Maire Devine (Sinn Fein)
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I thank the witnesses for their presentations. Maybe some of this was covered while I was in the Seanad for a vote. On the retention of staff, recruiting from abroad and attracting nurses and medics to return home, the World Health Organization has suggested we should not rob Peter to pay Paul. We need to refocus on how we provide our indigenous healthcare staff. We have the youngest population in Europe, yet we have a dearth of health service staff. What does that say? It is more than a crisis. If we have the youngest population, obviously everyone will try to pinch our staff, as they have done worldwide. We need to tap into that youth factor and try to mould it for our services. How can we do that?

We need large-scale change within the HSE and the health service. The position is especially poignant at the moment. There may be barriers preventing people from coming back. Staff are offered an adaptation course. How many hospitals are offering adaptation courses and how many courses are running at any particular time?

I wish to ask Ms Tierney about the recruitment process for the chief executive of the HSE. On 30 May last, I received a letter from the Minister for Health, Deputy Harris, stating that the post would be advertised shortly. I do not know if it is in the remit of the Public Appointments Service, PAS, to include an executive search. It is hoped that by the end of the year a Bill will be introduced to legislate for a board for the HSE. Based on the heads of Bill I have seen, we will table many amendments to the legislation. Does Ms Tierney believe clinical experience along with managerial experience is essential for the chief executive of the HSE? We need to eliminate political appointments to the board. Appointments should be based on experience alone. We need different people in there to represent the people and not just vested interests. I ask for an update on that.

I have some questions for the Psychiatric Nurses Association, PNA. Yesterday the INMO warned that our health services face a winter of discontent. We have had several winters of discontent. We seem to be continually in discontent and it has become normal. The INMO's point was that a report on pay and conditions was supposed to have been completed by the end of June. This has now been pushed out to later in the summer. I know members of the PNA in Tipperary, Galway and Waterford. That 98% of nurses are voting for industrial action speaks volumes not only regarding issues with pay but also the risks to nursing staff, other staff and patients using HSE premises. This is not just a case of a winter of discontent. What the PNA described is the tsunami that awaits us, if it has not already reached our shores.

I have repeatedly asked An Bord Altranais agus Cnáimhseachais na hÉireann, the Nursing and Midwifery Board of Ireland, to be more accountable and inform us of the criteria for and process of registering nurses. We need 100 to 200 nurses. The board is finding blocks and barriers, although it has tweaked matters somewhat following my nagging. Some 30% of graduate student nurses will leave within a year of qualifying. Child and adolescent mental health services, CAMHS, and services such as those provided in Cherry Orchard and the Central Mental Hospital, which opened five extra beds last week, depend on the September graduates to staff some of the units, CAMHS units in particular. Forgetting the 30% who will leave within a year, 60% or 70% of these graduates have spoken of their intention to move abroad, if have not already secured jobs abroad. Can the PNA confirm or deny that?

I would have liked a written submission from An Bord Altranais agus Cnáimhseachais na hÉireann because many nurses coming home through the Bringing Them Home campaign or trying to gain entry to the registration process here describe it as a bureaucratic nightmare. It is a pity we representatives of An Bord Altranais agus Cnáimhseachais na hÉireann are not here.