Anthony Lawlor (Kildare North, Fine Gael)
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I thank the Ceann Comhairle's office for allowing this topic to be selected and appreciate that the Minister for Health is here to address it.

Just before Christmas, there was a short strike by staff at Naas hospital regarding the number of staff in the hospital. I welcomed the Minister's announcement in February that the recruitment ban on nursing staff was to be lifted. In particular, I was glad to hear that Naas hospital was going to get 37 extra nursing staff as a result of that recruitment. As of Monday, one of those new staff members has been recruited in Naas General Hospital. There are 36 who have not yet been appointed.

The National Recruitment Service, NRS, was established in 2009, when there was a recruitment ban in place across the public sector. One wonders at the purpose of the NRS being established at that time as a centralised means of recruiting health service personnel. A certain number of health service personnel would have been recruited by it over the intervening period on an emergency basis. Since the lifting of the embargo, particularly in respect of front-line staff, I have found it difficult to explain how the Minister could make an announcement in February, yet only one staff member has been allocated so far.

The NRS told me it allowed the staff to be recruited locally. "Alleluia", I thought. I thought Naas General Hospital itself was going to be recruiting but no, that is not the case. The staff are now being recruited in Tullamore, which was the centre for recruitment in the former midland hospital board area. From what I can gather, the staff in Tullamore, who would not have had much experience of recruitment over the last six or seven years, are now being inundated, as the NRS has pushed this out to the various old boards that used to exist.

It is important that we get the staff in Naas hospital as quickly as possible, as is the case for any other staff that have to be allocated. I know there are other issues, and candidates going for interview should have all their appropriate qualifications available to show to recruiters. We are in a crisis situation and it is a different type of crisis from the one in 2009, when we could not recruit staff. Now we can recruit staff.

We are going to be actively recruiting staff in the UK who will come back to work here. We should have one organisation that will do it all and take responsibility for it rather than the haphazard approach that seems to be taken at the moment. As I said earlier, I thought Naas hospital would do the recruiting itself but the recruitment has actually been through the old health board HR offices in Tullamore.

I hope the Minister can give me some assurance that we will have a speedier approach with regard to recruiting staff. This week there was a spike in the number of people on trolleys at Naas hospital and across the whole hospital sector, and hospital staff are under fierce pressure. If I knew that could be alleviated through additional staff being allocated and put in place as quickly as possible, I would appreciate it.

Leo Varadkar (Dublin West, Fine Gael)
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I thank Deputy Lawlor for raising this issue. The national recruitment service, NRS, is actively recruiting hospital staff, in particular for HSE hospitals. Voluntary hospitals tend to do their own recruitment. The NRS was established to deliver high quality, cost effective recruitment through a shared service model in line with Government policy. To date, the NRS provides the full recruitment service for all areas of the HSE, with the exception of non-consultant hospital doctors and home helps.

The NRS carries out recruitment for vacancies that have been approved for filling. Some 1,063 posts in the acute hospital sector were filled in 2014, of which two thirds were nursing posts. From January 2015 to date, 529 posts have been filled in the acute hospital sector, of which almost half are nursing posts. There are currently 1,687 posts in the process of being filled in the hospital sector, of which 914 are nursing posts. As the Deputy can see, a lot of recruitment is under way. In local services, 115 nurses have been appointed and 403 nursing appointments are being processed locally.

A significant number of panels have been created for disciplines within the acute hospital sector, including national panels for staff nurses and allied health professionals such as therapists and audiologists, and bespoke panels for posts such as clinical nurse specialists, pharmacists and medical scientists. Jobs are being offered directly to people on these panels, thus reducing the time period for appointment to a post. A high profile national campaign to recruit nurses and midwives is in operation. This includes national and local interviewing of general nurses, registered children's nurses and midwives. The HSE has also established an international recruitment steering group to focus on attracting and recruiting Irish trained nurses back home to practice and build their careers.

In terms of consultant recruitment, 38 hospital consultant posts were filled in 2014 in HSE hospitals and 36 have been filled this year, so, in the first half of this year, we have recruited almost as many as in all of last year. Ongoing recruitment of 193 consultant posts is in progress and this is carried out in conjunction with the Public Appointments Service. Further appointments have been made in the voluntary hospitals and non-acute settings.

There are some specialties in which there are international shortages and which have been traditionally difficult to fill, regardless of the salary scale. Shortages in specialties such as emergency medicine, anaesthesia and psychiatry are a worldwide phenomenon and not specific to the Irish health service. There are also some hospitals to which it has been historically difficult to attract applicants, in particular small hospitals which are not recognised for training and continuous development, CD, purposes. The establishment of hospital groups will help to address this issue, as it will allow staff to be appointed to the group rather than one hospital.

Finally, where recruitment difficulties apply, individual strategies are developed for these in conjunction with the line managers. Where front-line staffing shortages exist, the HSE makes alternative arrangements to ensure continued service provision, including recourse to agency cover. However, it is preferable that sufficient numbers of doctors and nurses are recruited to permanent posts to support continuity of care.

In regard to Naas specifically, I am told the hospital has 37 active nursing posts it is trying to recruit for at the moment. This comprises four promotional posts, which are at campaign stage, two posts that are at job offer stage and one post at contract stage. Thirty staff nurse posts are being processed locally, which means the posts are being interviewed locally, offered locally and the clearances and the contacts are being dealt with locally. The NRS is not processing these posts. Local HR at Naas General Hospital has advised that it is actively appointing these posts in partnership with the director of nursing. In most cases, it is waiting for the return of documentation from candidates and this documentation is necessary to appoint candidates. It should also be recognised that some candidates may be offered posts elsewhere and might take those posts, which means starting the whole process again. Local HR is actively following up with candidates in this regard in order to ensure the posts are filled as soon as possible.

It is news to me that it is being done through Tullamore. As the Deputy knows, Tullamore was the centre of the old Midland Health Board. To the best of my recollection, Naas was in the Eastern Health Board and was part of the South Western Area Health Board, so I cannot imagine why it would be done through Tullamore. I will certainly have that checked out.

Anthony Lawlor (Kildare North, Fine Gael)
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I can verify, from both Naas hospital and the NRS, that it is being done. I understand the delays can sometimes be caused by the need to get Garda clearance and there might not be enough staff in the NRS to be able to recruit the correct numbers as quickly as possible. I might make a suggestion to the Minister, given he spoke about allocating staff to groups. Why not hire the staff through the HR department within a group, as this might be more beneficial and would be much more targeted, rather than having an over-arching body which is recruiting from all parts of the country and outside the country? The group itself could identify candidates. There is a CEO and a management structure in each group, and I am sure there is a HR department. Why should the HR departments within each group not recruit locally?

Another difficulty is that the voluntary hospitals are allowed to recruit. It is one HSE and all staff are paid through the one body. Why should there be preferential treatment for voluntary hospitals as against the non-voluntary hospitals such as Naas hospital? If we are working in a group system, let us have the recruitment on a group basis and not give priority to one hospital over the other.

I hope any staff who are going forward for interview would present as much of the documentation as possible so there is not this delay later on. I know we are in a situation where staff do not know if they will get permanent posts in the new recruitment process. I hope that, as this works its way through, it will be speeded up. We are at a sort of crisis point at the moment, as I see on a daily basis with people on trolleys at Naas Hospital and at other hospitals around the country. At the same time, there is potential for us to recruit the staff. I welcome that the Minister has given sanction for these staff and I appreciate his comments. However, I ask that the groups be able to hire separately from the NRS.

Leo Varadkar (Dublin West, Fine Gael)
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I make three points. The first is that we are in a very different situation this year than we were for the last three or four years. The last three or four years were all about not recruiting and not filling vacancies and now, all of a sudden, the NRS has been told to recruit lots of people very quickly. It is a struggle to turn around from being an organisation that was about staff retrenchment to being one that is now about recruitment. However, we have 1,000 more people working in our health service today than we had this time last year, so it is happening, albeit not quickly enough.

Second, it is my intention to allow the groups to recruit in the medium term. That is difficult at present, for one very obvious reason, namely, the groups do not exist as legal entities; they are administrative bodies and do not exist in law and, therefore, cannot be employers. That is in stark contrast to the voluntary hospitals, which do exist in law and can be employers. If one works in a voluntary hospital like St. Vincent's or the Mater, one is not an employee of the HSE but an employee of St. Vincent's or the Mater, whereas an employee at Naas is an employee of the HSE. That is a complication that, as the Deputy will have noticed, is making the newspapers in various different ways in the last while.

Third, one downside of going back to allowing the groups to recruit is that we then go back to one of the problems that caused the NRS to be set up in the first place. Before the NRS was set up, people would go around doing interviews in four or five different health boards, and 6,000 to 7,000 days were lost every year with people doing one interview in the Southern Health Board, then one in the Midland Health Board and then one in the Western Health Board. When recruitment was centralised, the number of days lost to people doing interviews was reduced by 70%. One of the downsides of bringing that back and allowing local and group recruitment is that many more people will be looking for time off either to do interviews or to be on interview panels. We would have to bear that in mind given the impact it would have on patient care.