Ms Geraldine Talty:

I thank the Chairman. There are many questions about skill mix, staffing numbers, registered nurses, health care assistants, costs, agency spend and so on. As a registered nurse and as a ward sister or ward manager, what I see is that the HSE is cutting incorrect priorities such as targets, money and cost savings. That the HSE puts those priorities before the needs of patients is detrimental for the public. I am a taxpayer and as such I am entitled to a good public health service. We must place quality of patient care and safety before any other aim.
Deputy Billy Kelleher asked a question about fear. There are nurses who go to work every day in fear and go on night duty in fear that they will not be able to provide adequate safe care for patients because there are not enough of them. It is unfair to patients and it is unfair to all of us. The irony of all this is that the HSE is trying to save €180 million but yet it is wasting money on providing services with agency nurses and other agency professionals when it will not allow us hire nurses directly. It is absolutely insane. This plan will cost money and lives. It will cost nurses their registration because we are being forced into making mistakes. A 2013 report from Mid-Staffordshire stated that good people can fail to meet the needs of patients when their working conditions do not provide them with the conditions for success. This is the problem we have at present. The HSE, my employer, is forcing me to make a mistake at work and forcing me to provide poor care for patients because there are not enough nurses because it is putting targets and costs before patient safety and patient care. That is detrimental.
On the issue of registered nurses and health care assistants, another irony is that the better the nurse and the better qualified the nurse is, the less likelihood there is of the patient or the client noticing what has actually happened. If I am a really good registered nurse and walk into a ward I can see in ten seconds what is wrong with a patient, what are the problems and a deterioration in the patient's condition. That is what Ms Grace Murphy is learning but she cannot tell that at the moment and any health care assistant will never be able to do that. That is the difference and that is how it will cost us money.