Jillian van Turnhout (Independent) | Oireachtas source

I thank the Chairman and thank the witnesses for their submissions, which were very informative and comprehensive. The submissions answered many of my questions by outlining a problem and drawing attention to different areas. We are all concerned about reductions in front-line staff and staff substitutions. I was particularly concerned by the alterations that have been made to the skill mix, as was outlined. I read the note circulated by the witnesses and see that policy has changed from a 50:50 division to 40:60 and this refers to a maximum so the figures can be even lower. This especially applies to services for the elderly and disabled.

The Chairman has outlined the process of these discussions so I will also ask the following question of the HSE. Who set this policy and how is it determined? Having visited many different centres I know that the needs of patients vary as does the mix of patients. How is any figure set, be it a 50:50 division or a 40:60 division? It seems like an arbitrary process when some centres do not require a significant mix of skills sets and others may have many high-dependency patients that need a specialised skill mix.

I spoke to some nurses I know prior to this meeting and they all raised the issue of the moratorium on recruitment and the difficulty it has created. As a consequence, there has been significant spending on agency nurses. We all know this is an issue so I wonder why the moratorium continues. Is it the case that if the moratorium was lifted flexibility to adapt the skill mix would be lost? I think this issue should be faced.

Another matter regularly raised is the increased administrative burden imposed on nursing staff by the Health Information and Quality Authority, HIQA, and others. Everyone stresses that the changes are welcome but repetitive form-filling takes nurses away from patients and this has increased in recent years. Professional staff are being taken away to do repetitive administrative work when other areas could be examined in terms of savings. I would welcome the views of the witnesses on this because it is a view I have heard.

The study presented by the witnesses on safe staffing raises issues such as length of stay and poor care and these issues must be examined as they are interrelated.