Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Deputy Martin Ferris and I raise the issue of the absence of nursing and medical support for the residents of the island of Inishturk off the County Mayo coast. Inishturk Island has a population of 58. When the resident nurse retired plenty of notice was given but no replacement was recruited to replace her. The island does not currently have a nurse and despite a promise of weekly visits, only three such visits have taken place since last September.

The population of Inishturk Island has the same health concerns that affect everyone living on the mainland. Some residents have contracted influenza, one woman is pregnant and many other islanders are elderly. They have been informed that a nurse has been recruited to the vacant position but certain paperwork remains outstanding. When will the appointee be in situ? As Inishturk is nine miles offshore, its population has great concerns that an emergency may present. The state-of-the-art health centre on the island is locked up and residents do not have access to the defibrillator located in the centre in the event of a cardiac emergency presenting.

I urge the Minister to ensure the population of Inishturk is provided with this most essential support in the interest of their ongoing health concerns.

Martin Ferris (Kerry North-West Limerick, Sinn Fein)
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As Deputy Ó Caoláin stated, Inishturk Island has 58 inhabitants, most of whom are elderly, with the age ranging from nine to 97 years. The island does not have a public health nurse. One of the residents is pregnant and a number of others suffer from diabetes and heart problems. The island also has a state-of-the-art medical centre. The resident nurse retired in September 2014 and the Health Service Executive was informed of the forthcoming retirement in December 2013. Since the nurse's retirement in September last, a public health nurse has made three visits to the island. Last week, the residents were told it was hoped to have a nurse in place shortly. While a replacement was recruited in November, the Health Service Executive is awaiting vetting clearance and so forth.

Deputy Gerry Adams received a reply on 3 February 2014 which stated the HSE was in the process of recruiting a nurse to cover Inishturk Island due to a retirement. It noted that while the process was taking place, the island would be covered on a whole-time basis. This letter was received almost 12 months ago, yet the issue has still not been addressed. It is an indictment of the health service that people living on an island nine miles off the coast are dependent on emergency services if they require medical attention.

It is Government policy that islands must be afforded health services on a par with their counterparts on the mainland. It is obvious that Inishturk Island is being discriminated against through the failure since September 2014 to implement that policy. It is a disgrace that any system would allow 58 people to have no medical cover or assistance.

Kathleen Lynch (Cork North Central, Labour)
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Deputy Ferris will have to find different language to describe this issue because the word "disgrace" should not be used in this context. While I agree that people living in an exposed and isolated area deserve the same type of health service as everyone else in the community, the issue the Deputies raise is not the result of a deliberate action. Given the difficulty being experienced in recruiting nurses in large towns and cities, recruiting a nurse for an isolated area, as beautiful as Inishturk may be, clearly will present a difficulty.

The delivery of a sustainable community nursing service which effectively meets the health needs of the population in a primary care setting is the principal aim of the Health Service Executive's public health nursing service. The nursing post on Inishturk Island became vacant recently when the island's nurse retired. The HSE has advised that there are no service or budget reduction elements relating to this issue. Finding a suitably qualified candidate who wanted to live and work on Inishturk was a significant challenge. A nurse has been recruited to take up the position and the successful candidate is undergoing pre-employment checks. As part of this process, the appointed nurse must obtain occupational health clearances. As soon as these have been completed, the nurse will be in a position to take up the appointment.

No one, including the two Deputies opposite, would suggest that a person, however qualified, should be allowed to work in a community without pre-employment checks first being carried out. While waiting on the new nurse to take up her position, residents have been advised to contact their general practitioner directly if they have any health issues. I am sure they will have done this as a matter of course.

I will check the position regarding the weekly visits the Deputies indicated had been promised. The HSE is conscious of the need to provide appropriate health services for island communities. In this regard, it has committed in its 2015 operational plan to conduct a review of primary care island services, with a completion timeframe of the second quarter of 2015. Plans are in train to develop terms of reference and to establish a working group to proceed with this.

With transport and communications improving, I hope people will move to more isolated islands and residents will have more children. This will require a different response. I am conscious of the issues that arise and thank the Deputies for raising the matter. The news concerning a nurse for Inishturk Island is good. That a nurse has not beenin situ before now was not intentional.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The Minister of State referred to residents being advised to contact their general practitioner directly if they have any health issues. Inishturk Island does not have a general practitioner.

Kathleen Lynch (Cork North Central, Labour)
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I may not have a GP living with me but I can still contact one.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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With respect, the Minister of State is not living nine miles offshore on an island in the Atlantic. When she refers to people contacting a general practitioner directly, she should note that they are dependent on other means of communication. It is not quite the same as the access she and I enjoy living on the mainland. Her answer is not adequate.

On pre-employment checks, when was the successful person identified and how long will the pre-employment checks take? When will a final decision be taken on the suitability of the new recruit to take up this opportunity on Inishturk Island?

In the interim, the services of a nurse from the adjacent Clare Island were to be used and she was to visit Inishturk Island weekly. Is that the case as this information does not correspond with the information available to us? We have been informed that only three visits have taken place since last September. Will the Minister of State clarify whether these visits are taking place weekly? The concerns raised are understandable given the circumstances Deputy Martin Ferris and I have described, including the age profile of residents, the presence of a pregnant woman on the island and the fact that islanders are no more immune to influenza than the rest of us, wherever we may live. Will the Minister indicate precisely when it is hoped the nurse will take up duties?

Martin Ferris (Kerry North-West Limerick, Sinn Fein)
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As someone who comes from a coastal community, I am well acquainted with islands and the logistics associated with trying to get medical care onto them, particularly in poor weather conditions.

The importance of having somebody present on the island in the case of emergency cannot be overstated.

What I find very disturbing is the reply from the HSE in Castlebar. This dates back to December 2013. When the HSE was approached about having a nurse in place, the residents' representative, Ms Mary Heanue, the co-ordinator on Inishturk, was told clearly that a nurse was not needed as there was no one in need of dressing full-time, there were no pregnant ladies on the island and there was nobody who needed injections. The HSE also made reference to the fact it did not have the resources necessary, whether it be personnel or otherwise, to fill the vacuum.

In November 2014 a nurse was recruited and is being vetted, which means, as we are almost into February, that it has taken four months to complete the recruitment. It is inexcusable that there is nobody in place yet. I am not blaming the Minister of State for this. At the end of the day, the ability of the HSE to provide medical care for people in need leaves an awful lot to be desired, in particular for those living in rural areas.

Kathleen Lynch (Cork North Central, Labour)
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I want to read again from my initial reply as I do not know if people deliberately misunderstand or refuse to hear. I said the HSE had advised that there were no service or budget reduction elements relating to this issue. The nurse was recruited. It was a difficult process and I understand that difficulty because we have had a similar difficulty in looking for nurses in areas in which there has been major development. The pre-employment checks that need to be made in the case of every person employed in the medical profession are good. Yes, they take time, but it is important that they happen.

I am not certain about this nurse's personal circumstances, but it may, for example, be someone who was living abroad. What I am certain of is that a nurse has been recruited and it will be a great relief to the HSE, me and, I assume, the people of Inishturk to have someone available to them 24-7. That is what is of central importance and it will and is happening. While I do not have the information on the starting date sought by Deputy Caoimhghín Ó Caoláin, I will send it to him.