Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank Deputy Louise O'Reilly, the other Sinn Féin Members and all other Members for their contributions to the important debate on nursing pay and recruitment that has been raised in this Private Members' motion. Similar to the Minister, Deputy Harris, I too appreciate the dedication and strength of character demonstrated by the nurses and midwives, and I value the contribution they make to the health service on a daily basis. I particularly commend those nurses who work in the disability sector. I accept the argument that all nurses deserve a decent pay rate and proper working conditions. That is one of the reasons I went into government, that is, to try do something about it. It is one of the reasons we included in the programme for Government the new accident and emergency hospital at Beaumont, the new cystic fibrosis unit at Beaumont and the recently opened new kidney unit. These are all practical issues that show clearly I am not propping up any Government and that I went into government to act on these issues.

To prove our sincerity, the Government will not oppose the motion, which is an important statement I am making on behalf of my colleagues in the Independent Alliance. It is clear from the contributions in the House that there are issues to be resolved but, similarly, we know measures are being taken which are clearly focused on addressing these issues. There are a number of points in the motion with which I strongly agree. We agree the nursing profession accounts for a significant and important part of the public health service and is predominantly female. We agree the average age of the nursing and midwifery workforce is 44 years and plans are required regarding this ageing workforce. We all agree the financial crisis has had a damaging impact on the delivery of service. At the same time, I will not take lectures from people who were involved in the devastation of our health service in the recent past. The recruitment moratorium occurred at a time when hospital activity and patient activity were increasing and they continue to increase. We also acknowledge that many nurses and midwives operate in a high-stress working environment and sometimes in difficult situations with vulnerable people.

Regarding the issues relating to recruitment and retention of nurses, a concerted effort is already being made by the HSE to increase the number of nurses and midwives as part of the nursing recruitment and retention agreement. The overall number of nurses and midwives at the end of 2016 was 35,835. At the end of 2017, it stood at 36,777. This is an increase of 942, including student nurses.

While we do not have the number of nurses we had in 2007, we must be realistic. There are challenges in recruiting and retaining some specialist staff, midwives in particular. There are ongoing efforts to address this issue. We have committed in the national maternity strategy to increase the number of midwives, and we remain committed to doing this.

I know that efforts to recruit the remaining nurses and midwives will continue into 2018. The agreement also set out other key measures, including the appointment of all nursing graduates; a career break scheme; 130 additional undergraduate places in 2017; reinstatement of some nursing allowances; and offering nurses and midwives improved educational opportunities and career pathways. Thankfully, we have moved away from the days when we were unable to offer our graduates a permanent job. I am pleased to say that all graduating nurses in 2017 were offered permanent contracts within a hospital group or community healthcare organisation, CHO, subject to their attaining registration. Once again, the HSE has issued an instruction that all graduate nurses are to be offered permanent contracts to work in the Irish public health service in 2018.

We all acknowledge that there is a global shortage of nurses and midwives, and that nurses educated and trained here in Ireland are sought after worldwide. There is evidence to suggest that the number of nurses seeking to work overseas has declined in the past 12 months. We are hopeful that Brexit will have a positive impact on our efforts to retain Irish-trained nurses and potentially attract nurses from overseas who would have previously considered the UK as their destination of choice.

Pay is a significant concern for nurses and midwives. We accept that argument. We have already begun to see the unwinding of measures taken under the Financial Emergency Measures in the Public Interest Act 2010, FEMPI, through the public service stability agreement, PSSA. This includes a series of salary increases that will see all public servants, including nurses, receiving an average increase of 7% over the lifetime of the agreement. A number of allowances have been restored to nursing staff. Pay parity for new entrant nurses and midwives is also being addressed as part of another process being led by the Department of Public Expenditure and Reform.

A comprehensive data-gathering exercise has been carried out. My colleague, the Minister for Finance and Public Expenditure and Reform, Deputy Paschal Donohoe, provided a report to the Oireachtas on the findings. This report makes clear the Government's commitment to working with the parties to address these issues, mindful of the significant cost involved. Further engagement is scheduled for the coming weeks.

As was said previously, addressing pay is a complex issue as it extends beyond the nursing grades. An evidence-based approach that can stand up to scrutiny needs to be taken in order to reach a solution. Phase two of the work of the Public Service Pay commission is now under way. The Commission is adopting a modular approach to reporting on its work. Its first module will include an examination of nurses and midwives. The Government looks forward to its report in June.

Irish-trained nurses and midwives are among the most highly-educated and well-trained in the world. There are training and development opportunities available to nurses and midwives. The recruitment and retention agreement committed to providing 120 advanced nurse practitioner places. This has been a huge success for both nurses and the health service. The agreement also provided an opportunity for nurses to attend leadership academy programmes. Nursing education is an ongoing process. Mandatory training and other courses are available through centres of nursing and midwifery education. Last year, these centres provided training to 28,027 nursing staff.

The work environment that nurses work in on a day-to-day basis has also received attention here today. The safety of all staff who work in the health service is of paramount importance. I can assure the Deputies that all hospitals have 24-7 security cover. The majority have security based either within the emergency department or close to it. An external expert was commissioned to undertake a review of security arrangements in HSE emergency departments, and the findings were sent directly to each hospital to progress implementation of the actions emerging from these reviews.

The issue of physical assault on staff from patients or service users is a complex one, as those being cared for may not always have the capacity to be responsible for the actions they carry out. Safety in the workplace is paramount to the HSE. A national incident management system is in place which records the number of assaults on staff. This has recorded 3,610 physical assaults. In response to a recent priority oral parliamentary question, the Minister for Health, Deputy Simon Harris, indicated that the HSE anticipates that the number of recorded incidents will rise as the new system becomes further embedded and better data becomes available. Much is being done by the HSE to address this complex issue and to ensure the safety of its staff in a balanced and cohesive way. I acknowledge that working in this type of environment can take its toll on a person and lead to job dissatisfaction and in some cases burnout. In these instances, I would urge any affected employee, be they a nurse, doctor, health care assistant or porter, to seek assistance from their employer and to use the supports that are in place in the HSE.

Nurses and midwives are a valued member of the health workforce. We acknowledge that there are recruitment and retention challenges. However, the measures that are already in place are having a positive effect. Work continues to recruit nurses and midwives. Pay for nurses is being addressed through the pay commission and the unwinding of FEMPI. Salary scales for new entrants will also be considered under the PSSA. We await the outcome of these processes. As the Minister outlined in his opening speech, an independent nursing commission is not required. The Department's Office of the Chief Nursing Officer is doing valuable work in developing the values and future role of nurses and midwives. As we work towards implementing Sláintecare and all it will bring, nurses and midwives will be an integral part to the health service of the future.

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