The question of increasing bed capacity in Letterkenny University Hospital will be considered as part of this process.
90. Deputy Jonathan O'Brien asked the Minister for Health the number of times Cork University Hospital broke its 24 hour emergency department waiting times for persons over 75 years of age to date in 2018; and if he will make a statement on the matter. [50870/18]
View answerI acknowledge the distress overcrowded EDs cause to patients, their families, and frontline staff working in very challenging working conditions in hospitals throughout the country. This year has been characterised by high demand for unscheduled care, particularly among the over-75 age group, which was further exacerbated by Storm Emma and the extended influenza season earlier this year.
My Department has been working with the HSE throughout the year to ensure the most effective response to the pressures on our hospital system associated with the winter period. As part of this process, integrated Winter Preparedness Plans have been developed by Hospital Groups and Community Healthcare Organisations to meet the anticipated surge in demand for healthcare services during the winter months. The Plans are designed to optimise existing resources and encompass:
- planning and escalation;
- operational management of patient flow; and
- maintaining public health.
The Winter Plan, which was endorsed by the Emergency Department Task Force at its meeting on 26 November, is now in place and is due to be launched on the 6th of December. The Plan runs from 1 December 2018 until 31 March 2019 and includes a period of focused action from 17 December to 13 January targeting 9 sites of concern.
These sites have been identified on the basis of pressures experienced in previous winters and include Cork University Hospital.
A key component of the Plan, which is already underway, is the provision of an additional 550 home care packages over the winter period to help patients return home from hospital with the supports they need.
The Winter Plan will also seek to increase capacity and the Department of Health is currently in discussions with the HSE, in the context of the National Service Plan 2019, to identify the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
91. Deputy Eugene Murphy asked the Minister for Health the reason the independent observer from the College of Psychiatrists of Ireland appointed to review the clinical assessments in a care home (details supplied) in County Roscommon has withdrawn from the process; the status of the review process; when an external person will be appointed to complete this review work; the timeframe for the review; if the HSE still plans to proceed with this review process which is contrary to the wishes of the families of residents at the home; and if he will make a statement on the matter. [50598/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly as soon as possible.
92. Deputy Stephen S. Donnelly asked the Minister for Health the status of the negotiation of a new general practitioner contract; and if he will make a statement on the matter. [50800/18]
View answerThe Department and HSE recommenced engagement with the Irish Medical Organisation in early October on a package of measures comprising service improvements and contractual modernisation and reform.
The goal is to develop a contractual framework that has a population health focus, providing in particular for health promotion, disease prevention and for the structured care of chronic conditions. This will enable general practitioners to better meet the needs of patients and will also promote general practice as a viable and rewarding career for both existing doctors and future medical graduates.
Agreement on the delivery of these service improvements and contractual reforms has the potential to facilitate a substantial increase in the resourcing of general practice on a multiannual basis.
In line with the long established approach to such processes, and by agreement of the parties concerned, I am not in a position to give further details at this stage.
93. Deputy Joan Collins asked the Minister for Health the way in which Article 44 of the Constitution will not impact on the new national maternity hospital in St. Vincent’s University Hospital in delivering abortion healthcare services (details supplied). [50591/18]
View answerI am committed to the development of the new maternity hospital on the St Vincent's campus. This is a vital project for women and babies in Ireland, representing the flagship project of the National Maternity Strategy and the largest single investment ever made in maternity services in Ireland.
Considerable work has been undertaken to develop a legal framework to protect the State's significant investment in the new hospital and to ensure that the new hospital building will remain in State ownership. The proposals will require consideration by Government, the National Maternity Hospital and the St Vincent’s Healthcare Group before they are finalised. This legal framework will underpin the operational and clinical independence of the new hospital, ensuring care in the new maternity hospital will be delivered without religious, ethnic or other distinction and any medical procedure which is in accordance with the laws of the land will be carried out there.
94. Deputy Eugene Murphy asked the Minister for Health the reason CHO 2 missed its target for home support hours during the first nine months of 2018; and if he will make a statement on the matter. [50700/18]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
95. Deputy Pearse Doherty asked the Minister for Health his views on the overcrowding crisis at the emergency department at Letterkenny University Hospital. [50593/18]
View answerI acknowledge the distress overcrowded EDs cause to patients, their families, and frontline staff working in very challenging working conditions in hospitals throughout the country. This year has been characterised by high demand for unscheduled care, particularly among the over-75 age group, which was further exacerbated by Storm Emma and the extended influenza season earlier this year.
By the end of October 2018, total ED attendances at Letterkenny University Hospital were up by 4.6% and ED admissions were up by 1.4%, compared to the same period in 2017. By the end of October 2018, compared to the same period in 2017, the cumulative count of patients waiting on trolleys at Letterkenny University Hospital increased by 28.8% to 2,570.
My Department has been working with the HSE throughout the year to ensure the most effective response to the pressures on our hospital system associated with the winter period. As part of this process, integrated Winter Preparedness Plans have been developed by Hospital Groups and Community Healthcare Organisations to meet the anticipated surge in demand for healthcare services during the winter months. The Plans are designed to optimise existing resources and encompass:
- planning and escalation;
- operational management of patient flow; and
- maintaining public health.
The Winter Plan, which was endorsed by the Emergency Department Task Force at its meeting on 26 November, is now in place and is due to be launched on the 6th of December. The Plan runs from 1 December 2018 until 31 March 2019 and includes a period of focused action from 17 December to 13 January targeting 9 sites of concern, identified on the basis of pressures experienced in previous winters.
A key component of the Plan, which is already underway, is the provision of an additional 550 home care packages over the winter period to help patients return home from hospital with the supports they need.
The Winter Plan will also seek to increase capacity and the Department of Health is currently in discussions with the HSE, in the context of the National Service Plan 2019, to identify the sites for investment and the associated number of beds, as part of an agreed capacity programme for 2019.
96. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 422 of 7 February 2018, the status of the roll-out and location of a primary care centre in the western area of Galway city; the details of the pre-planning survey; when it was completed; the expected date on which the centre will be operational; and if he will make a statement on the matter. [50614/18]
View answerAs the Health Service Executive is responsible for the delivery of healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.
97. Deputy Louise O'Reilly asked the Minister for Health when the position taken by Dáil Éireann following the passing of a Private Members' Bill on 3 May 2017, which called for the national maternity hospital to remain in public ownership and have legally guaranteed independence from all non-medical influence, will be implemented; and if he will make a statement on the matter. [50776/18]
View answerI have been quite clear that care in the new maternity hospital on the St. Vincent's University Hospital campus will be delivered without religious, ethnic or other distinction and as such any medical procedure which is in accordance with the laws of the land will be carried out there.
Considerable work has been undertaken to develop a legal framework to protect the State's significant investment in the new hospital and to ensure that the new hospital building will remain in State ownership. This legal framework will also underpin the operational and clinical independence of the new hospital. The proposals will require consideration by Government, the National Maternity Hospital and the St Vincent’s Healthcare Group before they are finalised.
98. Deputy Alan Kelly asked the Minister for Health the way in which the report by a person (details supplied) on an alternative system for dealing with claims arising out of the CervicalCheck scandal will be implemented. [50781/18]
View answerArising from the court cases relating to CervicalCheck the Government agreed that High Court Judge Charles Meenan would be requested to review, in the case of women affected by CervicalCheck issues, mechanisms which avoid, wherever possible, women and their families having to give evidence in court. The Judge was requested on 2 August, 2018 to undertake this review.
The Terms of Reference for Judge Meenan's work relating to CervicalCheck cases were to:
1. Engage with the women, their families and their representatives to assess what, in their opinion, could be done to provide an alternative to court;
2. Assess the management of cases, liability and quantum that arise, in conjunction with the State Claims Agency and other relevant bodies (State parties, laboratories, insurers, indemnifiers and affected parties);
3. Have regard to the work of Dr. Gabriel Scally's Scoping Inquiry and the International Clinical Expert Panel Review led by the Royal College of Obstetricians and Gynaecologists,and the British Society for Colposcopy and Cervical Pathology; and
4. Report to the Minister for Health within two months. The report to recommend a way through which these cases can be resolved, in a sensitive and timely manner, that is appropriate to these cases involving complex liability issues and multiple parties, outside of adversarial court processes.
The Judge submitted his report to me on 15 October, 2018. It was submitted to Government on 16 October and was published later that day in line with the Government decision. The Government noted that that I undertook to revert to Government with recommendations when the report had received detailed consideration by relevant Departments including the Department of Health, the Department of Public Expenditure and Reform, the Department of Justice and Equality and the Office of the Attorney General. I will revert to Government with recommendations shortly.
99. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to claims made by interviewees in a report (details supplied) that the HSE compelled organisations to sign service arrangements on the basis of known but formally unrecorded deficits; and if he will make a statement on the matter. [50777/18]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
100. Deputy Bríd Smith asked the Minister for Health the measures he plans to take to address the crisis in the retention and recruitment of nursing and specialised nursing staff in various departments of the public hospital system; and if he will make a statement on the matter. [50774/18]
View answerRecruitment and retention of nurses remains a priority for this Government.
Last year, the Government concluded an overall Public Service Stability Agreement with public sector unions which sees very significant increases in public service pay, including for nurses. In line with that Agreement, in recent weeks, the Public Service Pay Commission (PSPC) concluded a review in respect of key health service grades, including nurses.
Their report made a number of recommendation which would benefit approx. 18,000 nurses:
- Qualification allowance, Location allowance and Dual qualification allowance increased by 20%;
- Location allowance to be payable to those working in Maternity services; and
- Timeframe to become a senior staff nurse reduced by 3 years.
Alongside the PSPC Report, the Department of Public Expenditure and Reform also reached agreement with ICTU on the ‘New Entrant’ salary scale, which will benefit 60,000 public servants who entered employment since 2011. This includes about 10,000 nurses. The benefits under the measure will be effective from 1 March 2019 and will be restricted to Parties adhering to the Public Service Stability Agreement 2018-2020.
It is clear that these measures will improve the overall pay package for the majority of nurses and midwives and help address the recruitment and retention issues currently being faced. The Deputy will be aware, however, that both the INMO and the PNA have rejected the pay proposals. Notwithstanding their rejection of these proposals, officials from my Department and the HSE have met the nursing unions to clarify their issues. I understand that the parties have been invited to attend the National Oversight Body and I am hopeful this will help to progress matters.
