Ms Phil Ní Sheaghdha:

Niamh Adams is not attending today. Ms Kimberly Clarke is with us instead. She is a member of our organisation who works in north county Dublin and currently has great difficulty in obtaining childcare in order to allow her to work as a front-line worker in addiction services.

I will briefly discuss our submission. We will concentrate on the effect on our members, including front line nurses and midwives, of the restrictions on childcare. Members will see from our submission that in the background we set out the problem we had, namely, that the HSE has implemented a moratorium on recruitment since last May. Therefore, our staffing levels were particularly compromised. We have a significant reliance on overseas recruitment, particularly from non-EU countries. Statistics provided by the nursing registration board which demonstrate that last year 1,819 of the nurses who registered in Ireland were from non-EU countries, predominantly the Philippines and India, are listed on page 2 of our submission. Given the travel restrictions imposed since Covid-19, they are obviously not in a position to travel and help us to maintain staffing in our health service.

The second major issue that has affected staffing levels has been the infection rate among healthcare workers. At present, Ireland is top of the league and has the highest infection rate of healthcare workers globally. That is an absolute scandal. We have sought figures and the Minister for Health, Deputy Harris, instructed that figures be issued on a weekly basis when he met us two weeks ago.

We have now got the second set of figures, following on from that meeting with the Minister for Health. These again confirm that 88% of those infected who work in the health service got the virus at work. In other words, this is an occupationally acquired illness or injury and they, therefore, have to absent themselves for 14 days to self-isolate. We know from the figures that we received last Friday that 4,823 healthcare workers remain out sick, and "still ill" is the category that is stated. We know that 1,600 of those are categorised in the category of nurse or midwife. We have asked the HSE for the workplace settings but it has not been able to supply them to us as yet.

This obviously puts enormous pressure on rosters. As the committee will be aware, nursing and midwifery provide a service across the 24-hour cycle, so childcare has always been very difficult and requires a lot of juggling and preplanning. Some 92% of nurses and midwives are women and in order for them to continue in the workplace, they need to have a very robust childcare service available to them. That is often formal and informal, and it also relies heavily on partners and on the school system being open. What we have found is that, since the restrictions began on 13 March, when schools, crèches and registered childminders were closed, this has become a huge issue for our members.

As to what we have done, page 4 of our submission notes that we surveyed our members to see exactly what arrangements they had in place pre-Covid-19. We found, as I have just set out, that 27% of all of those who responded, and we had a very large response rate, were reliant on crèche, childminder and childminder in the childminder’s home. If members look at the column that shows the position during Covid-19, they can see the drop in that figure, for obvious reasons. Crèche was completely removed from the equation, childminder in childminder’s home dropped from 29.7% to 7.8% and childminder in the person's own home went from 11% to 13%, which is a slight increase. Many of our members rely on grandparents to provide an out-of-hours service and pickup from school when the shift pattern has not concluded. The figure for grandparents in the survey went from 32% to 10%. Obviously, preschool, primary school and secondary school were no longer available.

This was a huge problem, therefore, for the nursing and midwifery workforce, many of whom had to rely on taking annual leave or extending and changing their pattern of taking parental leave, which is unpaid, to maintain the employment contract. Ms Kimberly Clarke is here as one of those people who had to use eight weeks of her leave to ensure she could maintain the employment relationship.

The big issue, of course, is that a majority of our members are female, and 96% of those who responded to the survey stated they were female. Many of our members are lone parents and the problem was particularly more problematic for them. One of the lone parents responding to our survey said one-parent households cannot afford extra childcare since the schools closed, and another stated there is no thought for single parents who are front-line workers. Some 60% of those who identified as lone parents responded that Covid-19 restrictions caused additional expenditure for them in order for them to be able to attend work on the front line, where they wanted to be.