I propose to take Questions Nos. 727 and 730 together.
In a health service which is delivered on a 24/7 basis, there will always be a need for some element of agency staff. This may be to cope with increased unanticipated surges in demand on services or unplanned staff absences due to illness.
The HSE are continually working to reduce the level of agency but I acknowledge that more could be done in that regard. Recruitment and retention measures implemented by the HSE include offering student nurses and midwives permanent contracts as they graduate. The Bring Them Home initiative means that a nurse returning from abroad could receive up to €3,000 if they remain for a year. Educational opportunities and career path for existing staff have also improved. Ideally, I would like to see agency nurses choosing to become permanent members of staff. However, quite often when HSE management have approached agency nursing staff, the offer is declined. It may be that agency nurses prefer the flexibility of agency work and not being tied to one single employer.
I must take this opportunity to strongly refute this claim of a 20% 'pay gap' between agency nurses and their HSE nursing colleagues. I understand that the HSE completed a tender process for the supply of agency nurses and there are a number of qualified companies in place which supply nurses to the HSE. The rate of pay paid to a nurse through these qualified companies is the same as the directly employed HSE staff. Any additional cost is attributed to the fee paid to the employment agency and VAT. I understand, however, that in the unlikely event of these qualified companies being unable to provide a nurse, employment agencies who are outside of this contract can be engaged and increased costs on pay can accrue. However, this is in exceptional circumstances only and to describe this as a 20% pay gap is very misleading.