Deirdre Clune
Ceist:161 Ms Clune asked the Minister for Health and Children the plans, if any, he has to address the shortage of nurses; and if he will make a statement on the matter. [16421/00]
Written Answers. - Nursing Staff.
Nurse staffing difficulties largely relate to the greater Dublin area. Indications are that the level of applicants for nursing posts outside the Dublin area far exceeds the number of positions available. While some nurses have always moved from Dublin to other parts of the country, investment in hospitals and the development of regional specialities over recent years have increased demand for nurses outside the Dublin area. Within Dublin, issues such as housing costs, traffic problems and lack of car parking facilities have been cited as disincentives to the recruitment and retention of nurses. However, these issues are not unique to nurses or to the health service.
It should also be noted that nurse recruitment is carried out on an ongoing basis in most hospitals, and the level of vacancies fluctuate accordingly. At any given time, significant numbers of nurses would be in the process of being appointed by employers or moving from one employment to another.
While the recruitment and retention of nurses is primarily a matter for individual employers, initiatives have been taken or are being progressed with a view to stabilising the situation and, where possible, improving it.
New arrangements have been introduced to give better starting pay to nurses taking up employment by giving full recognition for previous experience at home and abroad. A significantly improved regime of allowances in respect of nurses working in specialised areas such as operating theatres and intensive care units has been introduced. Standardised overtime working arrangements have been introduced following agreement with the nursing unions. Some 11 hospitals around the country provided ‘back to nursing' courses in 1999 for nurses wishing to return to the workforce. A total of 304 places were available. The expansion of these courses is aimed at maximising the available nursing workforce. During 1999-2000 16 new post-registration programmes have been developed. This year there will be 660 places on post-registration courses in specialised areas of clinical practice. In response to an identified need, 11 of the 16 new programmes will be located outside the Dublin area. An anti-bullying policy document, prepared by the HSEA and agreed with the nursing unions, and was published in December 1999 and has been widely promoted within the service. The promotional structure within nursing, including the introduction of a clinical career pathway, is being significantly improved on foot of the recommendations of the Commission on Nursing.
Up to 1,250 clinical nurse-midwife specialist positions are being introduced for nurses who have recognised expertise in particular areas. These posts attract clinical nurse manager two salary. Nurses are also benefiting from an agreement to upgrade 1,100 staff nurse posts to clinical nurse manager one grade which is being implemented at present.
A study of the nursing and midwifery resource by the nursing policy division of the Department of Health and Children commenced in 1998 with the primary purpose of forecasting future nursing and midwifery resource needs. Following on from this, a national study on turnover in nursing and midwifery has been commissioned by the Department through the Health Research Board and awarded to the department of nursing studies, University College Cork.
Agreement has been reached between the relevant Departments on a procedure for fast-tracking immigration clearances and work permits for non-EU nurses. Data maintained by An Bord Altranais indicates that in recent years there has been a net inflow of nurses to Ireland. Inflow figures for 1999 show a dramatic increase to 3,181 in the number of nurses seeking to register here. Employers have stepped-up their recruitment from abroad with significant success in Scandinavia and the Philippines, for example, in addition to on going recruitment within Ireland.
Swift progress is being made on the implementation of the agenda for change mapped out by the Commission on Nursing. A priority action plan was agreed with the nursing alliance as part of the settlement of the nurses' strike. Additional funding of £10 million has been provided this year for initiatives in the action plan.
The Commission on Nursing recommended that the Department of Health and Children, health service providers and nursing organisations examine the development of appropriate systems to determine nursing staffing levels. The need to address skill mix issues was also highlighted in the Commission on Nursing report. Both of these recommendations are included in the priority action plan agreed with the nursing alliance as part of the settlement of the nurses' strike. These issues are being addressed by a joint committee representative of nursing unions and health service employers.
From 1 January 2001, nurses working in the public health service who want to undertake nursing and certain other undergraduate degree courses on a part-time basis will have their fees paid in full by their employing agencies. Fees will be paid in return for a commitment on the part of the nurses to continue to work in the public health service for a period of up to two years after the completion of the degree course. This fees initiative will continue until at least the year 2005.
Further funding totalling £400,000 was made available to the various schools of nursing throughout the country late last year to enable them undertake local marketing campaigns aimed at promoting nursing as a career.
This year there were more than three applicants for every available training place. This is most encouraging bearing in mind that the total number of training places is being increased by 25% over last year to 1,500 and the reduction in the volume of applicants for public service positions generally.
The annual maintenance grant for nursing students, which is not subject to a means test, has been increased to £3,325 with effect from 1 April 2000. The grant now is almost double the maximum grant for which other third level students may qualify. In addition, allowances for external clinical placements, books and uniforms have also been increased.
These initiatives represent a very significant effort on the part of my Department to improve the situation. In the longer term, it is hoped that the substantial increase in the number of student places will provide enough registered nurses to fill all vacancies.