Eamon Gilmore (Dún Laoghaire, Labour) | Oireachtas source

The Minister for Health will examine the results of the INMO study when published. Without the full details of how the work was undertaken and the findings, it is not possible to comment in detail on the study at this point. I am aware that other studies have cited figures which suggest Ireland has a more favourable nurse to patient ratio than in the United Kingdom. The Government has determined, in line with its commitment to reduce the size of the public service, that health sector employment numbers must be reduced substantially in 2013 and 2014. Spending on health services will also have to be tightly controlled. The cumulative impact of staff reductions this year and in previous years presents a significant challenge to the health system in delivering services. The priority is to reform the way health services are delivered to ensure a safe, more productive and cost effective health system. Effective service delivery requires processes to ensure there will be sufficient staff, with the right skills, diversity and flexibility at the right time to provide high quality care.

Skills mix is a central factor in staffing decisions. The Croke Park agreement has been crucial to the ability of the health service to manage in the difficult circumstances of recent years. The flexibility and adaptability shown by staff, including nursing staff, have meant that even with reduced numbers, service levels have largely been maintained, while performance in relation to emergency departments and hospital waiting lists has been markedly improved. In the grace period earlier this year the focus of the Minister for Health and health service management was on ensuring all critical and essential services were maintained. This was successfully achieved through measures that included the reorganisation of resources, more flexible working arrangements and the filling of a limited number of critical posts. The continuing reduction in staffing increases the need for reform, including greater flexibility in work practices and rostering and redeployment. The HSE is committed to fast-tracking innovative and more efficient ways of using reduced resources, including by providing for greater flexibiliy in work practices and rostering, especially of nursing and medical staff, and the changing of the skills mix. Further flexibility and efficiency measures are provided for in an updated health service action plan which has recently been completed.

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