Mr. David Hughes:

I will respond on the recruitment issue first. Deputy Harty outlined what the IMO said about doctors. Money is a big issue in the case of nurses and midwives. The overall remuneration package to attract nurses is simply not good enough to get the people who have left this country to return. All OECD countries are facing a huge shortage of nurses and health care workers generally in the next two decades. We are competing in an international market that is offering better terms and we cannot do that. We are even competing in an Irish market where private providers are making better offers to nurses to move to them. It is not realistic; the bring them home campaign showed just how unrealistic the efforts are. Unlike what the IMO said about doctors, money is a major issue in terms of getting those people back to this country and keeping them here.

We have the other issues in common. On the lack of educational opportunity, the last eight years have seen a big pull back on the educational opportunities for new nurses coming into the system and for existing nurses. There is a huge appetite among nurses and midwives for continuing education, and we see that in the services we provide. However, the funding of that has been left to individuals in many cases and has been pulled back. When we attract somebody back from another country, that is one of the reasons they leave again. They have lost what they had in England or in whatever other country they were in terms of educational opportunity and career progression. Those matters are equally important for nurses, but money is much higher than in the list of priorities the Deputy heard from others.