Cormac Devlin (Dún Laoghaire, Fianna Fail) | Oireachtas source

I welcome the opportunity to examine the issue of safe staffing levels in Irish hospitals, which are fundamental to delivering safe health services to the highest standards. It is important to acknowledge the programme for Government, which commits to the large-scale expansion of the health and social care workforce. This expansion has been significantly accelerated since the beginning of Covid-19. Record levels of capacity have been added to our public health service. Increased funding is supporting community intervention teams, GP supports and out-of-hours services to reduce the need for attendance at emergency departments.

In November, our total public healthcare workforce stood at 137,220 whole-time equivalents. Thanks to successive large increases in the health budget, there are 17,403 more people working in our health service than there were at the beginning of 2020. That is an expansion of 15%. This includes 5,169 nurses and midwives, 2,870 health and social care professionals and 1,801 doctors and dentists. Funding has been secured in 2023 to continue this considerable expansion of the workforce, with an additional 6,000 staff to be added this year.

Recruitment capacity is also expanding to ensure that ambitious workforce targets can be met and maximise the number recruited. I understand this has included the expansion of international recruitment markets, targeted recruitment campaigns and streamlined recruitment processes.

Record funding has been provided to permanently increase capacity in our healthcare service. This year's budget is over €24 billion, up from €14.8 billion in 2018. This is the largest allocation ever. I welcome the confirmation from the Minister that he has secured funding to continue this considerable expansion of the workforce, with an additional 6,000 staff to be added this year across all service areas and in key staff categories. Included are medical staff, nurses and health and social care professionals.

However, challenges obviously remain. While the consultant number has increased significantly, by 254 to 3,837 during the year ending in October 2022, it is still low by international standards, as the Minister is aware. We need about 6,000 consultants.

I welcome the new consultant contract and also the ongoing efforts of the task force that has been working closely with representatives of non-consultant hospital doctors, NCHDs, to improve conditions and opportunities for NCHDs and resolve unacceptable issues around placements and taxation. Equally, Deputies from across the House will be aware that there are significant challenges over the provision of GP care in the community and the provision of dental services. We have all seen these at first hand in our constituencies. More needs to be done, and I welcome the confirmation that the Higher Education Authority is working with higher education institutions to scale up capacity in dentistry, pharmacy, medicine, nursing, and veterinary courses. I understand recommendations on capacity are due to be submitted to the Minister for Further and Higher Education, Research, Innovation and Science shortly.

It is critical to have enough nursing or midwifery staff with the right knowledge and skills, in the right place and at the right time, to provide safe and quality care to patients and service users.

There are 18,516 more staff in our health service now than at the beginning of the pandemic, including 5,742 additional nurses and midwives. The years 2020, 2021 and 2022 have seen the biggest staff increases since the HSE was established. Ireland now has the second highest level of nurses per capitain the EU, at 12.8 nurses per 1,000 of the population, contrasted with an EU average of 8.3, and 8.5 across the water in the UK. These statistics are useful for comparison but the real indicators should be the levels and standards of care being provided.

Waiting lists for outpatient appointments are too high and the waiting times in emergency departments are too long.

I am aware that the Minister and his Government colleagues are making significant structural changes, including by establishing a safe staffing framework, to ensure safe care standards for patients. The framework has worked well in large hospitals and I welcome comments from the Minister that it will be fully implemented, particularly in smaller hospitals.

It is important to acknowledge the challenges and issues and deal with them, but it is also important to acknowledge the fantastic work being undertaken by the entire medical community. In my constituency, Dún Laoghaire, I have seen at first hand the wonderful care provided in St. Vincent's, St. Michael's and Loughlinstown hospitals and, of course, the newly expanded National Rehabilitation Hospital on Rochestown Avenue, which we got a chance to view. All of these hospitals are supported by the work of practitioners in the community, from GPs, community nurses and meals-on-wheels providers to home care assistants, pharmacists and, of course, carers. We are all grateful for their efforts.

I thank the Minister for his update today and look forward to the response.

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