Louise O'Reilly (Dublin Fingal, Sinn Fein)
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28. To ask the Minister for Health the steps that have been taken to implement the recommendations of an expert group report in August 2016 which called for additional nursing posts to be created and filled to look after all admitted patients in emergency departments and extra patients on wards; the steps that have been taken to secure and retain nursing positions that have been advertised; and if he will make a statement on the matter. [4858/17]

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The question is about staffing in emergency departments, which is a frequent issue and one which I am sure the Minister is looking forward to debating.

Simon Harris (Wicklow, Fine Gael)
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The report of the emergency department expert group identified a need to take on additional nurses to care for boarded patients awaiting admission from emergency departments. This is particularly where the number of patients awaiting admission occupy over 50% of the emergency department cubicle capacity for the hospital concerned. Having regard to the formula set out in the report for calculating the required nursing complement, an additional 107 nursing and midwifery posts are to be created and filled to look after all admitted patients in emergency departments. The group also recommended that nursing numbers in emergency departments are brought to their full agreed staffing levels.

There are many initiatives currently under way to improve staffing levels throughout the country. The number in nursing and midwifery increased by 1,650 between December 2013 and December 2016.

The HSE is offering permanent posts to 2016 degree programme graduates, and full time permanent contracts to those in temporary posts. The HSE is also focused on converting agency staffing to permanent posts. Its national recruitment service is actively operating rolling nursing recruitment campaigns. The campaigns encompass general, mental health, intellectual disability, registered children's nurses and also midwives. The acute hospital groups have advertised a number of emergency department nursing posts and are currently in the recruitment process. Of the 144 emergency department nursing posts that were identified as vacant, half have been filled to date.

The HSE ran a three-day open recruitment event over the Christmas holiday period in Dr. Steevens’ Hospital, which I was pleased to attend, for nurses and midwives from all disciplines who are interested in working in the Irish public health service. Some 220 people attended the event. Some 115 nursing and midwifery candidates were deemed successful following interview. This event will be followed by a series of career events for nurses throughout 2017 with the next one scheduled for 31 March 2017.

A relocation package of up to €1,500 continues to be available to nurses who return from overseas. These campaigns and others that are in the process of being developed will be used to fill the remaining vacant emergency department posts and the additional 107 posts that are to be filled. We remain absolutely committed to filling these posts. The Deputy will also be aware that we are currently in conversations about these very issues with the IMNO and SIPTU.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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That was a comprehensive and eloquent answer to a question I did not ask. I specifically asked about the 107 posts that were identified. Regrettably, we have all become used to accident and emergency department overcrowding. The staff, God love them, have to put up with it on a daily basis. Whatever plans this Government or the previous one had to deal with trolley numbers, they are now escalating out of control. I heard An Taoiseach contradict the figures as to whether it is 400 or 600, but those 107 nurses are specifically needed.

Last week, we questioned the HSE and they advised us that the budget was not there when they consulted with the Department of Health for 107 nurses who are designated to nurse patients on trolleys. This is effectively a signal that the Department has given up and is accepting that trolleys are a reality. Whatever the Minister is doing is not working. Some 107 nurses are required in order to cope. Can the Minister respond to the HSE's claim that the Department did not fund those 107 nursing posts?

Simon Harris (Wicklow, Fine Gael)
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The intention is to recruit 1,000 additional nurses this year. That was announced on budget day. The details of that will be worked out among the operational plans for each of the hospital groups. The process is under way and will conclude shortly for the individual budgets for each hospital. We do need to grow nursing numbers and I am not disputing that with the Deputy whatsoever. We do need to have more nurses working in our emergency departments. We are having an intensive engagement with the INMO and SIPTU on recruitment and retention. Given the Deputy's own background, she will understand the sensitivity of discussing that process now. However, these issues are being actively discussed and considered at the moment through an intensive engagement with the INMO and SIPTU. I hope we can make progress on that.

In talking about beds and trolleys, it is important to note that the issue is not just in emergency departments, but throughout hospitals. The fact that we have closed 104 hospital beds due to staff shortages indicates that recruitment and lack of nurses is actively causing pressures within our emergency departments. If we want to clear what is a vicious cycle in the trolley situation, which now happens annually - there are similar pressures in Britain and Northern Ireland - bed capacity, recruitment and a real move to primary care, which includes a new GP contract, are the three fundamental aspects that need to be addressed. We are committed to recruiting and have already filled half the vacant posts in emergency departments. We are committed to filling the rest of them and want to see the 107 nursing posts filled also. We are actively engaging with the INMO and SIPTU on that.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The HSE personnel were clear with us when they said that funding was not available or forthcoming from the Department for the 107 additional posts that are required. Let us be clear, they are required to nurse the people who are on trolleys.

Simon Harris (Wicklow, Fine Gael)
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True.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The fact that people are on trolleys is a failure of Government policy, and nobody could dispute that. The HSE said, however, that there is no budget for those 107 nurses. What does the Minister say to the man or woman standing beside their elderly relative this evening who is on a trolley or in a chair in an accident and emergency department? It was agreed that 107 nurses is the absolute minimum number needed to nurse those people on trolleys. Let's give up and accept that trolleys are going to be a reality for as long as they are needed, but let us try to provide a basic minimum level of staffing. Can the Minister confirm that the budget is there for those 107 nurses? Or can he confirm that it is not? The HSE personnel were very clear with us in stating that when they went to the Department of Health that budget was not there.

Simon Harris (Wicklow, Fine Gael)
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What I am clear about is that the budget is there to increase nursing numbers by 1,000 in 2017. That is what we funded for in the budget. How that is done is now a matter for the HSE in its operational plan. I am also clear that recruitment and retention of nurses is a key issue that needs to be resolved. I hear many doctors going on the radio saying that if one wants to end trolleys in emergency departments - which we have all wanted to do for decades, yet successive governments have failed to do it - we need more beds. I agree that we need more beds. It is not much good having the beds if they are closed because there are not enough nurses and other staff to open them.

There are 105 beds closed in the health service today due to staffing shortages. I fully accept that bed capacity and the ability to open extra beds is linked to the recruitment and retention of nurses, which in turn is linked to easing pressures on our emergency departments. That is why we have provided funding for 1,000 new nurses this year. It is a matter for the HSE to allocate how it wishes to do that. That is why we are actively involved today in discussions with the INMO and SIPTU. I will keep the House abreast of those discussions.