Deputy Séamus Healy:

I welcome the delegation from the INMO and thank them for their in-depth presentation. I wish to put on record my appreciation and thanks to nursing staff throughout the country and particularly in south Tipperary, where I have worked closely with nursing staff over a 20-year period. The presentation referred to crisis management in our hospitals and health service. Last night and this morning one of the hospitals I managed for more than 20 years has 26 patients on trolleys in the emergency department, in corridors and offices off the emergency department, and indeed in the atrium of the hospital. At the same time that hospital has had approximately 30 beds closed. I am speaking about South Tipperary General Hospital. That is clear evidence that there is now effectively crisis management in our hospitals.

There is no doubt that in recent years the face of nursing and the provision of services in hospitals has changed. That has put huge pressure on staff generally and on nursing staff in particular. That so many beds are closed and that we have lost so many nursing staff - almost 4,500 nursing staff have gone in recent years - is causing enormous difficulties and more nursing positions are ear-marked for reduction in the coming year. This, coupled with the move to more day-case treatments and reductions in the length of stay for patients has changed the face of nursing and placed enormous additional pressure on nursing staff throughout the hospital system.

In the context of this independent report, which contains international comparisons, it seems there are now no regulations or guidelines for staffing levels on wards in Irish hospitals. Has there been any engagement by the HSE or by the Department of Health with the INMO, or with staff generally, regarding the setting of agreed standards and ratios for hospital wards? How does the INMO believe the existing recruitment moratorium and the continuing reductions in staff will affect the current situation? I imagine it will create an even more difficult situation. I will not ask about the graduate scheme, Chairman, but how does the INMO feel the availability of opportunities for nursing abroad will impact on the availability of nurses here?