The Health Service Employers Agency undertakes quarterly surveys of nursing vacancies, the latest of which is for the year ending 31 December 2003, a copy of which will be forwarded directly to the Deputy. The survey shows that there were 994 extra nurses employed in the health service in the year ending 31 December 2003 and 788 nurses were recruited from abroad. The vacancy rate now stands at 1.73%, nationally.
While all sectors reported that recruitment was well ahead of resignations and retirements, employers reported that 675 vacancies existed at 31 December 2003, a decrease from 1,021 vacancies in December 2002. However, the combination of utilising agency nurses and overtime adequately compensates for this shortfall. Since the surveys began, the number of vacancies on 31 December 2003 is the lowest recorded. The highest was at the end of September 2000, when employers reported 1,388 vacancies. The latest figure represents a reduction of 51% on September 2000.
The current vacancy rate of 1.73% has been declining steadily in recent years and could be considered to be a normal frictional rate, given that there will always be some level of movement due to resignations, retirements and nurses availing of opportunities to change employment and locations. The recruitment and retention of adequate numbers of nursing staff has been a concern of this Government for some time and a number of substantial measures have been introduced in recent years. The number of nurse training places has been increased by 70% since 1998 to 1,640 from 2002 onwards. A comprehensive range of financial supports has been introduced to support nurses in pursuing part-time degrees and specialist courses, including back to practise courses. Since 1998 nurses have been paid for overtime. Previously they were given time off in lieu and the introduction of payment represents a further significant financial incentive for them.
I introduced a scheme of flexible working arrangements for nurses and midwives in February 2001. Under the scheme, individual nurses and midwives may apply to work between eight and 39 hours per week on a permanent, part-time basis. The figure of 33,442 whole-time equivalent nurses working in the health service translates into 39,119 individual nurses. Of these, some 28,366 work full time, and 10,753 work job-sharing or other atypical patterns. Thus, over one quarter of the nursing workforce avails of family-friendly work patterns.
There have been very substantial improvements in nursing pay since 1997. For example, a staff nurse on the maximum point of the scale has seen a 51% increase in basic pay up to 1 January 2004. There is an increase of over 8,200 during the period from 1997 to the present.
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It is clear from these figures that the recruitment and retention measures I introduced are proving very effective. The promotional structure within nursing, including the introduction of a clinical career pathway, has been substantially improved on foot of the recommendations of the Commission on Nursing and the 1999 nurses' pay settlement. The National Council for the Professional Development of Nursing and Midwifery has been especially active in this area and, to date, 1,522 clinical nurse specialist and advanced nurse practitioner posts have been created. Figures from An Bord Altranais for the same period indicate that there is a steady stream of new entrants into the profession, over and above those graduating from the Irish system, thus further increasing the potential recruitment pool. Since 1998, the total number of nurses newly registered by An Bord Altranais is 19,945. Of this number, 13,658 were overseas nurses.
The continuing attractiveness of nursing as a career for school leavers and mature code applicants alike is clearly evident from the number of applicants for such courses. For example, there were 7,507 applications for 1,640 places in the autumn 2003 intake. This means that applications for courses were oversubscribed by a factor of 4.6. This is most encouraging, given that our third level education system provides an ever-increasing array of attractive alternatives. My Department recently gave approval to the roll-out, on a national basis, of the health care assistant training programme. This fulfils a key recommendation of the Commission on Nursing. The main objective of the programme is to upskill health care assistants so that, working under the supervision of nurses, they are enabled to take on a wider range of duties, thereby freeing up nursing resources to concentrate on exclusively nursing tasks.
The HSEA surveys to which I have referred also contain data on the use of agency nurses. The average number of agency nurses used per day in 2001, 2002 and 2003 was 434, 401 and 312, respectively. These figures demonstrate a continuous and substantial downward trend in the use of agency nurses. I am confident that the extensive range of measures I have outlined, including the substantial increase in training places, the recruitment of overseas nurses, the more effective utilisation of the professional skills of nurses and midwives, in addition to close monitoring and assessment of the situation on an ongoing basis, will continue to prove effective in addressing the nursing workforce needs of the health services.
