Dáil Éireann Debate, Tuesday - 6 July 2004
385 Mr. Wall asked the Minister for Health and Children if his attention has been drawn to the major problems in regard to lack of nursing staff at a hospital (details supplied) in County Kildare; the plans he has to overcome the problems; and if he will make a statement on the matter. [20493/04]
Amharc ar fhreagraAs the Deputy will be aware, the provision of health services in the Kildare area is, in the first instance, the responsibility of the South Western Area Health Board acting under the aegis of the Eastern Regional Health Authority. My Department has therefore asked the chief executive of the authority to investigate the matter raised by the Deputy and reply direct to him as a matter of urgency.
386 Mr. Wall asked the Minister for Health and Children the number of nursing vacancies within the ERHA and specifically the South West Area Health Board region; the number of nurses in training in the area; the number of positions available to trainee nurses within the board in any given year; the process of application for such positions; and if he will make a statement on the matter. [20494/04]
Amharc ar fhreagra387 Mr. Wall asked the Minister for Health and Children if he has satisfied himself with the number of trainee nursing positions available within he ERHA; if his Department has made funding available for the training of nurses; the enlisting of trainee nurses; if he will give on overview of the way in which hospitals can overcome the major problems of nursing shortages within the health boards; and if he will make a statement on the matter. [20495/04]
Amharc ar fhreagraI propose to take Questions Nos. 386 and 387 together.
A number of significant measures have been introduced to increase the supply of nurses to the Irish public health system in recent years. A major development in nursing education was the commencement of the new four-year undergraduate nursing degree programme in 13 higher education institutes, HEIs, in autumn 2002, with an approved annual student intake of 1,640. The Government has approved capital investment in excess of €240 million to ensure the provision of purpose-built facilities for nursing students, with state of the art clinical skills and human science laboratories. In addition, when the programme has a full cohort of students in 2006, the total annual revenue cost will be in excess of €90 million.
The number of training places has increased by 70% across the three disciplines of general, psychiatric and mental handicap nursing since 1998 as follows:
|
Discipline |
1998 |
2004 |
|
General nursing |
759 |
1,057 |
|
Psychiatric nursing |
92 |
343 |
|
Mental handicap nursing |
117 |
240 |
|
Total |
968 |
1,640 |
The number of training places was increased in direct response to the identified needs of the services involved and is a key element of my overall strategy for ensuring that sufficient home-trained nurses are produced for our health services into the future. Currently the number of students in training is over 4,500.
The ERHA catchment area is served by three HEIs: Dublin City University, the University of Dublin, Trinity College, and University College Dublin. There are currently 640 places available annually on the undergraduate nursing degree programme across the three disciplines as follows:
|
General nursing |
|
|
Adelaide/Meath Hospital Tallaght |
70 |
|
St James’s Hospital |
78 |
|
Beaumont Hospital |
75 |
|
JCMH |
27 |
|
Mater Hospital |
75 |
|
St Michael’s, Dun Laoire |
40 |
|
St Vincent’s Hospital |
65 |
|
Psychiatric nursing |
|
|
St Patrick’s Hospital |
15 |
|
SWAHB/ECAHB |
30 |
|
NAHB Psychiatric Services |
40 |
|
St Vincent’s Fairview |
20 |
|
St John of God |
15 |
|
Mental handicap nursing |
|
|
Stewart’s Hospital, Palmerstown |
20 |
|
Moore Abbey, Monasterevin |
20 |
|
St Joseph’s Portrane |
15 |
|
St Joseph’s Clonsilla |
35 |
|
Total |
640 |
All applications for the undergraduate nursing degree programme are made to the Central Applications Office in common with all other degree and diploma courses. As mentioned previously, there are currently 1,640 places available nationally in 13 HEIs. Demand to the CAO for these places is high. For various reasons, including demographics, the number of applicants to the CAO on 1 February 2004 was down by 4%. The number of applicants for nursing in 2004 was, however, up by 15% compared to 2003, from 7,202 to 8,299. This bodes well for the future.
The SWAHB catchment area is served by one HEI, the University of Dublin, Trinity College. There are currently 233 places available annually on the undergraduate nursing degree programme across the three disciplines as follows:
|
General |
|
|
Adelaide/Meath Hospital Tallaght |
70 |
|
St James’s Hospital |
78 |
|
Psychiatric nursing |
|
|
St Patrick’s Hospital |
15 |
|
SWAHB/ECAHB |
30 |
|
Mental handicap nursing |
|
|
Stewart’s Hospital, Palmerstown |
20 |
|
Moore Abbey, Monasterevin |
20 |
|
Total |
233 |
The Health Service Employers Agency, HSEA, undertakes quarterly surveys of nursing vacancies, the latest of which is for the month ending 31 March 2004. According to this survey there are 505 WTE vacancies in health board facilities and voluntary hospitals in the ERHA region. Within SWAHB there are 185.36 WTE vacancies in health board facilities and voluntary hospitals. I do not have a regional breakdown for the voluntary intellectual disability sector, but the survey states that the national nurse vacancy figure for this sector is 95 WTE.
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. As already mentioned, the number of nursing 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 practice courses. Since 1998, nurses have been paid overtime. Previously they had been given time off in lieu and the introduction of payment represents a further significant financial incentive for nurses.
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 33,765 whole-time equivalent nurses working in the health service translates into 40,119 individual nurses. Of these, some 29,629 work full-time and 10,490 work job-sharing or other atypical patterns. Thus, over a quarter of the nursing workforce avails of family-friendly work patterns. In 1998, there were 26,612 whole-time equivalent nurses employed in the public health system. By the end of December 2003 this figure had reached 33,765. This represents an increase of more than 7,150 during the period, or 26.8%. 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, 1,563 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.
My Department gave approval in late 2003 to the roll-out on a national basis of the health care assistant training programme. This is in fulfilment of a key recommendation of the Commission on Nursing. The main objective of the programme is to increase the skills of health care assistants so that, working under the supervision of nurses, they are enabled to take on a wider range of duties, thereby freeing nursing resources to concentrate on exclusively nursing tasks.
At a regional level, the ERHA has taken a number of initiatives to assist nursing recruitment. There is an ongoing targeted nurse recruitment media campaign in the eastern region. There has been local and national advertising in newspapers as well as a radio campaign. Directors of nursing have received interview training and are now interviewing locally for their own services. A website with recruitment details has also been set up. This process is managed by nursing recruitment in Eastern Health Shared Services. Regular meetings take place between staff from shared services, directors of human resources from the three area boards and staff from the ERHA to monitor the nursing recruitment process.
The Dublin academic teaching hospitals, DATHs, have conducted recruitment campaigns in 2004 in India, the Middle East and Finland. Further overseas recruitment is planned, including a campaign in the Phillipines in July 2004. There are currently 385 nurses on the DATHs overseas panel. However, non-EU nurses must undertake the international English language testing system, which since July 2003 is a mandatory requirement for registration with An Bord Altranais. The measures outlined have proved very effective to date. My Department will continue to monitor the situation closely and work with the relevant stakeholders to address issues as they arise.
