Ms Phil Ní Sheaghdha:

It is, and the only obstacle at the moment is the cap. Thankfully, there are more school-leaver applicants than places available, which is a good sign. The WHO has advised Ireland that it needs to recruit ethically. In other words, it has to grow its domestic supply of healthcare workers to avoid poaching – this is the term used – from countries that need their own workforces but that are poorer and whose healthcare workers consequently migrate. We are now heavily dependent on non-EU workers, particularly in nursing. Our population of Indian nurses has grown significantly. The WHO has given us a target for recalibration by 2030. We have to ensure we train domestically so as not to rob countries that need their own healthcare workforces of those workforces. This means that, by the period 2030 to 2035, we should, if following what the WHO has stipulated, be training over 7,000. We are training about 2,100 at the moment.

Every time a nurse works as a public health nurse or in the community, she has to do postgraduate education for a year. Going to college takes these nurses off the front line for a period. They work as students while training and, again, that requires supervision and clinical mentors. All the posts just do not have any level of protection in the current system with its moratorium.

Based on what Sláintecare has projected, we need an additional 700 public health nurses and an additional 2,000 registered nurses working in the community just to have needed services expanded into the community. We do not have a chance of achieving this with a postgraduate course that produces about 140 public health nurses every year. The training happens only once a year, meaning that if you do not fill your places, you do not get a second chance. Community general nurses advise that postgraduate education has not been provided for them, specifically in respect of the community. It is an ask that dates back over a decade. Many of the nurses tell us they must sometimes cover two roles when health nurses are not available. Clearly, there are not enough public health nurses employed.

Overall, the HSE is too reliant on nurses in training. We met student nurses again last week. Senator Black asked what makes nurses want to stay. It is heartening to see students with enthusiasm for the career they have chosen but they tell us they are being absolutely exploited. They are on no pay, working in clinical placements and given responsibilities they should not be given. It is not even that they are low paid because, from first year through to third year, they get no pay at all. When they are in fourth year, for 36 weeks they get 80% of the pay at the first point of the qualified nurse salary. We saw during the Covid pandemic that the exploitation of unpaid labour, particularly of those in the student nurse grade, was just extraordinary, and that is still going on.

We have a situation where we want people to stay where they train. It is really important to consolidate your training and stay working where you did the bulk of their training. It is good, the evidence is there, and we all know that, but our system, our overwork and the exploitative nature of short-staffing means they make decisions not to stay. That is fixable. That is easily fixable.