Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

Ceithre nóiméad an duine. I commend Deputy O'Reilly on bringing this important motion before the House. It is very prescient. There are two interrelated issues that must be considered when we examine nurses' pay. The first is that of basic fairness, the unwinding of FEMPI measures and setting appropriate levels of pay for front-line workers in the health service. The second issue is that of poor pay and conditions, which are contributing to overall strain in our health service.

From the outset, it is important to state that as qualified professionals, nurses and midwives are the lowest paid professional grade in all of the Civil Service. The starting pay for a qualified staff nurse who has undertaken and completed a degree and clinical placement is €30,802 per annum. This compares, for example, with respiratory technicians who start on €37,000, or radiographers who start at almost €36,000. Both the Irish Nurses and Midwives Organisation, INMO, and the Psychiatric Nurses Association of Ireland, PNA, have called on the Public Service Pay Commission to address this pay scale as a matter of urgency. The pay scale must be understood in tandem with the unequal conditions for new entrants into the profession introduced under FEMPI.

While the process of unwinding the FEMPI cuts will continue as part of the public service stability agreement, PSSA, up to 2020, it is undoubtedly still the case that many nurses continue to vote with their feet and travel abroad to work. It is a scandal that we export highly educated professionals to Australia, the Middle East and North America when their skills are so much in demand in this country. According to an INMO study, the purchasing power parity, PPP, of nurses in public sector hospitals in Ireland compares badly relative to other countries. Crucially, PPP for nurses in Ireland is below Australia, Canada and New Zealand, the destinations to which Irish nurses are most likely to emigrate.

In addition, the PNA tells us that UK nursing packages include items such as an €8,000 relocation support grant, subsidised accommodation and a shorter working week. Unless these disparities are addressed, nurses will continue to seek work elsewhere.

The second issue is the inability of the HSE effectively to retain nursing staff and the impact this is having on the delivery of care right across the health service. Pay aside, nursing and midwifery are stressful and sometimes dangerous occupations. The number and frequency of physical assaults on nursing staff have increased in recent years, along with reported cases of burnout. When we look at the figures, we can see a shocking level of understaffing in our hospitals which is undoubtedly contributing to the high turnover of staff and the eroding levels of job satisfaction. It is a vicious cycle. If we take psychiatric nursing as a case study of understaffing, the figures are shocking. PNA branches across the country tell us that up to 500 nursing vacancies exist in mental health services alone. If A Vision For Change is to be fully implemented, a minimum of 1,963 new nursing posts will need to be filled. In August 2017, HSE showed that only 93 psychiatric nurses were recruited in the previous 12 months. It is no surprise that many are going abroad to develop nursing careers in countries with functioning health systems where they are treated with respect and valued. The staff turnover rate in 2016 was almost 8%. Unless we address these issues, the haemorrhaging of staff will continue. The proper remuneration of nursing staff is crucial in order to ensure the recruitment and retention of these highly-trained professionals and for the proper functioning of our health service. We cannot continue to ignore this fact.

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