Louise O'Reilly (Dublin Fingal, Sinn Fein)
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2. To ask the Minister for Health if his attention has been drawn to the increased incidence of assaults on staff in the health service, if reports have been conducted into the issue of assaults, the measures taken to protect staff and if he will make a statement on the matter. [16981/18]

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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Unlike Deputy Donnelly, the Minister and I tend to disagree quite a lot but I think we can all agree that there is a recruitment and retention crisis in our health service. I have said this many times. I believe this Government, the previous Government and even the one before that have made our health service a very unattractive place in which to work. We now see that our health service is becoming an increasingly dangerous place for healthcare professionals. This is contributing to the recruitment and retention crisis. It is making it worse because not only do we have unattractive pay, conditions and places in which to work, we now have unsafe places in which to work. My question is very simple. Is the Minister aware of the increase in assaults and will he do anything about it?

Simon Harris (Wicklow, Fine Gael)
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I do not think Deputy O'Reilly and I disagree on quite as many things as we like to think. I know it is very important that we stress those differences but in respect of recruitment and retention, I certainly agree with her that this is a challenging area. As she is aware, the Public Service Pay Commission is doing a body of work. I know the unions and representative bodies have fed into that process and I hope it is helpful in coming up with new strategies regarding how we recruit and retain nurses and indeed other healthcare professionals, including doctors, in this country.

The Deputy's question is extremely important and timely. Whatever else we disagree on, I am sure this is something on which everybody in this House can agree because the safety of all those who work in our health service is of paramount importance. Obviously, it is a complex issue as those being cared for may not always have the capacity to be responsible for the actions they carry out. That is a reality. In terms of the number of assaults reported, I understand better data is now emerging from the national incident management system, which was introduced in 2015.

I understand that 4,769 physical assault incidents by patients on staff were recorded in 2016. The number for 2017 was 3,610. These figures would seem to indicate that the number of assaults had reduced but it is still a very high level. In the longer term, the HSE anticipates that the number of recorded incidents will rise as the new system becomes further embedded and better data is available to us. The HSE continues to encourage reporting of all incidents, regardless of the level of harm, if any, so that we have very accurate data. Safety in the workplace has received considerable attention and focus from the HSE. A national strategy for the management of aggression and violence throughout the health service is in place.

The HSE also has a policy on the management of work-related aggression and violence and a policy on lone working. A detailed frequently asked questions document on work-related aggression and violence is also available to all staff. Management and staff receive training to equip them with the necessary skills and knowledge to recognise risks associated with aggressive or violent behaviours and the safety measures that can reduce or minimise these risks. Much is being done by the HSE to address this complex issue and ensure the safety of its staff in a balanced and cohesive way.

I also want to tell the House that a security review is being undertaken in our health service. Recommendations are being implemented and we are looking to grow the security presence and make sure there is appropriate security in or nearby our emergency departments, which I know is also a cause of concern. No staff member should ever have to work in an emergency department under threat of violence or assault, verbal or otherwise, and we need to do more in that regard.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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That is a fine statement but they are working under the threat of violence currently. I am glad the Minister says it is not acceptable and that a national strategy exists. He says that security staff will be in accident and emergency departments or nearby. They need to be in accident and emergency departments. Nearby is not good enough. Staff are very well trained. They know how to recognise assaults. Notwithstanding the fact that our staff are trained to the very highest level, from January 2011 to July 2016, assaults increased by 65% from 673 to 3,462. This is a figure of 34 nurses and midwives per month. These are the people we are desperate to keep within our health service. They are the lifeblood of the health service and the people without whom we cannot deliver health services and we are putting them in a situation where it is dangerous for them to go to work. Will the Minister commit to increasing security in our hospitals for the benefit of the staff - not near our hospitals or where the assaults are happening but where the assaults are happening? The physical presence of a security guard is a great deterrent. Our staff are well trained and know how to recognise when an assault is imminent. They are working in intolerable conditions and are short staffed. The Minister cannot deny that. In that atmosphere, assaults are increasing day on day. Can the Minister commit to putting a security guard into every single accident and emergency department?

Simon Harris (Wicklow, Fine Gael)
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I can commit to increasing security in our emergency departments. Sorry, I thought that was what the Deputy asked.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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Putting a security presence into accident and emergency departments.

Simon Harris (Wicklow, Fine Gael)
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I believe that has already been agreed through the emergency department agreement negotiated with my predecessor in 2014. I have discussed this with the INMO and have made it very clear to it and the HSE that this needs to be addressed. When the INMO pointed out to me areas where it did not believe this to be the case, I asked the HSE to take action. I want staff in all our hospitals to be safe - we all do - and we will increase security presences where that is appropriate and necessary. The figures I put on the record of the House are the first available figures through the State Claims Agency, which has only been measuring this since 2015. I want to break down some of those figures. In 2016, 965 of the recorded incidents of assaults by patients on staff were in mental health units. This rose to 1,478 in 2017. Overall, we have seen the number of assaults decrease in our health service but we have seen the number of assaults in mental health services increase. They now account for roughly 40% of reported assaults. The HSE does believe that a significant amount of this increase in mental health reporting is due to improved reporting so it involves having the data. Mental health services have a very proactive lead for quality and service user safety. We have put a number of schemes in place to support staff who find themselves in these unacceptable situations.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The rate of staff turnover for nurses and midwives is 7.9%. This should not be the case. It should be a career for life and somewhere people want to work and stay because we really need them to stay but the workplaces are unsafe. It is regrettable that there are accident and emergency departments where staff are exposed to a level of risk and do not have a security presence. The Minister uses the phrase "in or nearby". That is not good enough. Whether or not we say assaults may have decreased slightly or we include or exclude mental health, the fact is that there is an unacceptably high level of assaults against front-line staff. They are bearing the brunt of staff shortages and all that goes along with that. The physical presence of a security guard in an accident and emergency department is an active deterrent. I can tell the Minister this because I have also spoken to the INMO and health service unions. That is not happening and it needs to happen. We need a commitment to ensure that this will happen in every single emergency department.

Simon Harris (Wicklow, Fine Gael)
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I take what the Deputy said very seriously. This is a very important matter. The safety of staff in our emergency departments, which is an area on which she wishes me to focus with regard to this question, should be of paramount importance. I will get a report from the HSE about all our emergency departments. Where they have security staff within the emergency department, I will share that information with the Deputy and other health spokespeople in this House and will commit to engaging with the INMO and the HSE to make sure there is security staff in all emergency departments. I will revert to the Deputy when I have that information.