Staffing requirements in the areas highlighted by the Deputy should be viewed in light of the substantial increases in employment levels achieved in the overall health service in recent years. The Deputy may wish to note that there has been an increase in the level of employment of 23,706, excluding home helps, in whole-time equivalence terms since 1999, or 32.6%. In this context, comparing employment levels at end-December 2003 to those at end-1999 shows that there were 26%, plus 1,407, more medical-dental personnel and 85%, plus 5,853, more health and social care professionals employed in the health services in whole-time equivalents, WTE, terms. In 1997 there were 25,233 whole-time equivalent nurses employed in the public health system. By the end of September 2003 this figure had reached 33,442. This is an increase of over 8,200 during the period or 32.5%. It is clear from these figures that the recruitment and retention measures I introduced are providing effective.
Developments such as pay increases, improvements in career structure and enhanced opportunities for professional and career development have all supported increased staffing levels for key health and social care professions. The implementation of the pay recommendations of the public service benchmarking body — subject to the successful ongoing completion of the performance verification process — is making a further important contribution to recruitment and improved retention. The continued implementation of the action plan for people management — a key action under the health strategy — has a crucial role in improving retention and reducing turnover of skilled staff.
The Deputy may wish to note that specific human resource initiatives in key areas will contribute significantly to meeting the workforce requirements of the health services. As far as medical personnel are concerned, the recently published report of the national task force on medical staffing details the number of consultants and non-consultant hospital doctors that will be required in the coming years to provide a high quality, consultant-provided service.
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.
According to the most recent survey of nursing vacancies by the Health Service Employers Agency, the number of nursing vacancies stood at 675 at the end of December 2003. This represents a 51% reduction in the number of vacancies reported at the end of September 2000.
The current nursing 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.
Significant progress has also been achieved in doubling the total number of professional therapy training places, that is, physiotherapy, occupational therapy and speech and language therapy, in line with the recommendations of the report, Current and Future Supply and Demand Conditions in the Labour Market for Certain Professional Therapists, commissioned by my Department from Peter Bacon and Associates and published in June 2001.
The Deputy may wish to note that responsibility for human resource planning rests with the chief executive officer, CEO, of each board. Each CEO in managing the workforce in his or her region is responsible for determining the appropriate staffing mix and the precise grades of staff to be employed in line with service plan priorities, subject to overall employment levels remaining within the approved regional employment ceiling.