Mr. Neill Dunne:

Public health nursing is geographically based, meaning that when there is a vacancy, there is a community without a nurse. You will often see that. There has been advocacy at TD level regarding communities with no public health nurse. Public health nurse recruitment is once per year through the student public health nursing programme and it did not reach its potential this year. The circumstances are even more worrying for next year. Currently, there are only 21 registered public health nurse vacancies within the system. That is extremely concerning. We have spaces to train 140 per year. When there is no nurse in an area like south inner-city Dublin, nurses must cross-cover, and that is when burnout arises. It means no patient- or family-centred relationship. We do not get to work upstream in circumstances where we need to work on the preventive side. Early contact with families and children on referrals is really important to later outcomes. Therefore, trying to protect the clinical workforce is so important, and that is obviously the job of the committee today. There is a particular challenge within community nursing or public health nursing services.

We do not have safe staffing. We do not have the science behind it yet. While it will arise at some stage in the next couple of years, we do not have a scientific measure. The model is based on an historic model, from 1966, for public health nursing and community nursing.

We want to deliver Sláintecare, so it is important that we have a strong foundation of generalist community nurses within Sláintecare working with specialist nurses. However, we do not have that balance, and we do not have a model of care for public health nursing either. I could go on, but that gives a flavour of some of the challenges within public health nursing.