Mr. Peter Hughes:

We estimate that recruitment goes through nine pairs of hands and possibly twice through some. I am not aware of delegated authority having been given to a director of nursing. Prior to appearing before the committee, we contacted our branches to get the information used to compile the chart and received an almost identical response from each CHO area. If a person making up one of the layers takes annual leave, the recruitment will not be signed off until that person returns. As was stated, the process does not start until the person leaves. A person may have worked his or her last day six or eight weeks previously but he or she does not come off the books and the process with health business services, HBS, does not begin until he or she leaves. A recruitment retention agreement going back to 2016 states that process should take 28 days but that is not being achieved in any area. It is taking months. As I stated, all it takes to cause a delay is for a person making up one layer to take annual leave.

I am unaware of any director of nursing having been delegated authority. We suggest that directors of nursing be given the authority to recruit because there are significant vacancy rates of up to 20% in several areas. I do not see why one should have to go through a pay bill group on a monthly basis to ascertain whether a nurse is needed and for the related shortage to be dealt with by agency workers and overtime. The HSE has stated that there is a saving of 14% to 16% in having directly employed staff rather than using agency staff. There are similar savings in regard to overtime. When it is very obvious that someone is leaving or indicates an intention to leave, a replacement should be recruited within a very short period of time.

We issued a survey to some of our members in private areas. If a panel is in place, it usually takes a maximum of six weeks for the new recruit to begin work. Issues with Garda clearance, etc. may cause delay in some areas but that is the general timeframe.

On foreign recruitment and foreign nurses, we were recently contacted by a nurse in the United States who has been trying to return to Ireland for a year but is having difficulty getting his or her registration verified. I also received several emails from an Irish nurse who works in Qatar. As Skype is not available in Qatar, the United Arab Emirates and neighbouring countries, there was no facility to interview the nurse, who had nine years experience in CAMHS and wanted to come back to Ireland to work in CAMHS but is still in Qatar. That Irish-trained nurse was not facilitated with an interview and I have received numerous emails on the matter.