Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I welcome the Minister. I want to discuss the recruitment and retention crisis and his views on what is happening. Let me start with consultants. We know one in five consultant posts is currently vacant and that a very small number of consultants are applying for vacant posts relative to ten years ago. We know that in many hospitals it is becoming impossible to hire-in consultants particularly when more experienced consultants are needed. We know there has been an increased use of locums, which has risen by one third between May and October of this year. There are allegations that some of these locums are not as well qualified as consultants would be and obviously they can cost more money. We know that several areas are now losing specialist services. Let me give examples. Kerry University Hospital is about to lose its only histopathologist, which puts cancer screening services, including CervicalCheck and many other surgical services, at risk. My understanding is that Cork is not hiring additional resource and there is no plan in place yet to deal with this. Tralee has recently lost its rheumatologist. Patients are now being referred to Cork but at present there is a two year waiting list with 1,500 patients already waiting to be seen. I am told that unless somebody has an extremely urgent case, there is no realistic plan to ever see them. This week the hospital in Tralee lost its urologist and we are told that in Kerry, they are now struggling to get the locums for these posts.

We have discussed the situation in Our Lady's Hospital for Sick Children. Children with scoliosis are waiting more than three years for operations. In the urology department in St James's Hospital, the waiting list for a routine appointment is now more than six years. The list goes on and on. We can talk about hospitals all over the country. The scarcity of qualified consultants has now become so acute that they are beginning to shut down services for patients.

There are also serious issues when it comes to nurses and midwives. The INMO told me recently that it estimates that the services are now short approximately 175 midwives, which is a very large number. Galway University Hospital has 16 operating theatres, five of which, that is, one third of the region's entire surgical throughput capacity for the only level four hospital in the area, are permanently closed. The reason given to me for these closed surgical theatres is that they are not able to hire a relatively small number of theatre nurses. We know agencies are paying nurses on the fifth point on the scale and an additional 20% on top of that. Agencies are paying nurses 50% more, relative to a new entrant nurse in the public system. The INMO, as I am sure the witnesses are acutely aware, is balloting for strike action, to include work stoppages, on Monday. The INMO understands that a de factomoratorium on recruitment is now in place for the rest of this year due to budget constraints. It told me that 57 nurses were meant to be hired to help support patients on trolleys in the upcoming winter crisis but they are now not being hired.

Does the Minister accept there is a crisis in recruitment and retention both for consultant posts and for nurses and midwives? Does he accept that the new entrant pay equality discrepancy is a major driver of that crisis? Why have talks not started with the Irish Hospital Consultants Association, which represents more than 90% of the consultants in the system? The Irish Hospital Consultants Association says it has tried to meet the Minister and has been trying to meet officials for a year but cannot get any meaningful engagement. Nurses and midwives have not gone on strike in nearly 20 years.

In the context of us spending more money on the health service than ever before, with considerable overruns, how has it been allowed to get so bad for nurses that they have got to the point where they feel they must ballot for strike action? Will the Minister confirm whether there is a de facto moratorium on hiring for the rest of this year?