Mr. Bernard Gloster:

I agree entirely with Deputy Shortall on the clinical placements. We cannot ask the further and higher education system to develop more capacity if we are not prepared to provide the practice supervision for the students. I do not think it is the case that we are maxed out on that yet. I think we require a different approach to that.

If I take the allied health professionals, for example, in physiotherapy, speech and language therapy and occupational therapy, we have now put just over 2,000 additional people in those posts into the community. I would expect a substantial portion of those should be able to provide supervision and clinical placement and learning for the students that are coming on. I do not think we are without capacity but perhaps our model is not as strong as it should be. It certainly is not as consistent as it should be. It has tended to grow up in arrangements between individual universities and local HSE areas and it just needs to be more consistent.

Retention is an enormous challenge. The first point I must accept is that our workforce is now a very global, young one and people like to move for lots of reasons. I do accept that people also move or leave because they find the experience too difficult, challenging or just very hard to keep going in. We have to start from the point of hearing that and acknowledging it rather than just denying it, as it were.

In terms of a retention strategy, I am particularly focused on the next round of a HSE-wide staff survey, which I hope people will participate in. I am specifically looking at that to see what it tells us we need to do for people. I will not overcook it but one of the things I am told may help goes back to what I said about the RHAs and bringing chief executives and chief officers closer to the centre even before I get the RHAs is the processes. People find it very cumbersome to do things in the HSE - to get approvals for different things, for a local initiative to have the freedom to proceed or to use a post in a particular way. People find the environment very strictured and then when you add that to an exceptionally busy, demanding shift after shift, that can become quite demoralising for people. I must look at the opportunities to improve the work experience of people and at the same time recognise that there is a long way to go and we cannot make that perfect.