Ms Martina Harkin-Kelly:

I apologise for my hoarseness. Even though we work in the health service, we are subject to illness and vagaries within the health service as well. I welcome the debate. I am somewhat perturbed by what appears to be the messengers being shot this morning in respect of the issues we are bringing to the committee's attention. As we sit here, 37 patients are awaiting beds in University Hospital Limerick. There were 63 waiting for beds yesterday. There are 28 awaiting beds in University Hospital Galway today. In total, 284 citizens of this country are languishing on trolleys and in inappropriate spaces in our emergency departments today.

While pay is a huge problem, another difficulty is the political mindset which views health as a leakage rather than as a priority. Spending and making the correct investments will offset much of what I refer to as the revolving-door patients coming through our emergency departments.

The problems relating to pay, recruitment and retention apply across the board. I am dismayed that as we are celebrating the centenary of women getting the vote, 92% of nursing profession are female and yet we seem to have the denial of pay for work that is vital work within this economy. We are all professionals as my medical colleagues have said. While I am not particularly looking at Deputy Donnelly, in the context of the work we do, I do not think, as Ms Clyne said, he can compare architects with nurses or medics. The decisions we make are critical to the life of the individual. There will always be stops and checks in place when a bridge is being built and before traffic is allowed to cross it. That does not happen in the health service environment. We make acute and critical decisions, and we are not always supported by our employer.

Everyone has pointed out that medical professionals are emigrating. The weather is lovely at present and we are enjoying it. However, the pay differentials are obvious. There is a moral dilemma attached to what we are not currently able to do. Nurses and medics go elsewhere because they are able to action the care they want to action in other jurisdictions. They are given the capacity and the resources. They are not made feel potentially bad about it.

Senator Colm Burke spoke about a survey he carried out. We have conducted two surveys of our new graduates, one in 2017 and one in 2018. Astonishingly in 2017, some 79% of them said they would emigrate. The survey in April of this year indicated that 71% of them would emigrate. The elephant in the room is, of course, the need to increase pay and, above all, staffing levels. Some 76% of them said staffing levels are not adequate to support their learning in the clinical environment. As Ms Ní Sheaghdha pointed out, newly-qualified nurses make critical decisions with very little support. There is not the support from senior qualified staff because we also have difficulty retaining them in the system.

We have heard much of the political, economic and socioeconomic factors and we have heard much about the demographics. However, the demographics within nursing are that 65% of us are over the age of 40. We have a conundrum with regard to those people even being in the system within the next 15 years. Some 57% of the graduates we surveyed had been approached by overseas agencies and only 18% were offered permanent posts by the HSE. There is a dilemma. As Ms Ní Sheaghdha pointed out, pay differentials are huge. It is a sad indictment of the system that a staff nurse has to work 15 years to reach a salary of €45,000.