Emer Higgins (Dublin Mid West, Fine Gael) | Oireachtas source

I am glad to contribute to this debate. As a Dublin Deputy, staffing levels in the hospitals in our capital are a massive concern to me and my constituents. This is because they are far from safe. I know of one hospital whose accident and emergency department has almost 50 nursing vacancies and where, when there should be 18 nurses working on any given day, there is often half that number. As few as nine nurses sometimes run the accident and emergency department. On a good day, that number might increase to 11.

This continuous understaffing has become the norm for people in these hospitals, which is leading some healthcare professionals to feel sick at the thought of having to go to work and face another shift in appalling working conditions and then dreading the day when they themselves actually feel sick and have to call in sick. We all know politics can be a stressful job but it does not begin to compare with the stresses facing our healthcare workers right now.

My main concern, which I know is shared by many nurses, doctors and healthcare staff, is safety. Healthcare settings are simply not safe. They are not safe for patients or staff. The fact that more accidents and deaths do not occur is a credit to the staff in our hospitals but the point is that staff and patients should not be in that position. Patients should not be waiting up to 20 hours to see a doctor and hospital staff should not be pushed to their limits day after day. Staff should not have to put up with unsafe working environments. It is not sustainable and we all know it contributes to the numbers leaving the profession.

Travelling and seeing the world is a very common career move for young people in general, including young people in healthcare professions. However, whereas every year, there is usually a group leaving and a group coming back to balance that out, all of the people who were prevented from travelling in the past couple of years due to Covid are now leaving and this is compounding an already worrying problem. They are not necessarily leaving for Australia, New Zealand or Dubai. In many cases, staff are leaving just to go to tertiary hospitals outside Dublin where conditions and staff levels in some cases are better. We are losing senior nurses and doctors in our major hospitals to burnout.

One thing we can do to boost staffing numbers and support staff is to iron out existing visa delays.

We have large numbers of healthcare staff who are looking to come to work in Ireland but many are being delayed by visa issues. I am in favour of prioritising those people for visa decisions given the major shortage we are facing in healthcare in our front-line workers. For a long time our health system has relied on nurses, doctors and other healthcare professionals from outside Ireland to keep us functioning. Our hospitals would not survive without these people. We need to ensure that process of applying to live in Ireland and work in our health service is as quick and seamless as possible.

We also cannot ignore the impact of housing. There is no sector that is not impacted by the cost and shortage of housing. That is particularly acute in Dublin. Healthcare professionals I meet say that colleagues outside Dublin and from rural Ireland are leaving in their droves to move back home because they as if one is not from Dublin what is the incentive to stay here. If they could work in a smaller hospital in a more rural area where housing is cheaper than Dublin why would they not do that? That applies to people coming from abroad to work here too. Many foreign nationals coming to work in the health service stay in Dublin for the length of time that they are contractually obliged to. It is usually a couple of years. Once that is done, because they have no ties to Dublin, they move on to somewhere else. We need an incentive to keep our healthcare workers in our capital city whether it is a Dublin grant or bursary towards housing. We need to look at it because the cost of housing in Dublin and the staffing issues in our busy city hospitals are incentivising no one.

We also see it on the ground. We see it in Newcastle and Lucan in particular where there is a lack of service due to a lack of public health nurses in my community. That is impacting families of young children, and babies in particular. In my community, there is also a shortage of GPs. I know we have invested in recruiting more GPs and in more GP college places but we need to incentivise more GPs to establish practices in our community.

While there is really significant investment planned, and ongoing in some places, in primary care centres in Dublin Mid West, Lucan Esker and Lucan village are being underserved and they need proper primary care centres with access to all of the primary care services.

The number of people presenting to hospitals is back to well above pre-Covid levels. It is fair to say that in many hospitals staff morale is at an all-time low. While they continue to provide the best care they can, the stress and the burnout is unsustainable. In many cases it is looming. That will not change until staffing is at a safer level and conditions are improved. That is what we as a Government need to prioritise.

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