John Connolly (Galway West, Fianna Fail)

The healthcare sector is one sector of our public service that relies heavily on attracting and recruiting practitioners and staff internationally. In 2024, 6,000 of the 17,000 critical skills permits provided by the State were in the health or social work sectors, 5,031 of which were for nursing staff. In 2023, the OECD said that 54% of nurses working in Ireland had trained in other jurisdictions. The equivalent figure in the UK was 18%. I harbour a guess that many of them are probably Irish. I arrive at two conclusions from this. First, we are not training an adequate number of healthcare professionals, in particular practitioners and particularly nurses. Second, nurses particularly are choosing post qualification to seek opportunities in countries other than Ireland. Both of these conclusions need to be interrogated.

I will start with Deputy Sherlock's questions on the patient safety (licensing) Bill and cervical cancer screening. The patient safety (licensing) Bill came through Cabinet today and the Minister can go through the details with the Deputy in due course, in terms of specifics on safe numbers, safe staffing and so forth. A lot of it has been introduced without legislation in accordance with agreements. The Minister will continue to resource the cervical cancer programme and other cancer screening programmes. It is important to say screening programmes are the first stage. They are population screening programmes designed to intervene early and identify but they are not the ultimate in diagnostic approaches. If people present with symptoms, they may need more detailed diagnostic assessment. We have to get the balance right. The public needs very clear information on screening programmes and what they can achieve and on the importance of always consulting a GP or consultant. That is extremely important because there are limits to screening programmes. There are calls to expand the number of screening programmes in different areas. We have made a lot of progress on cervical cancer screening because of new technology and new methodology but we are open to improving further and engaging with the various groupings to see what issues have been identified as problematic and how they can be improved. I will talk to the Minister for Health about that.

Deputies Daly and Cahill raised the shingles vaccine. My understanding is it is a significantly expensive vaccine. I am struck by the research Deputy Daly cited regarding its impact on the risk of dementia. A figure as high as 20% is very significant. He said the research was published recently in Nature so I will talk to the Minister for Health about that. Generally, I am a supporter of vaccines. As a public health intervention, they have been extremely effective in the history of this country. People are not dying of what people died from 100 years ago any more, primarily because of the successful introduction of vaccines to deal with a lot of infectious diseases. That is easily forgotten in modern discourse and debates. The Covid-19 vaccine was essential to society coming back to some degree of normality. Without that vaccine, we would still be in deep trouble. It is important to state that. I will go to the Minister in respect of that.

Deputy O'Rourke raised CHI. Every family must be told whether their child required surgery. There has to be complete transparency from CHI in respect of that. There has to be diligent follow-up with all concerned, as it declared. We will ensure that happens. I will talk to the Minister on engaging with CHI on that issue.

Deputy Coppinger raised CHI, again, and the issue relating to young boys. That is a very serious issue, which needs to be addressed transparently and comprehensively by CHI. The HSE and the Department of Health should be involved in respect of that issue. The Dickson report from 2017 on urology services in CHI proposed the consolidation of all paediatric urology services into a single, cohesive centre, the establishment of a multidisciplinary urology team and so forth. That key issue needs to be further examined in light of that report. The issues the Deputy has identified should have been disclosed earlier.

That is a very good agreement between the HSE and the unions. Healthcare staff numbers have risen enormously in the past four to five years with 30,000 extra. We cannot keep on saying, "Let's get another couple of thousand." There has to be a balance.

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