James Bannon (Longford-Westmeath, Fine Gael)

I welcome the Minister for the Environment, Heritage and Local Government, Deputy Phil Hogan. I also thank the Ceann Comhairle for affording me time to discuss this important matter, namely the need for the Minister for Health and Children to outline his position on the issue of agency nurses, given the untenable cutbacks in the wages of such health care professionals and the abuses in the system which are leading to a stranglehold in the employment of such staff through the endorsement by the HSE of the monopoly position of one agency which I believe was paid €47 million in the period 2007 to 2011.

I cannot stress more strongly the need to address the current situation in the employment of nursing personnel which is leading to what I can only describe as a major abuse of the health care system. While I am aware that this is in no way an indictment of the position of the Minister who inherited the problem from the previous Administration, it is one that needs to be urgently addressed. That money needed for patient care is being squandered on private employment agencies is scandalous.

From my perspective and that of any taxpayer, it is an outrage a situation has been allowed to developed which has seen an embargo on the employment of front-line staff and resulted in money being made hand over fist by a private employment agency at the expense of the sick and vulnerable and nursing staff. All right thinking people are outraged that the embargo on the employment of front-line medical staff has led to a situation where a gravy train has been created for private agencies. The €376 million spent by the HSE on agency nurse wages employed by 277 companies between 2007 and June 2010, with €100 million going to agency owners, is indicative of the abuse of the system.

For the HSE to have handed a monopoly in the provision of agency staff to one private agency is incomprehensible and very annoying. It is my understanding €100 million has been paid to agencies to attempt to maintain staffing levels without breaking the previous Government's moratorium on the employment of new staff. To put it mildly, this is criminal. Given that it has been proved that employing a stand-in nurse can cost more than one third more than a full-time staff member, where is the logic in continuing this practice? It is obvious that patients do not benefit from the continual turn-around of staff; nurses do not benefit in any way from engaging in temporary work and, to make matters worse, the taxpayer is being screwed yet again. It should be borne in mind that agency nurses are now at the mercy of one agency and have seen pre-tax salary cutbacks of between 20% and 50%. They enjoy none of the rights of full-time employees. They have no entitlement to sick pay, pensions, maternity leave or paid further education programmes such as postgraduate courses.

I understand an attempt has been made by the HSE to establish a national pool of nurses, which would eliminate the middle man or woman. While this would go some way towards removing the terrible waste, I cannot help but think that if the health boards were still in place, this could be done better at a regional or local level.

Another abuse of the system is the allowing of double-jobbing. Nurses who availed of the buy-out package or early retirement are returning to the system on a temporary basis, which means they are receiving both a pension and a salary. This is totally unfair to those who are struggling to make ends meet on wages which have been paired to the bone.

Slashing the pay of agency nurses would not improve services. In the long run it would be detrimental, as having high numbers of rotating agency nurses on wards would remove continuity of care, leaving patients, staff nurses, doctors and management with new faces on a daily basis. While all agency nurses are professionals, it takes time to adjust to a new ward, thereby causing potential inefficiencies at ward level.

Last week alone in one midlands hospital 58 shift periods were left uncovered. The first consideration is patient care. Another is the stress on ward staff to make good the lack of necessary personnel. Front-line services are being severely affected by the lack of staff. Wards are being closed, services reduced and waiting lists becoming ever longer. Unless one has an emergency one will not be treated in a timely manner and many less urgent illnesses or ailments are left being untreated owing to a lack of services.

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