Mr. Neill Dunne:

Yes, the expectation of the public in respect of what you can provide is very stressful for staff on the ground, where families are, rightly so, looking for service and we are just not able to provide it, and obviously with management levels. There is also the demand from acute hospitals with regard to discharge. We are just not able to provide. For diabetics, urology patients and the people who need the care, people who are going to be with us for the rest of their lives and our work lives very often, we just cannot provide that service with the current challenges in recruitment. Public health nurses do take a long time to recruit, as the Deputy can understand, with the student public health nurse programme being a once-a-year programme. There are recommendations to look at that with regard to other pathways into public health nursing, and that is through 39 recommendations, which we could talk about at another stage, around microcredentialling community-registered general nurses.

The problem also is that there is a huge clinical nursing demand in the community, particularly with Sláintecare and the move to the left, and we have not looked at the workforce required for that. Where your public health nurse, who is a generalist nurse, is constantly pulled into clinical nursing, wound care and the chronic thing, they are not then getting to the children or the child developmental assessments because there is that generalist role. What is needed is the community RGN to be able to step up to that. There is no science yet. We do not have safe staffing within that, like in the acute hospitals. We need to increase our community RGN workforce to allow public health nurses to do what they were trained to do.

With the Department of Health and the dedicated child-health workforce in the next few years, there will probably be a recommendation that public health nursing retain that child-health focus because we know that early intervention creates much better outcomes in life. That is the challenge we have - the general public, the acute hospitals and the need for new clinical grades in the community to support public health nursing, if possible.