Vol. 494 No. 6
2 Ms Shortall asked the Minister for Health and Children if he will report on the extent of the problem of the shortage of nursing staff throughout the health services; his views on the underlying reasons for these shortages; and the steps, if any, he is taking to deal with this urgent problem. [19018/98]
On 22 May 1998, a total of 57, 317 nurses were registered with An Bord Altranais. Of these, 47,863 were on the board's live register. The number of nurses employed in the public health service has increased steadily in recent years. Between 1990 and 31 December 1997, the whole-time equivalent number of nursing staff employed in the public health service funded directly by my Department increased from 24,732 to 27, 426, an increase of 2,694 or 11 per cent.
Over recent years the traditional apprenticeship model of pre-registration nursing education has been replaced by a new diploma-based programme. Nursing students on the new programme are supernumerary to service requirements. The "traditional" student nurses' service contribution is being replaced by an appropriate skill mix of qualified nurses and other grades.
Because of these changes in arrangements for professional training, there is an underlying trend away from less qualified student nurses to fully qualified staff nurses. Another factor which should be taken into account is the increasing trend in recent years among health service employers to facilitate nurses who, for personal reasons, do no wish to commit themselves to full-time work. There are now nearly 4,000 nurses working in formal job-sharing arrangements, in addition to the significant number who work part-time.
While the recruitment of nurses is primarily a matter for individual employers, I have asked my officials to keep the overall issue of the availability of nurses under review and to examine with health service employers whether any special initiatives are required in relation to recruitment. I am aware there is a difficulty in recruiting staff in acute hospitals, care of the elderly service, psychiatric and mental health handicap services. The shortage, however, is not evenly distributed throughout the country.
Ireland is not unique in having a shortage of nurses. The United States, the United Kingdom and most other European countries are also experiencing a shortage of nursing personnel. Many of these countries are experiencing a serious decline in the number of applicants for general nurse training. While this is not yet the case in Ireland, we must not become complacent about the number of applicants for training as we have a declining school-leaving population who have a greater range of third level courses to choose from than ever before.
In response to the current difficulties, the Health Service Employers Agency has established a task group to examine the full nature and extent of the difficulties in recruiting nursing staff and to make recommendations on appropriate action. My Department is awaiting the outcome of those deliberations. The HSEA will be holding a seminar next week on the question of nursing shortages. The seminar will provide a very broad overview of the extent of the nursing shortage, the main reasons underlying it and the range of measures being implemented by health service employers to address the issue.
I might add that last year a new Nursing Policy Division was established in my Department. Its primary function is to ensure that there is an integrated and strengthened nursing function within my Department at this important stage in the development of nursing.
In the coming months a number of nurse researchers will be appointed to the division. One of these researchers will be specifically engaged to research nursing manpower needs for the coming years.
Earlier this year, my Department undertook a concerted campaign to attract more entrants to nurse training. While the position on general nurse training is still satisfactory, there were difficulties in recruiting students for the psychiatric nursing registration/diploma programme. A seminar to examine the issues in relation to the recruitment of psychiatric nursing students and to make recommendations on future action will be held on Friday, 23 October. All agencies involved in the provision of psychiatric nursing education and training will be represented at this seminar which is being organised by my Department.
My Department is also engaged in discussion with An Bord Altranais on the development of further promotional literature and video materials for use in an ongoing recruitment drive.
Is the Minister aware that many of the 750 beds which he forced hospitals to close during the month of August cannot now reopen because of difficulties hospitals and health boards are having in recruiting nursing staff? Can the Minister tell us the number of full-time equivalent nursing posts there are in the system, and the number of current vacancies?
The number of nurses in the system is 27,426, which is an increase of 11 per cent since the beginning of the decade.
I asked about the number of nursing posts, not the number of nurses.
I have been asked to report on the extent of the problem of the shortage of nursing staff throughout the health services, my views on the underlying reasons for the shortages and the steps we are taking to deal with the problem. My reply deals with those three components of the questions.
We cannot talk about the extent of the problem or the underlying causes unless we know how many posts are there and the extent of the shortages. Can the Minister tell us the shortfall at the moment?
I gave details of the whole-time equivalents. The Deputy will have to accept that I am asked what initiatives are being taken in relation to the problem generally. If there is a specific statistic required——
I asked about the extent of the shortages.
——it can be obtained, but it is not in this question. The Deputy asked me to report on the extent of the problem of the shortage of nursing staff and I have given the extent of the problem. It is as I have outlined it.
How many full-time posts are there at the moment?
I do not have in the supplementary information available to me the detail the Deputy requires. I can tell her what initiatives are being taken and how many additional training places there are. The purpose of Question Time is to elicit information. If there is specific statistical information that the Deputy requires I will arrange to obtain it and get it to the Deputy immediately.
I would have thought the nature of the information I was seeking was evident in the question. Can the Minister tell us the number of whole-time equivalent posts within the public health services and the number of vacant posts which exist at the moment? The IMO are suggesting that there are approximately 1,000 unfilled posts in the Dublin area alone at the moment. Can the Minister confirm that figure? I am surprised he does not have those basic figures at his disposal today.
They are in my reply. The whole-time equivalent number of nursing staff employed in the public health service funded directly by the Department is 27,426. That is an increase of 2,694 or 11 per cent over the 1990s.
How many of those are unfilled?
That is the number who are working in the service. The Deputy asked me what was the number of whole-time equivalent nursing staff employed in the public health service. That is the figure — 27,426.
The six minutes for dealing with that question has expired. We must move on to Question No. 3.
With respect, a Cheann Comhairle, I asked a question. The Minister has told me the number who are employed, not the number of posts.
There is a strict rule allowing six minutes only. I ask the Minister to answer Question No. 3.
The Minister is glossing over the fact that there is a serious shortage of nurses which is seriously restricting our health service and nurses are not available for recruitment. Can I have the information within the next 24 hours?
I will supply the Deputy with whatever statistical information she requires once she has asked. It was not asked in this question.
The Minister seems to be denying the extent of the problem.
I have been asked what initiatives I am taking and I have given them. The Deputy should ask the questions and I will give her the answers.
It seems I have to spell it out more than I have already.
3 Mr. Shatter asked the Minister for Health and Children his views on whether nurses are entitled to have extra qualifications fully recognised in their pay scale; the Government's policy in the referral of this issue to the Labour Court as recommended by the Commission on Nursing; and his views on whether nurses with extra or specialist qualifications are entitled to extra remuneration or allowances. [19015/98]
The commission on nursing has recommended that outstanding claims for allowances for qualifications of the nature specified by the Deputy should be referred to the Labour Court for argument and determination as a matter of urgency. Health services management have been invited to attend the Labour Court on Wednesday, 28 October, 1998 and they will be in attendance. Likewise, any invitation from the Labour Relations Commission will be accepted by the management side.
In the light of this development, I hope the Deputy will appreciate that it would be wholly inappropriate for me to comment further on this matter.
Do the Minister and the Government accept in principle that nurses with extra or special qualifications are entitled to extra remuneration or allowances to respect their special qualifications and the additional expertise they possess?
That is a matter that will be dealt with under the independent labour relations system.
Would the Minister accept that nurses who have extra and special qualifications should get additional remuneration, or does he believe in principle that nurses in such circumstances should not get additional remuneration? Which approach is the Minister advocating?
I know what the Deputy is asking, and none of us is politically naive. The position is that these issues have been referred to the labour relations process and that is where they will be dealt with. I do not intend stating anything here today which might be interpreted as deviating from the Government line on this matter which has been well articulated and put in the public domain. It does not serve the issue well one way or the other for me to get involved now that the process has been referred to the independent labour relations machinery. That is the situation, and whatever number of supplementary questions I am asked, I do not intend pursuing that line because I do not find it helpful.
Is it still the Minister's and the Government's line that this is not an issue that should result in any additional remuneration being paid to nurses and that it should be dealt with in the context of overall national wage agreements? Has the Minister's initial view as expressed now been changed by the Taoiseach?
Despite a series of attempts to suggest otherwise, the Government position is a united position as outlined in the Taoiseach's statement.
What is the position?
When the report of the Commission on Nursing was presented to me, I indicated that the Government accepted the broad thrust of the report and that I wished to talk to the nursing unions about a partnership approach to its implementation. As an indication of that commitment to the report I also announced an action plan aimed at implementation of its clear recommendations. The Government's position on the pay issues arising from the report is that these can be dealt with in a way that is consistent with the directions set down in the Taoiseach's address to the social partners last July.
Would the Minister accept that in the context of the huge shortfall of nursing staff and the leakage of nurses to other countries where they can work under better conditions and where qualifications are properly recognised, it is in the national interest that the Government should approach this issue by accepting in principle that nurses with additional qualifications or particular specialities should be entitled to greater remuneration and that that is in the interests of the general public, patients and the proper functioning of the medical and hospital services?
The Deputy has a view on this matter. Mine is that these matters are best dealt with by the machinery which has been set up to deal with them, and that is not here on the floor of this House.
