Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I am sharing time with the Minister of State, Deputy Butler. Today, which is International Nurses Day, I would like to recognise the presence in the Public Gallery of Caroline Gourley, president, and Phil Ní Sheaghdha, general secretary, from the Irish Nurses and Midwives Organisation, INMO. Ms Ní Sheaghdha has been president of Irish Congress of Trade Unions since last July. I congratulate here on that. I understand that we also have in attendance the CEO of the Nurses and Midwifery Board of Ireland, NMBI, Caroline Donoghue, and that organisation's president, Áine Lynch. They are very welcome here to join myself and other Members in marking International Nurses Day. This is an occasion recognised around the world to honour the professionalism, commitment and vital contribution of nurses to our health services and to society as a whole.

The them for this year's International Nurses Day, "Our Nurses, Our Future. Empowered Nurses Save Lives", is a powerful and timely message. It is also reflected in this Government’s clear objectives to deliver structural reform that supports a sustainable supply of nurses to meet population health demands and support improved working conditions. The Government is committed to supporting innovation, a range of career opportunities and strong professional governance and leadership. Nurses have demonstrated that they can and want to work to the very top of their training, and we need that. This is essential for patient safety and a sustainable health system into the future. I want to reflect honestly on the challenges nurses face as we try to get to that.

I am aware of the recent INMO survey that indicates a high level of burn-out, stress and increasing violence and aggression in the workplace. While these issues are not specific to Ireland or to nursing here, nurses and midwives, as the largest workforce, are disproportionately affected. This poses a greater risk to staff well-being, workforce retention, and the delivery of safe patient care. Nursing is the largest professional group within our health system. Simply put, the breadth and depth of healthcare, working across every care setting. At every stage of life, and at moments of greatest vulnerability, nurses are often the first point of contact and most enduring point of contact for patients. They provide highly skilled care, lead with strong clinical judgment and deliver care with compassion that ensures patients, families and service users remain at the centre of the work they do. I would like to take this opportunity to formally acknowledge and extend my thanks to nurses in every service right across the country. I have seen first hand their leadership, professionalism, skill and commitment to the health and well-being of patients and all of our service users.

It is important to acknowledge the significant progress that has been made in Irish nursing over recent years. My Department is the great beneficiary of the work of the chief nursing officer and her team in the Department, who are leading on nursing policy solutions for the health service. I would like to make people aware of the integration of the nursing team into the Department. It is a mixed team of professionals and civil servants. Our chief nursing officer is Rachel Kenna. Her deputies are Karen Greene, who was the director of nursing in Beaumont Hospital, Kelly Mofflin, who was previously director of nursing and mental health nursing, and Gráinne Sheehan, who was previously a nurse specialist in cancer care. They are supported by nursing project officers Úna Rogers from midwifery, Claire Townsend and Tara Mulleary, who are public health nurses, and Helen Carlin, who works in the area of renal nursing. They are supported by a team of civil servants. I mention this in order that Deputies will have a full sense of the integration of nursing into the Department of Health and the importance we place on that within the Department, leading on nursing policy solutions for the whole healthcare system. That has delivered not only a well-developed national nursing workforce, but also one that is highly regarded internationally. Significant investment in nursing has enabled a more sustainable, highly skilled and motivated workforce in line with Government commitments. That is very much in partnership with nursing representative organisations and every single nurse working in the Irish State.

Nursing in Ireland is a progressive, well regulated and forward-looking profession. Nurses are trained at undergraduate level in general, mental health, intellectual disability and children’s nursing, enabling that system-wide contribution from the outset. This strong focus on education is clearly reflected in the recent review of undergraduate nursing education. This not only sets out the commitment to modernising practice, but the education reforms that reflect the future health care environment graduates will be working in. It has considered digitally enabled care, universal healthcare and integrated services. From 2027 onwards, students will spend substantially more time training in community settings, supporting early career pathways in community care and acting as a key enabler of Sláintecare delivery. I want to acknowledge how nurses and midwives work in an integrated way to provide person-centred care, combining their expertise in a seamless way to support individuals and families across the full continuum of healthcare.

The report The State of the World's Nursing, published in 2025 by the WHO and the International Council of Nurses, highlights that the global nursing shortages remain a critical challenge. Nursing is the largest professional group within our health system. In Ireland we are in the enviable position of having 14.3 practising nurses per 1,000 population. This is more than nearly all other European countries. I believe that only Finland and Norway have higher numbers but that also reflects the very different geographical spread of their populations. Nevertheless, I am very pleased that Ireland is so highly position among European countries in having so many practising nurses per thousand of population.

There are almost 93,000 nurses and midwives registered with the NMBI. That represents a 3% increase on last year and is the highest number of registrants ever recorded. Overall in 2025, there was an increase of 883 nurses. This is a hugely significant addition in a single calendar year, but it has been bettered this calendar year so far. Already in quarter 1 of 2026 we have an additional 843 nurses. That is a real commitment to recruiting nurses into permanent positions and it is very clear that nurses want to work in Ireland.

In addition to our Irish-trained nurses - who, the NMBI has told me, are staying more in Ireland than has previously been the case - we benefit greatly from the contribution of a diverse international nursing workforce. It is important to place on record that our recruitment approach is firmly grounded in ethical recruitment. Ireland has signed up to and is aligned with the WHO global code of practice on the international recruitment of health personnel. When I was at the World Health Assembly last year, we sat at the front of the table, alongside the representatives from the Philippines, in terms of leading the conversation about ethical international recruitment. We will continue to need international professionals; however, given the global shortages of health care workers, a more sustainable health and social care workforce is the focus. Nursing has a significant and unsustainable reliance on international recruitment.

Significant Government investment is being provided to expand healthcare education capacity here. A €28.5 million investment over the next three years aims to deliver 1,100 additional healthcare training places, each year, across medicine, nursing, therapy professions, pharmacy and dentistry. The years 2020 to 2025 saw first-year nursing places in Irish higher education institutions grow by 23%.

There are very real pressures in our system, such as increased demand and growing complexity, demographic changes, technology advances and financial challenges, but having a sustainable workforce is critical for the future of health in Ireland, and that is what we are working towards.

Despite the recruitment success I have outlined in 2025 and in the first part of 2026 - I hope there is more to come, and we have an awful lot more to do on that - nurses continue to experience staffing gaps in acute and community settings and there is too much reliance on agency staff in certain areas. International as well as national evidence has shown the direct correlation between nursing staffing levels and better patient outcomes, improved safety and reduced adverse events. It has also shown that appropriate staffing enhances staff well-being and improves retention.

Nursing in Ireland has shown national and global leadership by developing the framework for safe nurse staffing and skill mix, which we call the framework. This is an evidence-based approach to determining appropriate nurse staffing levels across different care areas. The framework is designed with patient need at the core. It is not about blunt staff ratios or minimum staffing levels. It is patient focused. It is flexible. It is a flexible model that adapts to the Irish context. Phases 1 and 2 of the framework are national policy. Phase 1 essentially applies to inpatient adult medical and surgical settings, while Phase 2 applies to adult emergency departments. Since 2020, a total of €56.2 million has been provided by the Government to implement this framework. That has delivered an additional 2,000 whole-time equivalent registered nurses and healthcare assistants. The framework is now fully implemented in all of our adult emergency departments nationally and it is nearing full roll-out in all applicable wards.

I believe the framework continues to demonstrate positive impacts for patients, staff and hospitals. Some examples include reduced length of stay, shorter wait times and fewer nurse-sensitive adverse events. It has improved working conditions and demonstrated a reduction in signs of burnout, lower levels of absenteeism and improved staff retention. From a cost and safety perspective, it helps to reduce reliance on agency staff and focuses on stabilisation through permanent whole-time equivalent staff. The Irish Nurses and Midwives Organisation, INMO, and nursing representatives are very supportive of the framework and want us to drive as hard as we can in its implementation. In many respects, we are the envy of Europe in having this very professional structure. We want to continue to drive that and retain the leadership position we have in Europe in this way.

Advanced practice is a hugely important part of what we are trying to do to support nursing generally and support patient care. Advanced and specialist nursing practice has been the cornerstone of reform in recent years, delivering high-quality, autonomous care across acute, community and specialist settings. Care pathways are being transformed by providing quicker access to care, timely assessment, diagnosis, treatment and follow-up. It is reducing waiting times, improving continuity of care and supporting care closer to home. Advanced practice is not only a key lever for optimising the capacity of the existing health workforce. It is important in supporting and advancing meaningful and significant clinical career pathways for nurses, and it strengthens retention. I want nurses to work at the very top of their expertise, the very top of their licences and the very top of their profession, and advanced practice is the way towards that. As a result of sustained investment, the number of nurses and midwives practising at an advanced level in March this year was 1,354. We now have 2.7% of the nursing and midwifery workforce at advanced level and we are on track to reach the 3% policy target. That positions Ireland as a global leader for advanced practice. We have begun a national evaluation of the impact of that, and this will be central to shaping the next phase of advanced practice.

Virtual care and the pace of digital and technological reform has opened many opportunities to innovate, change and improve care for patients. Let me particularly mention this today because nurses are playing a pivotal role in the innovation and safe expansion of virtual and digitally enabled care. Through nurse-led virtual clinics, remote monitoring and community-based models of care, nurses are actively improving access for patients, supporting chronic disease management and reducing unnecessary hospital attendances and exacerbations of people's long-term illnesses. Our nurses are at the forefront of embedding digitally enabled services, ensuring the new models of care are well co-ordinated, safe and focused on the needs of patients. That leadership is clearly demonstrated in the virtual wards now in every region. Those initiatives have been extremely successful at improving patient comfort. I spoke yesterday with a man in Kilkee in County Clare who had been on a virtual ward from Limerick for five weeks after experiencing a neurological event, and he spoke of it very positively. We have supported 2,800 individuals and patients like him, and it has delivered over 27,000 bed days for us, freeing up beds and other hospital resources for patients who require more traditional care. Virtual wards are not for everybody but for those who they are, they are being supported, delivered and led by nursing. Taken together, safe staffing, advanced practice and virtual care clearly demonstrate how nurses are actively shaping service reform. They are not simply responding to it; they are shaping it.

I attended the INMO conference last week and had the good fortune to meet many nurses and midwives from all over the country. I know and, indeed, heard again first hand about how passionate nurses were about what they did, about the challenges they experienced and about their commitment to their profession and their patients. I want to refer to the Expert Review Body on Nursing and Midwifery, which provides 47 recommendations of real significance. The positive impact of the expert review body’s work continues to be realised year on year in many different ways, but there have been delays in implementing some recommendations and that has caused frustration. Work is ongoing to finalise processes under way for those recommendations.

I want to reaffirm the Government’s clear recognition of the importance of actively supporting the continued development of the nursing workforce. I also want to acknowledge the practical improvements that will be delivered from local bargaining under the 2024 to 2026 public pay agreement. I am informed that the proposals being finalised will deliver a broad range of measures to strengthen pay and progression across the nursing and midwifery career pathways and are an important part of supporting retention and ensuring a sustainable nursing workforce.

International Nurses Day provides an important opportunity for me and, indeed, all Members of this House to formally recognise the professionalism, skill and unwavering commitment of our nursing workforce. I want to acknowledge not only the extraordinary contribution nurses and midwives make every single day, but the leadership, innovation, compassion and support they bring to every person in our health service in the face of significantly growing demands and ongoing pressures. On this day, I reaffirm my strong personal commitment and, indeed, that of my Department and the Government to the nursing profession. I really do welcome contributions from Deputies and I hope - I know - that they will join me in once again placing on the record our sincere gratitude for the continued dedication and professionalism of our nurses today and every day and acknowledging the many improvements and supports we are trying to advance for the excellent nurses in our State.

Mary Butler (Waterford, Fianna Fail)
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I am pleased to join the Minister for Health today in marking International Nurses Day and in recognising the extraordinary contribution nurses make to our health service and society. I was also pleased as Chief Whip to fulfil the request by Deputy Devine, who wanted these statements held. I was pleased to be able to put this onto the agenda because it is important that we acknowledge the fabulous work nurses do.

As the Minister of State with responsibility for mental health, I would like to make special mention of the role of mental health nurses in the health service. Mental health nurses look after some of the most vulnerable people in our communities. They support individuals at moments of acute distress, at points of recovery and throughout long‑term engagement with services. Their work, like that of all nurses and midwives, is grounded in clinical expertise, therapeutic relationships and sustained commitment to person‑centred care. They are often the consistent presence for people navigating complex mental health needs, building trust over time and supporting continuity of care across services.

Nursing roles today are carried out in a context of significant and evolving demand. Mental health needs in our society are increasingly complex, services are multidisciplinary and care pathways extend well beyond traditional clinical settings. Mental health nurses are essential to navigating and responding to these challenges. I have seen first hand how nurses adapt practice, support innovation and help to shape how modern mental health services are delivered. I am also aware of how lucky we are in Ireland to train mental health nurses at undergraduate level. Across the EU, most countries do not train mental health nurses as a separate undergraduate field. Every mental health nurse who graduated last year in Ireland was offered a position here. It is important to acknowledge that.

The role of the mental health nurse has evolved significantly in recent years. We are seeing clinical leadership and a growing level of specialisation across the workforce, reflecting both the complexity of need within services and the expertise required to meet it. Mental health nurses work across a broad range of advanced and specialist roles, contributing not only to direct care but also to assessment, care co-ordination, prescribing, governance and service development. I want to give a special shout-out to mental health nurses who work across the psychiatry of later life. They do an amazing job supporting older people at a time in their lives when all they want to do is stay at home to live their best lives in their own communities. They actually go to the house to support people who might have an enduring mental health condition or who might be struggling with anxiety or distress.

I have seen it first hand and I cannot pay enough tribute to them for the work they do and their kindness and understanding of the client who they are seeing. We see this also in the delivery of services such as the national clinical programme for suicide ideation and self-harm where experienced and skilled nurses work in our emergency departments to respond in real time and provide support to people in severe distress.

While we are continuing to expand crisis alternatives in the community, we know people in distress will always present to hospital for emergency care. In responding to this reality, I believe the solution is to establish specialist nursing teams in our emergency departments, staffed by advanced nurse practitioners and clinical nurse specialists working out of hours to support the non-consultant hospital doctor on duty and the consultant on call. I have funded these new teams for all model 4 hospitals in budget 2026, and I will do the same for model 3 hospitals in the next two budgets. This is further recognition of the role nursing can play in expanding the scope of how we provide mental health services and utilise the extensive skills and experience of our nursing workforce.

Similarly, the suicide crisis assessment nurse, SCAN, service is another example of how our nurses go above and beyond for their patients' well-being. SCAN is a key component of national suicide prevention and crisis response efforts. It provides a timely response to requests from GPs for the assessment of people experiencing suicidal crisis, with assessments often taking place in primary care or community settings.

The SCAN service provides a short-term, specialist, community-based clinical response for individuals presenting with suicidal ideation or self-harm that does not require acute hospital admission. As of 2025, there are 33 funded SCAN clinical nurse specialist posts for adults operating across 15 counties, alongside three under-18 SCAN services. Funding provided in budget 2026 supports expansion to a total of 45 posts nationally through the allocation of six new SCAN teams for Kerry, Limerick, Galway, Kildare, Dublin south city and an under-18 team for Linn Dara in West Dublin-Kildare. An under-18 SCAN service commenced in Donegal in July 2025.

As the Minister, Deputy Carroll MacNeill, said, this Government is fully committed to facilitating nurses to continue to work to the top of their licence.

Supporting advanced and specialist pathways not only strengthen services but also supports retention, professional autonomy and leadership within the workforce. These developments are essential to building a sustainable mental health system that can meet current and future demand.

It is important to acknowledge the realities of nursing in the mental health sector and, indeed, nurses and midwives across all sectors. Many work in settings that are highly demanding, emotionally complex and, at times, high risk. We are aware that these pressures can contribute to reduced job satisfaction, stress, burnout and challenges with staff retention.

My colleague referred to the recent INMO survey highlighting high levels of burnout, stress and exposure to growing levels of violence and aggression at work. The WHO Mental Health of Nurses and Doctors, MeND, survey in 2025 found similar results across the European region.

These issues are not unique to Ireland or, indeed, nursing. This is a reality globally for the health and social care workforce. However, nurses as the largest workforce can be disproportionately affected as reference by the Minister, Deputy MacNeill. The increased awareness of these issues has, however, identified evidence-based policy actions to assist in addressing them. I am pleased that in Ireland, the Government is supporting many of these actions.

The Minister has set out the recent and ongoing policy responses, and it does not surprise me that nursing in Ireland is a global leader in some. This Government will continue to invest in our nursing workforce. Our commitment to this is reflected in our approach to workforce planning. All recent graduates, as I said, of psychiatric nursing programmes have been offered posts within our health service. This is a clear statement of the value placed on mental health nursing and the recognition of its importance to the delivery of mental health care nationwide.

International Nurses Day is an important opportunity to recognise the unwavering professionalism, compassion and expertise that nurses bring to every aspect of our health service. This is very evident in the area of mental health, where the training enables skill, empathy, and resilience that makes a profound difference to the lives of individuals and families every day.

I want to restate my deepest appreciation for our nursing workforce and to reaffirm my commitment to strengthening the profession through an ongoing focus on safe staffing, professional support, leadership and working conditions. When we support and empower our nurses, particularly those working on the front line of mental health care, we strengthen our entire health system and improve outcomes for patients and service users across the country.

Mental health nurses also play a critical role in supporting effective integration across physical, psychological and social services. This is essential to ensure continuity, improve outcomes and support holistic recovery for patients. This is important across CAMHS teams where you have multidisciplinary teams and the clinical nurse specialist embedded in the team, providing a huge amount of effective supports and reaching out to all the various definitions to make sure the young person receives the care that they need. Together, mental health nurses working in partnership with colleagues across all fields of nursing strengthen integrated care, ensuring that every patient receives holistic, compassionate and seamless support throughout their health journey.

I welcome the contributions of my fellow Deputies, and I hope they will join me in, once again, expressing our sincere gratitude for the dedication, courage and humanity that nurses demonstrate day in, day out.

As former Minister of State for older people, I want to touch on the phenomenal work that public health nurses do in communities every day of the week. Whether it is supporting a mother with a new baby, supporting people at their end of life or supporting people to live their very best life, they play a phenomenal role in the community. We have been challenged in some areas of Dublin, for example, in recruiting public health nurses into areas but I fervently believe, as somebody rooted in my own community, the importance of public health nurses, especially for older people when they are receiving the supports of home care, day care and meals on wheels, is to know that the public health nurse is there at a time when, for example, coming home from hospital, an older person might need a hospital bed or some kind of physical supports as well as the clinical supports that we provide to support older people to age well in their own community. We are very lucky in Ireland to have the calibre of nurses we have. Whether it is public health nurses, nurses who are supporting you at end of life, nurses who are supporting you when you go into hospital or the nurse in your GP service, they are the backbone of health all over the country and I proud to salute them here today.

Máire Devine (Dublin South Central, Sinn Fein)
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As the only nurse in the Dáil, I stand here very proud. I am fortunate enough to have served on the board of St. James's Hospital, the largest hospital in the country. I am delighted that the Government agreed to have these statements on International Nurses Day and I thank the Minister and the Ministers of State. It is a first for the 100,000 plus nurses across this island, North and South. We hardly ever agree to things and this might be a rare occasion.

I concur with most of what the Minister said. There are details in other areas I would disagree with but today is a day of celebration and we will not get too snarly with each other. It is about, I suppose, recognising the hard work of nurses, globally and nationally. We are the backbone of the healthcare service - the glue that holds it together - and keep it going, albeit in unsafe conditions.

I recognise my colleagues from the Psychiatric Nurses Association of Ireland, the INMO and Nursing and Midwifery Board of Ireland, NMBI, formerly Bord Altranais, in the Public Gallery. Tá céad míle fáilte romhaibh, a cháirde. International Nurses Day was first celebrated 65 years ago on the anniversary of the birth of Flo, Florence Nightingale, also known as the Lady with the Lamp. I also honour our own Irish nursing heroes - Cumann na mBan's Elizabeth O'Farrell and the very matronly Margaret Huxley, in whose name they still have yearly awards in hospitals for the most high-achieving nursing student.

This year's theme, as the Minister said, is "Our Nurses. Our Future. Empowered Nurses Save Lives." This means ensuring the nursing workforce has the resources, the authority and the safety necessary to improve healthcare outcomes. Nurses are carers but they also need to be cared for. The insecurity of poor working environments with so many vacancies compromises patient care. That is just the way it is. Our healthcare system is in trouble. It is shaken to the core by the rapid and steady exit of medical professions to perceived greener pastures. An estimated 25,000 Irish qualified nurses and midwives left the healthcare system in the past two decades.

The significant long-term trend of emigration deepens the nursing crisis in Ireland with three quarters of new graduates considering emigrating due to burnout, poor working conditions and, of course, the housing crisis. Some 6,000 funded posts remain vacant, meaning that recently announced HSE staffing controls are extremely worrying to all nurses.

As the INMO warned, nurses cannot provide safe care and are scraping by with unsafe staffing levels. Essential worker recruitment is the first cut in every healthcare budget overrun. Likewise, the Psychiatric Nurses Association of Ireland has flagged the HSE's shocking proposals to close ten CAMHS beds in St. Vincent's in Fairview. Serious difficulties in recruitment and retention of psychiatric nurses give rise to grave concerns of the feasibility of opening the 11 beds in Linn Dara, as the Minister of State will be aware, and the 20 new CAMHS beds at the national children's hospital, whenever that opens.

I am grateful to the registered nurses from outside Ireland who have arrived to help. A large proportion of our nursing force is now from other lands. It is a global phenomenon, as the Minister rightly said, and we are now heavily reliant on international staff to help steady our wobbly ship. While on the one hand we have a brain drain of trained nurses, we are also posing a drain on nurses from the less-advantaged countries of the world, negatively impacting their own quality of healthcare. The WHO has identified more than 50 countries that are exporting nurses, putting their own healthcare systems at risk. Everyone is entitled to look for a better life as our nurses have done abroad. However, the solution is not just in recruitment, but in retention and increased capacity for those wishing to train as nurses. That means a strong commitment to the existing workforce in terms of pay and conditions, safety, respect, support and professional development.

We must invest in affordable housing for nurses, midwives and their families near their workplaces. Locally, I am talking to the approved housing bodies and requesting of them in the Dublin 8 area, which is the health hub of our country, to retain some of the new housing builds for accommodation for local nurses through their four years of training.

I cannot help reflecting on the HSE's appeal at the beginning of the Covid pandemic. The Be on Call for Ireland campaign was heard loud and clear around the world. Tens of thousands gave up jobs and homes and returned to Ireland to assist. Many were nurses and were given a mere three-month contact, as I was. The HSE squandered the opportunity to decrease the billions of euro spent on agency workers and overtime over the last number years and instead provide skilled, knowledgeable and experienced nurses. It was a crucial missed opportunity to end long hours and burnout, provide safety and allow us to carry out our duty of care.

I conclude by acknowledging all of the healthcare professionals who have been abducted, injured and killed in Palestine due to Israel's horrific and violent attacks on the health infrastructure there. What they have endured is truly abominable. We are witnessing the loss of humanity. Humanity is a core component of what it takes to be a nurse.

Donnchadh Ó Laoghaire (Cork South-Central, Sinn Fein)
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Nurses are held in huge esteem in this Chamber and right across the country. It is worth asking why that is. The reality is that it is because they perform their duties with compassion, dedication and commitment to public service and to the communities in which they live. We all hold them in huge esteem. The problem is that, far too often, esteem and respect are not followed through in policy.

I am concerned at the situation we are facing in Cork and others are facing in other regions where this new control on spending could potentially - I want clarity on this - lead to a freeze on recruitment. There are some 5,000 vacant midwifery posts across the State, hundreds of them likely in Cork and Kerry. We have just had the busiest April for some time when measured by people on trolleys. The waiting lists in Cork are absolutely exploding. This is at a time when Irish nurses right across the world are desperate to return home to work in Irish hospitals to do what they can to assist in what is, in my view, still a crisis in our healthcare system. How can it be anything other when we have exploding waiting lists, growing numbers of people on trolleys, and appointments, elective surgeries and diagnostics constantly being postponed and cancelled? I find it difficult to understand why we could even be contemplating a potential freeze on recruitment for clinically front-facing posts, which could include nurses. That needs clarity.

The other people I am thinking of today who serve our communities are our paramedics. I urge the Government to engage with them, to meet them without preconditions to ensure that they get what they have been waiting for for five or six years, which is recognition for the job they actually do in this modern day.

Rose Conway-Walsh (Mayo, Sinn Fein)
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International Nurses Day is about recognising the extraordinary dedication, professionalism and compassion shown every day by nurses across our health service. They are the backbone of patient care. I have seen at first hand in Mayo the incredible work nurses do every day. However, too many are working under relentless pressure in overcrowded hospitals, understaffed wards and unsafe conditions that are driving exhaustion and burnout. Successive Fianna Fáil and Fine Gael Governments have failed to deliver safe staffing levels. That is the bottom line. Nurses are being asked to do more for less while patients wait longer for care and healthcare workers carry the burden of a system stretched beyond capacity. If we are serious about protecting our health service, we must invest in the workforce that sustains it. That means delivering safe staffing levels, improving pay and working conditions, and ensuring that nurses have the support and respect they deserve. We also need urgent action to recruit and retain our graduate nurses. Every year, highly trained graduate nurses leave Ireland because they cannot secure permanent posts, affordable housing or decent conditions. We continue to train nurses for export while our hospitals suffer from understaffing.

As we sit here today, SIPTU members in the National Ambulance Service across the country are taking strike action. We must acknowledge the pressure facing these workers. Their concerns on staffing and working conditions deserve meaningful engagement and a fair resolution. On International Nurses Day, Sinn Féin stands in solidarity with our nurses, our front-line healthcare workers and our ambulance workers. We value their incredible work and dedicated service, and we demand the recognition from the Government that all healthcare workers deserve.

Shónagh Ní Raghallaigh (Kildare South, Sinn Fein)
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Is é inniu Lá Idirnáisiúnta na nAltraí, ina dtugaimid aitheantas do na daoine a choinníonn an córas sláinte ag feidhmiú lá i ndiaidh lae, go ciúin agus go dícheallach ar bheagán buíochais. Go raibh maith agaibh. Today is International Nurses Day, a day to give thanks to the people who are the backbone of our health service, the unsung heroes doing so much of the heavy lifting of care work in our hospitals and communities. However, one day of appreciation is not enough. Respect for nurses must be shown every day of the year. According to the INMO, we are short more than 5,000 nurses across the State, yet last week the HSE introduced a recruitment moratorium affecting nursing posts. At a time when our health service is already under enormous pressure, we need more nurses, not fewer. If agency spending is too high, the solution is to invest in direct employment, not to freeze recruitment.

Nurses are overworked and increasingly unable to deal with the cost of living. We are effectively training nurses for export. I have dealt with a young full-time nurse in my constituency of Kildare South. She is a single mother and at risk of homelessness after receiving an eviction notice from her landlord. This is happening across the State and it is shameful. Strikingly, community nurses, predominantly women, were forgotten about in the most recent package of measures despite facing drastically increasing cost pressures tied to their work.

We must also speak about safety. No one should go to work fearing abuse or intimidation, yet we know nurses face verbal abuse, physical threats and, far too often, racism in the workplace with 12 incidents reported daily. This is not acceptable and is not inevitable. If we truly value nurses, we must provide safe workplaces, fair pay, sustainable conditions and a health service where nurses can build a life and a career in Ireland. Teastaíonn uainn an t-ómós atá tuillte ag altraí na hÉireann a léiriú le pá cothrom, coinníollacha maithe agus ionad oibre sábháilte. Mar sin a choinneoimid altraí ag obair agus ag fanacht in Éirinn.

Natasha Newsome Drennan (Carlow-Kilkenny, Sinn Fein)
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I strongly welcome these statements. I want to express my solidarity and thanks to all the nurses working and training across Ireland right now. For the many thousands of nurses who have been forced to emigrate by the failed policies of Fianna Fáil and Fine Gael, I want them to know this: we will work to build the conditions that give them the real choice to return home, with secure housing and a good quality of life. Over the past ten years, our health service has paid a heavy price because those in power have failed to value and respect our nurses. The knowledge and expertise that we have lost to places like Australia are hard to comprehend.

While members of Fianna Fáil and Fine Gael will line up here today to sing the praises of our nurses, it will just be empty words. To be fair, Fine Gael has never hidden how it views our nurses. We all remember the then Minister for Health, Simon Harris, threatening to impose financial penalties on striking nurses, or Leo Varadkar telling us that it is best to keep our hospitals under-resourced, with fewer beds, because, according to him, if a hospital is not under pressure, the staff will kick back and relax. That culture in Fine Gael has ensured that any improvement in working conditions for nurses has had to be dragged out of the Government.

It is that critical mindset that shows that Fine Gael simply does not understand what it is like to work as a nurse - the long unsociable hours, the chronic understaffing, the physical demands, the high patient-staff ratios and the harsh workload. That is ever more present in St. Luke's Hospital in Kilkenny. Those who do their best get punished more. We see resources for hospitals going into black holes. Hospitals like St. Luke's Hospital do the very best with what they get, but they get a slap on the wrist for it. They do not get the resources they need. The Government needs to look at this.

Despite these harsh conditions, day in, day out, our nurses go above and beyond. They provide a level of warmth, care and support to members of the public who find themselves in need at a time of great vulnerability. That deserves more than praise. It deserves action.

Marie Sherlock (Dublin Central, Labour)
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I welcome the opportunity to speak today on International Nurses Day. The theme is: “Our Nurses. Our Future. Empowered Nurses Save Lives”. I have just come from the new national children's hospital. I want to pay particular tribute to the nurses who are leading the charge there, as well as Lucy Nugent, the chief executive of CHI, and Julia Lewis, the head of transformation. It is wonderful to see so many nurses now coming into senior leadership roles across the health service, where for so many years, it was dominated by the other professions.

I also pay tribute to the nurses I encountered in the Mater emergency department last night, when I was there with a friend, for the incredible professionalism and work rate that they bring every day to their jobs in what is a very difficult environment. We have seen a lot of commentary in recent weeks about violence and aggression. This is seen not only in the Mater hospital, but in many hospitals across the State. The reality is that many nurses go beyond the call of duty to deliver care across a variety of environments. It is important that when we talk about nurses today, we are not just focusing on the nurses who work in acute hospitals, who are incredibly important to the conversation, but we also recognise nurses in nursing homes, primary care clinics and GP practices, as well as community midwives and public health nurses.

Some 15% of the nursing workforce in this country has come from other countries. Our health service, particularly our nursing workforce, would not be able to survive were it not for people from countries like the Philippines and India coming to this country year after year to join our workforce. We must be very thankful to them. We also need to mind them and look after them. Certainly, the increasingly racist commentary that we hear among politicians, but also the really crude discourse that exists out there online and in our communities, has put the fear of God into many migrant nurses and other workers. It is something the Government needs to act on in a much more comprehensive fashion. We were promised an information campaign on the benefits of migration. We see it in our hospitals, day in, day out, but we have yet to see that campaign. I impress upon the Minister of State, Deputy O'Donnell, that we need to see something specific to the health service and many other sectors to reassure those workers who have come to our country, but also to call out the racism that is out there.

I have three questions. They are principally directed to the senior Minister for Health, but I know the Minister of State will take them on board. The first concerns safe staffing ratios. We know that in 2017, the then Minister for Health, Deputy Simon Harris, introduced the general scheme of the patient safety Bill. It went through pre-legislative scrutiny, but it has been gathering dust ever since. We have to ask why that is, and what are the Government's intentions in this regard. When we look at the reality on the ground, the INMO national conference last week and its annual survey laid bare the extraordinary strain that so many nurses are working under. Some 67% of staff believe their current staffing levels and skill mix do not meet the clinical and patient demands required in their work area. Over half of respondents said that patient safety was almost always put at risk, or certainly very often. Almost half were pressurised to work additional hours or shifts. Shockingly, a quarter of the nurses who responded to that survey said they had to attend a GP due to work-related stress. We know that those in other grades within the health service are similarly suffering enormous stress and strain, as seen, in particular, in the Fórsa survey produced earlier this year.

We have to ask what the Government response to this is. I acknowledge that the number of nurses has gone up significantly in the past five years, by some 9,700, or just short of 10,000. That is significant. However, we know that when we benchmark Ireland against many of the other European countries and OECD norms, we are significantly short. That has to be part of the conversation on the future path for nurses working across our health system, and how we ensure that they and the patients are kept safe. That piece of legislation is vital. There are minimal staffing ratios in childcare and education, yet we do not have that within our hospitals, where nurses and other staff are providing a crucial service.

We also have to look at the attitude of the Government and the HSE to commitments they have made to nurses and other health staff in recent years, particularly the WRC agreement in 2024. There were specific commitments with regard to agency, outsourcing and maternity cover, yet the unions had go to the Labour Court last November with regard to the non-implementation of the WRC agreement by the HSE. That is simply not on. It as a misuse of the HSE’s time that it has to go trekking down to the WRC. It committed to that agreement. Why is it not abiding by it? In February of this year, we saw nurses in Naas General Hospital going on strike because of unsafe staffing. This is a very real issue. We need the HSE and the Government to respond.

I am alarmed that we now have a recruitment freeze. We have heard all the reassurances from the Government, but the reality is that it is going to hit front-line workers. The Minister said this week that an extra €300 million is required for the health service. That is going to impact outcomes and services. We raised these issues at the budget last year, and we were told we did not need to worry because the health service was properly resourced. We knew then it was not the case, and now that is bearing fruit. That is serious mismanagement by the Department of Health in its budgeting.

The second question that I have for the Minister-----

Verona Murphy (Wexford, Independent)
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I am afraid we are too late. I call Deputy Eoghan Kenny.

Eoghan Kenny (Cork North-Central, Labour)
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I am happy to share my time.

Verona Murphy (Wexford, Independent)
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In that case, it is fine.

Marie Sherlock (Dublin Central, Labour)
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The other two questions I have relate to the strategic review of GPs. We have been promised this for a year and a half. It is late. Are we going to see a reference to GP nurses? They provide vaccines and smears. I refer to the new chronic disease management programme. Are we going to see a reference and proper provision for them in the new GP contract?

The last thing I want to say is with regard to public health nurses. From what I can see, the number of public health nurses across the country is lower now than it was five years ago. I looked through every region. Every single region has fewer public health nurses than it did five years ago. Why are the HSE and the Department of Health showing such contempt to public health nurses and the delivery of nursing care in our community? That needs to change.

Eoghan Kenny (Cork North-Central, Labour)
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Today we must recognise the immense pressure that our nurses are under in this country, but also other front-line health professionals across Ireland. This morning, I met with paramedics outside Mallow General Hospital who do not take this strike action lightly. Listening to them this morning, it was clear that this dispute was more than pay and grading. It is about burnout, staffing pressures, retention and a workforce that feels ignored for far too long. Last night, I spoke with nurses from CUMH and CUH who are genuinely fearful about the impact this strike action it will have on patient care, particularly vulnerable patients who may now have to rely on private transport. I want to make clear, however, that workers do not take strike action lightly. Ambulance staff, paramedics, nurses, healthcare assistants and front-line workers have carried this health service on their backs for years. They worked through Covid, through overcrowding crises, through staffing shortages and through increasing pressure in our emergency departments and hospital wards.

This is nowhere more clear than in specialised nursing care. I want to specifically raise the concerns of Parkinson's Ireland regarding the shortage of Parkinson's nurse specialists. These nurses are essential for people living with Parkinson's disease. They support self-management, help patients manage systems and medications and reduce avoidable hospital admissions and pressure on acute services. In Ireland, we have around 60 Parkinson's nurse specialists. We currently have just 25, with two of those funded by Parkinson's Ireland itself. A recent UCC audit found that 57% of people living with Parkinson's in Ireland have documented access to specialised nurses. That is compared with 95% in the United Kingdom. There is a huge amount of work to do for front-line health services in this country, particularly for nurses.

Cormac Devlin (Dún Laoghaire, Fianna Fail)
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I join the Minister in welcoming the representatives of nursing who are in the Gallery. They are all very welcome to the House. I thank them for being here. It is important to hear the contributions being made today. I am sure they are not agreeing with everything that is being said, but they are all very welcome.

I am very happy contribute to these statements as we mark International Nurses Day, and to join with colleagues across the House in paying tribute to our nurses and midwives. Every family in this country has a story about a nurse: the nurse who sat with an elderly parent through a long night; the midwife who delivered a baby and steadied a worried first-time mother; the community nurse who calls to the door each week so that a neighbour can stay longer in their own home; or the public health nurse who picked up early warning signs that a child needed additional help. These are not small things; they are moments when our health service delivers and lives up to its promises and, in certain cases,k goes way above and beyond the call of duty.

In my own constituency of Dún Laoghaire, that work is carried out every day in a network of hospitals and community services that constituents rely upon. St. Vincent's Hospital at Elm Park is a major acute hospital serving a huge catchment area, with a nursing workforce of over 1,000. St. Michael's Hospital in the heart of Dún Laoghaire town runs a busy local emergency department and 130 inpatient beds, with several hundred nursing and clinical staff. I had personal experience of that over the last number of months. I want to put on the record, as it is appropriate today, that the nursing staff, Dr. JJ Barry and all the team there do immense work, not only for a relative of mine but indeed for so many constituents. St. Columcille's Hospital in Loughlinstown, with around 450 staff in total, provides the medical assessment unit and injury unit that so many people and families have turned to over the years. On top of that, there are the public health nurses, community nurses, school nurses, nursing home staff, hospice nurses and practice nurses working across Dún Laoghaire every single day. We owe all of them a huge debt and gratitude and simply say, "Thank you". We know what you do and we are grateful for it.

Gratitude on its own is not enough, of course. Nurses themselves would be the first to say that. The recent INMO member survey is a serious document, and the levels of stress, burnout and pressure that it records cannot be brushed aside. I heard Phil Ní Sheaghdha on the radio recently talking about this document. Some of the statistics in it are quite startling. The World Health Organization recognises burnout as an occupational phenomenon. The international evidence tells us it has to be tackled on two fronts at once, that is, through individual supports and through structural change in how services are staffed and organised. That is what this Government is doing.

As of the end of March, there were 10,975 more nurses and midwives working in our health service than there were at the start of 2020, bringing the total to 45,591 whole-time equivalents. Over 93,000 nurses and midwives are now on the NMBI register – the highest number ever recorded. First-year nursing places in Irish higher education institutions have grown by 23% since 2020 and an additional €28.5 million is funding more than 1,100 extra healthcare training places every year for the next three years. The framework for safe nurse staffing and skills mix is now fully implemented in emergency departments and is nearing full roll-out in wards, backed by €56.2 million since 2020 and around 2,000 additional registered nurses and healthcare assistants. The evidence is showing what nurses have long known: when staffing is right, patients do better, missed care reduces, retention improves, and reliance on agency staff comes down.

We are also seeing real progress on advanced practice. Ireland is now a global leader in this area, with advanced practice accounting for 2.7% of the nursing and midwifery workforce. That has meant shorter waiting lists, faster access for patients, and clear career pathways for nurses themselves. Of the 47 recommendations in the expert review body report, 36 have been closed, with the rest on track for 2027.

The goal of universal healthcare, a public service that delivers the best possible care when it is needed, will not be reached without the nurses and midwives of this country. They are not a cost to be managed; they are the reason the system works at all. On International Nurses Day, I want to acknowledge them, particularly in Dún Laoghaire and right across the country, and to give a clear commitment that this Government must continue to back the nursing workforce in the work they do.

Martin Kenny (Sligo-Leitrim, Sinn Fein)
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I am very glad to be here today to speak on behalf of everybody in Ireland and thank the nurses for the work that they do, particularly on International Nurses Day. It strikes me, on this International Nurses Day, that so many of our nurses are international when you walk around the hospitals. I think between one in five and one in six are from overseas. Many of them come here because they have the opportunity to come here. That is an issue that needs to be dealt with. I have spoken to many nurses and other healthcare professionals who have come from overseas with contracts to the HSE. They have families and they want to bring their families here. It is very difficult to do that. That is something that needs to be reassessed because many of these people are reconsidering their options. If they are talking to others who are considering coming here, they are certainly telling them to think carefully about doing so because it is very difficult for their family to join them. These people are independent. They have their salary, a house and everything they need, yet they find it very difficult. It is an issue that needs to be dealt with.

I have personal experience. My daughter, Claire, is a nurse. She has wanted to be a nurse since she was small. As a parent, you always want your children to do well and to be successful in whatever way they can, and to hopefully do better than you do. That is the plan that we always have in life. To be a nurse is something very special. It reflects a caring individual, somebody with humanity and great empathy. They are prepared to roll up their sleeves and do the hard work as well. There are those two sides to it. From speaking to her and others in that profession, it is often not recognised to the level it needs to be, particularly because of the stresses they are under. If I talk to nurses and ask what the one thing is that would change things and make them better, they will say more staff - more nurses, more than likely. That is the big pressure that they are under, in many cases. In many cases, they are working in circumstances where logic would tell you there should be three or four working in a ward but there are only two.

They are facing real difficulty. That is one of the big issues that needs to be dealt with.

It has been mentioned that there are over 5,000 vacancies in the service. That needs to be addressed. We need to put the pressure on to ensure we can deliver those staff and ensure we can get an adequate health service that deals with all of these issues. Indeed, my daughter, Claire, said to me that as bad and as difficult as it often is for nurses, they are not the first ones at the scene when there is a car accident or when there is somebody in serious trouble having a heart attack. The first people there are the paramedics who have driven an ambulance to get there. Often, in tragic circumstances when a person is deceased, they have to cut them out of the vehicle. The trauma and difficulty of that and the level of skill they have is not recognised by the level of remuneration. That is why they are on strike today. I visited them today in Ballyshannon, Sligo and Carrick-on-Shannon on my way here.

Many people in the health services are under huge pressure. If the State wants to celebrate nurses, it needs to celebrate everybody in the health service and ensure it deals with this issue in regard to the ambulance services.

Pádraig Rice (Cork South-Central, Social Democrats)
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On this International Nurses Day, I want to commend our nurses and midwives and thank them for their work and service. Nurses and midwives need more than thanks on the floor of the Dáil. They need better working conditions, they need more staff and they need more resources. That is what would make their jobs easier.

We know April was the worst April on record for overcrowding, with 11,000 patients treated on trolleys. It is putting huge strain on nurses, midwives and staff which means really bad outcomes for patients. This needs to change.

We have also seen in the Irish Nurses and Midwives Organisation, INMO, survey of their members really shocking and startling results: 70% say there is inadequate staffing and skill mix; 60% considered leaving their job in the last month; 40% said work negatively impacted on their psychological well-being; and 25% of nurses and midwives attended a GP due to work-related stress in the past year. The stress and the strain our nurses and midwives are under because of the working conditions should be setting off alarm bells in the Department of Health. It really is not good enough.

The Minister for Health says the safe staffing framework is well resourced. I would ask her to talk to nurses, midwives and patients because the experience on the ground does not reflect that. It has never been fully resourced and it needs to be. In other countries, they do this. In Australia, they have enshrined in law that the safe staffing framework must be resourced. We can do that too.

Our time today would have been better spent legislating for safe staffing levels in our hospitals instead of talking about and giving thanks to nurses, and actually improve their working conditions like they have done in other countries. We know people are leaving here to go to work in places like Australia where there are better working conditions. The Australian health practitioner regulation agency saw an 86% rise in Irish healthcare workers registering there since 2019. People are moving because of the working conditions. People are leaving the health service because they are under such stress and strain and it really needs to change.

I submitted a parliamentary question to the Minister in November on the staffing levels and found out there are over 3,700 funded posts from 2024 and 2025 that have not been filled. Of the 2024 funded posts, 27% remain unfilled. Of the 2025 funded posts, 80% remained unfilled. We provided the funding for them but they have not been filled by the HSE. That is on top of the 3,100 previously unfilled vacant posts. Across the service, 7,000 posts across the HSE are vacant. This is why nurses and midwives are under such stress. It is because there are vacancies right across the service. We know 1,100 funded nursing and midwifery posts remain vacant while the HSE spends €124 million on agency staff.

The decision last week on the hiring freeze on non-front-line workers was a knee-jerk reaction done without consultation with workers and unions. It is going to have a big impact. Who is going to do the administrative work? It is going to fall on the clinicians and it is going to really impact on services. While I do welcome the controls on agency spend, we have been here before. We know that since 2020, €4 billion has been spent on agency staff. That is a staggering amount of money. It is poor outcomes for staff, patients and the public purse and it needs to change.

We know targets were set for converting agency posts into permanent posts. There was meant to be 960 conversions over 2024 and 2025. However, the Department and the HSE fell 132 posts short of that, 77 of which were in nursing and midwifery. Converting those posts into permanent posts is a basic thing that could be done. It is a staggering amount of money spent on agency staff. That money should be spent on filling these permanent posts, improving the services, resourcing our health service and it is not being done.

Crucially, what needs to happen is that we need a multi-annual budget for the health service. Since 2016 it has been promised time and again, Government after Government, but we have not had it. It would lead to better planning, more sustainability and we would not have this knee-jerk reaction of pausing recruitment and stopping hiring. If you were going to buy a car, you would ask if you could pay off the loan over three or four years. You would not think of one year at a time. We need to have better planning for our health service and we need a real guarantee from the Minister that there will not be a freeze on front-line workers. I would love the Minister to make that commitment on the floor of the Dáil and say that this will not be extended to front-line workers. Ultimately, we need to have those safe staffing levels. That should be the guiding benchmark in terms of recruitment for our staff. That would have the biggest impact on nurses and midwives.

Liam Quaide (Cork East, Social Democrats)
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International Nurses Day should not be treated as an annual exercise in sympathetic, soothing words about how great our nurses are. Nurses do not need another round of empty public praise or applause that carries no willingness to improve their working conditions behind it. Our nurses need a health service that take their safety, their working conditions and their health and well-being seriously. Of course, we should recognise and celebrate the work nurses do. Every day, in hospitals, community services, mental health wards, disability services, older person services, emergency departments and public health settings, nurses carry an enormous share of the health service. They are often the people who notice when a patient is deteriorating; the professional a family turns to when they are frightened or confused; and the worker trying to hold a service together when staffing is short, beds are unavailable and the wider system is failing around them.

If the tributes being paid today are to mean anything, we must be honest about what many nurses are asked to endure. One of the clearest examples is violence and aggression at work. A HSE response to a parliamentary question I submitted last year showed there were almost 17,800 reported assaults on HSE staff between 2022 and 2024. These included physical, verbal and sexual assaults reported through the national incident management system. The category of worker most affected was nurses. There was almost 11,000 incidents reported involving nursing staff over those three years. Mental health services accounted for almost 7,500 incidents. Disability services represented over 3,470 and acute hospitals recorded almost 4,000.

This means nurses being threatened, punched, kicked, spat at, grabbed, sexually harassed or verbally abused while carrying out their work. We need to be careful and humane in how we discuss these realities. Many incidents happen in settings where patients may be extremely distressed, frightened, intoxicated, psychotic, cognitively impaired, traumatised or unable to regulate their behaviour because of disability, illness or crisis. However, none of that takes from the impact of these assaults on staff. A serious response means safe staffing levels. It means proper training in de-escalation. It means appropriate security where needed and ward and service environments that reduce risk rather than compound it. It means proper follow-up after incidents and psychological support. It means managers and senior decision-makers treating workplace violence as a major occupational hazard, not as background noise in a health service under pressure.

Assaults are only one part of the wider picture. Nurses are also dealing with injuries from moving and handling, exhaustion from unsafe staffing, missed breaks, relentless pressure and the psychological toll of trying to deliver safe care inside a system that too often makes that impossible. There is a particular kind of stress and dejection in knowing what a patient needs and not having the staff, time, beds, equipment or community supports to provide it. That is not just frustrating but over time, it is corrosive. It damages morale. It pushes experienced nurses out. It makes recruitment more difficult. It affects patient care. The State cannot keep speaking about retention while ignoring the conditions that drive people away.

I want to briefly raise healthcare workers living with long Covid. During the pandemic, healthcare staff were asked to answer the call of duty in settings that were fraught with danger and uncertainty. Many were exposed to Covid before vaccines were available, before PPE was consistent and before the long-term consequences of the virus were properly understood.

Some people are still living with those consequences. Long Covid, as we know, can involve debilitating fatigue and pain, cognitive difficulties, breathlessness, post-exertional crashes and a range of other symptoms that make ordinary life extremely challenging, not to mention returning to demanding clinical work. The special Covid leave with pay scheme for public health service employees with long Covid has now ended, with remaining staff moved onto the ordinary sick leave scheme. I welcome the Taoiseach's recent engagement with unions on this issue, but I also want to mention the many nurses as well as other healthcare workers who fell outside eligibility for special Covid leave with pay and who remain disabled by their symptoms and unable to return to work. If nurses are central to the future of healthcare, safe staffing is imperative. If nurses were asked to carry the health service during Covid, those still living with the consequences of the pandemic should not be abandoned. The tribute nurses need is not sentimental social media soundbites; it is protection at work, proper staffing, fair treatment when injured or ill and a health service that stops asking them to absorb the consequences of political failure.

Pádraig O'Sullivan (Cork North-Central, Fianna Fail)
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I thank all the nurses around the country on this day, International Nurses Day. It is only fit and right that we start our speeches in here by saying "Thank you", not just as a formality or a generic line in a speech but as a meaningful and heartfelt one. All of us in here have experienced healthcare at various stages of our lives or with our family members, and nurses have always been there to help us along those sometimes most treasured moments in our lives but sometimes the most difficult moments in our lives as well. If you think about it, the first hands that would have touched many of us in this world have been those of a nurse or a midwife. When we were frightened in hospital as children, it was a nurse who sat with us. When our parents or grandparents were at their most vulnerable, confused, in pain, afraid, it was a nurse who often stayed with us, who explained things gently, who held a hand when no family member could be there, who made a cold, clinical environment feel somehow human. There is no qualification in the world that teaches you how to do that; that comes from something deeper, from the character of every one of those nurses and from genuine compassion. Irish nurses have that in abundance.

The INMO represents over 42,000 nurses and midwives across the island, 42,000 people who made a deliberate choice to dedicate their working lives to the care of others, who sat their exams, completed their training, put on their uniform for the first time and decided that this was how they wanted to spend their days. That decision deserves to be celebrated loudly and genuinely here today.

Irish nursing also carries a history to be enormously proud of. For generations Irish nurses have been regarded as among the finest in the world, sought after, respected and trusted in every corner of the globe. Their reputation was not handed to them; it was built ward by ward, shift by shift by the women and men who gave everything to their patients and to their profession. We stand on the shoulders of that tradition today and we should acknowledge it with pride.

The dedication continues. Right now, there are nurses in Cork, Munster and every county across the country who are on their feet doing what they do quietly, expertly, without fanfare. They are not looking for applause - they never have been - but they deserve it all the same.

Celebrating our nurses means asking ourselves an honest question: are we doing enough to make Ireland a place where they want to stay, where they feel valued enough to build their whole career, their whole life, right here at home? The truth is that Irish nurses are wanted everywhere: Australia wants them, Canada wants them, the Middle East wants them. Who could blame any country for wanting the best? However, we want them here also and we need them here. More than that, they belong here, in the hospitals and communities they grew up in, caring for the people they know, building something lasting in the country that shaped them. It is worrying that Ireland has the highest proportion of foreign-trained nurses in the entire OECD, 51.8%, more than twice the level of the second highest country. That is not a badge of honour; it is a warning sign flashing red for all of us, so we need to take heed.

The INMO has told us that there are currently 5,000 nurse and midwife vacancies across the country. That is not just a number on a page; it is 5,000 opportunities for Irish nurses to come home, to step in and to be part of rebuilding something, and it is 5,000 reasons why we must make Ireland as attractive as possible for nurses to stay and to return.

That is why we should be making Ireland the best place in the world for an Irish nurse to build their career. We should be investing in pay that properly reflects the responsibility nurses carry every day. A staff nurse starts on €37,288. We need to keep building on that year on year until the gap between what Ireland offers and what other countries offer is no longer a reason for anyone to leave. We should be moving urgently towards safe staffing legislation and real enforceable ratios in order that every nurse can finish their shift knowing they gave the standard of care they trained so hard to deliver.

We should be providing genuine career progression in order that nurses qualifying today can look ahead and see a future here that is fulfilling, sustainable and rewarding. We should be making the choice easy. Right now, for too many nurses, it is not easy enough. We want the young people who are considering nursing as a career to choose it with confidence. We want newly qualified nurses to look around and see a country that has their back. We want the experienced nurses who have given years of service to feel their dedication is truly seen and truly valued. Ireland is blessed with nurses who are second to none. We should make sure Ireland is a country that is second to none in the way it looks after them.

Conor McGuinness (Waterford, Sinn Fein)
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Today, on International Nurses Day, we recognise and thank nurses working across every part of our health service and at every stage of life. We think of those nurses in our hospitals, in GP surgeries and in communities. We think of public health nurses, addiction nurses, mental health nurses, intensive care nurses, palliative care nurses, paediatric nurses, geriatric nurses, and those working in disability services, cancer care, maternity care, health promotion and the Irish Blood Transfusion Service. Irish nurses have earned a reputation across the world for excellence, professionalism and compassion. That is a source of enormous pride for this country.

My aunt Stephanie worked as a nurse and a midwife for much of her life. She cared for patients here in Ireland but also in many areas affected by war, famine and insecurity. She taught nursing and midwifery in some of the largest and worst refugee camps in the world. Today, on International Nurses Day, I think of her and of all of those nurses, healthcare workers and health facilities that have been attacked, particularly in Gaza but also in the West Bank and Lebanon, as Israel continues with its genocide.

Today is also an opportunity to recognise the international character of modern nursing in Ireland. Nurses working in our health services have come here from every corner of the globe. We are deeply grateful to every nurse, whether from Ireland or beyond, who cares for people here with dignity, skill and humanity. Gratitude alone is not enough, however. If we truly value nurses and nursing, we must ensure safe staffing, fair pay, decent and safe conditions and affordable housing. We must tackle the burn-out, exhaustion and unsafe workloads.

The figures from the INMO are deeply worrying. Too many nurses report unsafe staffing levels, serious stress and pressure to work additional hours. Many are considering leaving their workplace or leaving their profession entirely. It speaks to the compassion, dignity and discipline of nurses that, when they are asked to do more, they tend to do so until they hit the point at which they can do no more. That is not sustainable for workers or for patients.

As we are speaking here, I will also express solidarity with nurses' colleagues in the National Ambulance Service. These workers taking industrial action today are paramedics, advanced paramedics and EMTs and provide extraordinary front-line clinical care under immense pressure. They also deserve proper staffing, recognition and meaningful engagement from Government.

No more than paramedics and the rest of their colleagues in the health service, nurses are essential to society and to humanity. They deserve action, fairness and protection. They need to be acknowledged. If it boils down to one word, it is "respect". Gratitude and platitudes are easy but respect costs.

Ruth Coppinger (Dublin West, Solidarity)
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During this whole discussion, there have been elements of déjà vu as regards Covid. I was not here but, like many others, I looked at the screen and saw the applause for nurses in the Dáil. It was the height of hypocrisy. There was applause but no pay rises. Long Covid supports have just been ended. Nurses were urged to go onto the front line. It was mainly nurses who suffered from that condition. I seriously wonder how nurses around the country, particularly those at University Hospital Limerick, and nurses abroad feel hearing this debate. This April was the worst on record for overcrowding in the hospitals. Some 11,175 people were treated on corridors according to the INMO's trolley watch. That long-term degradation of their working conditions has an absolutely massive impact on nurses' well-being and so on. They face stress, burn-out and unsafe conditions.

In a survey, two thirds of nurses said that staffing levels and the skills mix around them did not meet patients' needs. I could go on forever. One quarter of nurses have gone to their GP due to work-related stress in the past 12 months. To be frank, it does not sound like nurses are valued, does it? The INMO has gathered many statistics on this. Some 61% of nurses are considering leaving nursing and 80% report unsafe conditions. Nearly half of all nurses reported pressure to work extra shifts.

I will add something else into the mix. It is International Nurses Day, a day on which we also celebrate midwives. Some 15% of the entire HSE workforce come from international areas. There have been 200 racist incidents against nurses in Ireland in the last year. In some cases, nurses are travelling in groups to their workplaces because they are afraid. One member of the INMO said that things like verbal comments and exclusion can have an impact and that this comes on top of everything else you are getting on with. That is a real issue because we rely so heavily on nurses coming here from other jurisdictions. They should be treated with respect.

What do nurses want? It is obvious. They want safe working conditions, decent pay so they can actually afford to live, and to feel they are able to keep going in the job. We need massive investment in the health service to provide the staff that are needed and to get rid of the unsafe working conditions nurses are being forced to put up with. We need less applause and fewer statements on International Nurses Day. Once again, a highly feminised workforce is just expected to put up with crap again and again.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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It is obviously good that we are at least getting this opportunity to talk about the issues affecting nurses but it is pretty rich given the issues highlighted by the INMO at its conference, including stress, burn-out, unsafe staffing levels and student nurses. I do not know how many years ago it was that we had motions about student nurses and the number of them who were contemplating leaving the country because they felt it was not doable for them because of the way they were being treated and what they were facing in the Irish health service. Many of them were leaving the country and going to Australia or wherever. All of those issues that the INMO have been campaigning about all of these years remain with us. Really, nothing has changed. A quarter of nurses are needing to see their GP because of the impact the job is having on them.

Last year, this all became very tangible for me rather than being somewhat abstract. I was in the hands of the nurses who were looking after me when I was in a difficult spot. It is then that you realise just how important they are and how much they do for you. We then find that nurses are treated in this way.

The Government is now talking about recruitment embargos again. I cannot believe it. When we have unsafe staffing levels and the union has been campaigning to place a legal obligation on the State to ensure safe staffing levels, we are back to recruitment embargos. The Government has given no real clarity as to whether these will impact on nurses and the front line and therefore on patients, the quality of services and all of the rest of it. The Government has consistently underbudgeted for health. That is why we get overruns. The pay, conditions and the situation in our health service are so bad that the service cannot recruit people and has to rely on outsourcing. Working in the public health service is just too unattractive to nurses. The last thing we need is recruitment embargos. We need a recognition from the Government that it has been underfunding and under-budgeting for our health service. Quite frankly, it is scary that the Government is talking about recruitment embargos as a response to its failure to acknowledge the amount of money it needs to put into our health service and into backing our nurses and other healthcare workers. "Hear, hear" for the nurses but the Government needs to step up to the mark.

Charles Ward (Donegal, 100% Redress Party)
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Nurses play a vital role in caring for patients in hospital and healthcare centres. Their work and their impact extend far beyond medical treatment. They are often the first people patients see. They are the ones who spend the most time providing care and comfort for the sick and injured. They are often the ones who provide emotional support to families during extremely difficult times. They do all of this while juggling immense workloads and dealing with overcrowded hospitals, staff shortages and long working hours.

The physical and emotional pressures they come under caring for patients every day cannot be underestimated. This is reflected most in the HIQA report on Letterkenny University Hospital where risks were identified in the emergency department, particularly with regard to overcrowding. Despite this the nurses were observed being courteous, attentive and respectful in their interactions with patients. The report said they were aware of this and demonstrated commitment to providing care and dignity and autonomy in delivery of care, and they retained a calm reassuring presence despite the pressures of a busy department with long waiting times. This is consistent with many reports you hear about Letterkenny hospital. Despite this and the many challenges they face, the nurses are exceptional in their work and the care they provide.

I do not think they get the recognition they truly deserve, and I am glad we are taking time to recognise them today. They deserve far more recognition, and the Minister of State knows this. At last week's INMO conference, an emergency medical nurse who worked in Letterkenny hospital for 22 years described how she left due to stress, anxiety and the physical demands of the job. She said she would go back in a heartbeat except her health was so damaged. She was one nurse potentially looking after between 30 and 40 patients in a busy emergency department. The shifts are physically hard and demanding. These are 13-hour shifts where you are on your feet and it is constantly go, go, go. It also takes a significant mental toll on their health, and they suffer from burnout. This is pushing them to the brink until they can physically and mentally do no more. We must support them and support their jobs.

We must also support our National Ambulance Service. The HSE's failure to update the ambulance workers' pay scales to reflect changes in their responsibility and workloads over the past 20 years is shocking. We must do all we can to support them. Two weeks ago, I was in the accident and emergency department in the middle of the night with my youngest child who had a high temperature. I received fantastic treatment there. One of the Indian nurses came in and she was magnificent. She cared for my child like it was her own. We need to recognise this but we also need to recognise that we have to look after our nurses.

John McGuinness (Carlow-Kilkenny, Fianna Fail)
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I thank all of the nurses and midwives we are speaking about this evening. I certainly appreciate them. I thank them for their passion for the job, and for their commitment and dedication. I also recognise that we stood in this House and applauded all of the front-line workers and made comments and statements about nurses and others. Yet, we did not fulfil what is necessary, which is pay and conditions, the proper number of staff and allowing them to perform their functions, which they are very good at.

I stand in solidarity with the ambulance drivers today and say we should recognise what they are doing and improve the range of qualifications now in play and ensure they have the numbers to do the job the way we expect them to do it. It is hypocrisy to speak here and for the HSE or Government, whoever is at fault, to not give the appropriate pay and conditions to those we are speaking about. We need to change that radically.

St. Luke's in Kilkenny is a level 3 hospital. It is short between 70 and 100 nurses. They use a lot of money to bring them in from the private sector to nurse in that hospital. When I see that, I think of the management and structure in the HSE. It is not good. It is not best practice, and it is not good business for the country. We should be doing a lot more to manage the staff we need and the qualifications we need within the health service. We should be doing an awful lot to support the nurses and midwives financially and in terms of their work arrangements.

There is a new hospital ready to be opened in Thomastown. I hear no talk about that in the context of staffing levels. Have they been completed? We need to have fewer promises from Government and politicians with regard to how all of this going to be achieved. We should be dealing with the reality of the crisis that faces nurses, be they in general hospitals or in the mental health setting, but we do not. I would like to see more time given to a discussion about management to deliver what we are speaking about to the front-line workers and to ensure they get the best for their jobs.

In his day, Bernard Gloster promised a skills facilitator for St. Luke's in Kilkenny. It never happened, and that is what I am talking about when I talk about promises made. You need to do what you say. You need to ensure the workers and nurses we see on the front line are properly compensated and we need to ensure those who continue to argue about long Covid are answered. They are not just doing it for the fun. Some of these nurses and front-line workers have been very sick following Covid and we have not recognised it. We have pitched them all back to the HSE to work out their deal for their ongoing income. A lot of them are really stressed about all of this. They are suffering depression, anxiety, burnout and so on. We talk about it here. We identify where the problem is but for some reason we refuse to address it. Until such time as these issues are addressed, the Government can stand and be counted as not fulfilling its first obligation, which is to keep its people safe.

Nurses and front-line workers deserve better. If the management were any way right, or any good at all, the strikers would not be out there today. That matter would have been dealt with long before it happened. If the Government was in private business, it would look across the range of employees it has and make it super attractive to keep them there, particularly when there is a shortage of skilled staff. That is what is done but it does not seem to be done by Government or the HSE. That needs to be talked about and corrected.

Peter Roche (Galway East, Fine Gael)
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I am glad to have the opportunity to add my voice of thanks to the many nurses around our country. I also give a shout-out to those in the ambulance services who are striking today and want us to do more for them. Strangely, my first job at 16 years of age was in a nursing home during the summer holidays. I never forgot the impact that had on me because I saw the outstanding work the nurses did. It resonated with me and the outstanding care left an indelible mark on me. Every patient was like their own parent, brother, sister or father. I thought that was incredible. From my circumstances in the past year, we lost two members of my family. We lost my daughter-in-law this time last year and my brother in recent times. I had lots of good reason to visit hospitals. I have often felt that nurses are born to be nurses. They are not manufactured. They come with such empathy, care and compassion and wonderful tolerance. They can cope with almost anything. I saw lots of times how people struggling with dementia might strike out. The nurse is able to withstand that and take that as if it is par for the course. I am not sure there is any other occupation with the tolerance to do that. The work they do is resounding. It is high time we said thank you loudly to them.

Saying thanks, as others have indicated over the last while, is a small thing, though significant, but what is really needed is for us to take stock and be cognisant of what they are enduring. There needs to be fair play for the contribution they make to society. That is one of the most compelling things, which we should really be doing. All of the contributions here today have been along the lines of praising them highly and speaking about the challenges. We all know those challenges and aware of the tremendous threat.

I am one of those, and God knows there are plenty more, who witnessed the nursing staff never allowing that stress or front-line pressure to have any impact on their patient. I can recall, as I said in recent times, when my brother was critically ill just a few weeks ago that it was a comfort to him to press the red help button. The expression on anyone's face, particularly his, when that nurse arrived into the room showed that was a lifesaver.

These are the things that I take from today's conversation. It is about acknowledging that wonderful contribution that they make to society. They continue to do personal development and improve their skills. Many are finding it a struggle to find their first job in their nursing career, and there are those who are abroad and want an opportunity to come home and work here. Many of those who are abroad, be it in Australia, America or Canada, go as a life choice and come back with a wealth of experience to offer to the health system here. I add my voice of thanks to the wonderful nursing staff around the country for what they do to keep the clock ticking on life.

Maurice Quinlivan (Limerick City, Sinn Fein)
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I begin by sending my solidarity to those in the National Ambulance Service who are engaged in strike action today. I know they would much rather be at work. Today's action should and could have been averted but the Government failed to address the issues that caused them to strike. At this late hour, I call on the Government to intervene and engage with the workers, and ensure that ambulance staff receive the respect and safe staffing that they deserve.

Nurses are the backbone of our health service. While the direct role is often to deliver medical care, the functions that they undertake span many more tasks than that. Nurses are medical professionals. They are the person a patient will trust and often confide in, the provider of emotional support to the ill, the comforting voice in a maternity ward, and the shoulder to cry on for those consumed by loss. Given the immense role they play across the health service, it is appropriate that there is a day to celebrate them today. The work they do and the hours our nurses put in comes with a cost to them personally. A 2026 member survey by the Irish Nurses and Midwives Organisation noted high levels of stress, burnout and concern about working conditions for nurses. Some 39% of respondents reported that their work negatively impacted their psychological well-being, and 24% of respondents reported visiting the GP due to work-related stress over the preceding 12 months. These are stark statistics.

Beyond this staggering personal toll, there is a danger that we will continue to lose our highly trained nurses to other jurisdictions. The INMO survey results are damning in this regard. Some 61% of respondents have considered leaving their work area in the month prior to completing the survey. Some 80% of those reported unsafe staffing levels in their areas. It is clear from these results that staffing levels and workload pressures remain a huge stress on our nurses. We need to establish in legislation safe staffing policies to protect both our nurses and patients. How can we expect to attract people to a sector if we cannot guarantee their safety, we cannot guarantee their leave days will be available when they need them, and we cannot guarantee that they will have manageable and safe nurse-patient ratios?

I briefly mention the nurses who work in my hospital, University Hospital Limerick, UHL, and commend them. For many years, they have been doing their already challenging job in some of the most difficult conditions faced by healthcare workers in any medical facility in the State. They are among the best heroes of our health service. Over the last number of years, the overcrowding in UHL has got worse for thousands of patients treated on trolleys all over the hospital. This severe risk to patient safety has often been mitigated by the professionalism and dedication of our nurses, and I thank them from the bottom of my heart. While people become frustrated waiting in the emergency department and despondent from being treated in the corridor, the feedback we receive regularly is that once you get in the door, the care you receive at UHL is pretty good.

I salute our nurses and midwives for the wonderful work they do. I commend the INMO for its attention to the needs of its members, and I call on the Government to ensure that our nurses are provided with safer and more secure working conditions.

Richard O'Donoghue (Limerick County, Independent Ireland Party)
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I thank all the nurses in the country, especially five of them in a place called Athlacca in County Limerick. There is a family of six, with five girls and one boy, and five of the girls were nurses. They are Marie, Eileen, Noelle, Angela and Cliona. They are the O'Keeffes. I grew up with them. The whole family have dedicated their lives to care and nursing. It was unbelievable to see. I thank all of the families, male and female nurses across the country, for what they have done, for the care, and for the families who encouraged them and gave them the help to become nurses so they can actually provide for others. I grew up with it. My sister is a nurse who is now retired. They grew up at a different time for nursing. At the time, they were in hospitals with matrons and each ward was run by the matrons. From those times to the training that we have today, the care that nurses gave and still give is above and beyond. They are the link between all staff, between the doctors, the consultants, the nurses, and everyone else, because they meet the patients and their needs. They get to the root of the problem. I thank them for everything they have done for this country and its vulnerable people. Small changes need to be made to encourage people to go into nursing. People can become apprentices today and are funded. Those who are becoming nurses should be funded the same.

Michael Collins (Cork South-West, Independent Ireland Party)
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I thank nurses across the country. Without them, we would not have a health service, but the reality is that student nurses are being worked full time caring for patients while struggling to afford rent, transport and food. Much of this work is unpaid. Travel accommodation and fuel costs are pushing students into debt, hardship and even homelessness just to qualify. By the time they graduate, many are already burned out. That is not sustainable. If we want nurses to stay, we must support them properly during training, not after.

We also have serious issues with nurses on work permits. In Bantry General Hospital, a nurse is still waiting on her Irish residence permit card and cannot travel home to see her family. This is simply not good enough. I also raise the case of Ms Elma Joseph, an Indian national with a valid critical skills employment permit to work as a nurse. She has been told she must leave the State due to a change of employer despite being lawfully here and working in a sector crying out for staff. That completely undermines the purpose of the critical skills scheme.

I call on the Government to sort out these issues immediately. Our health system cannot afford to lose these nurses, especially on a day when all paramedics are taking strike action. The Minister will have to sit up and listen to this. I listened to the Taoiseach's answers about those paramedics who are on strike today. They have been wronged, not for a week and not for two weeks, but for years. The Government seems to be using every kind of mechanism against the ordinary working paramedic who has given their time to save lives and upskill. A report was brought in in 2020. All of this was there before this Government and the last Government, and the paramedics have been left there and forgotten. This cannot continue. The Government has been neglectful and caught sleeping at the wheel. People are striking. That is no place for good, genuine, hard-working people who want to go out, save lives and do what they are trained to do and should be paid properly to do.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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On behalf of Independent Ireland and our TDs, I start by saying thanks to every nurse working across Ireland in the hospitals, nursing homes, community care, mental health services and emergency care. I thank every one of them for the tremendous work and their vocation in this State.

Without them, we would be in a terrible situation. The irony is not lost on me as we are thanking nurses on this day for what they do for the State that there are nurses in Australia, the United Arab Emirates and Canada who want to come home but cannot. There has been lots of talk on this side of the House about nurses coming home and that we must bring our nurses home, but what would they be coming home to? They are coming home to rents they cannot afford. They are coming home to a property market so difficult to get into that there are no properties there for them to buy. We are spending €100,000 plus every year advertising in Australia and probably €500,000 advertising across the world asking Irish people to come back home, but what have they got to come back home to? That is the worrying thing. I see many people leaving. One Member said earlier that they left by choice and for lifestyle. That may be the situation when people are younger and they want to explore the world and do those things, but most people want to come home. They want to settle down near their families, near their mothers and fathers, they want to be back working in the country they grew up in. They want to give something back to this country. I do not believe that this State is truly interested in bringing back those people who we have educated and done everything right for because it is saying to forget about them. We are not making it viable to come back into this country with the tax brackets. We are not making it viable to come back and buy a property here and we are not making it viable for them to come back by giving them good work conditions. That has to be addressed.

While we are all praising nurses in this House today, we must remember that we are letting an awful lot of nurses down across the world who come from and were educated in Ireland. That needs to be addressed.

Paul Lawless (Mayo, Aontú)
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I want to start by thanking all of the nurses, not just in this country, but all of our Irish nurses right across the world in Australia, Canada and America. Some of our best and brightest young people are educated here, which is paid for by the taxpayer, and then essentially forced abroad. That is what has happened over many years. It is devastating to hear that there are new talks of a recruitment freeze, given that the previous recruitment freeze drove our best and brightest away. Now, the Department is talking about another recruitment freeze. This cannot happen. We cannot repeat the mistakes of the past. The health service is under immense pressure. Nurses are under immense pressure. There are over 5,000 unfilled nursing and midwifery positions in the HSE.

I also want to talk about the National Ambulance Service. I support all of the men and women who are standing on picket lines across the country. In Mayo, there are areas that are incredibly poorly served. In Erris recently, Stephen Lavelle, God rest his soul, was left without an ambulance for a considerable length of time. I support them and I urge the Minister of State to do so. They are under immense pressure, and we need to support the National Ambulance Service.

Paul Gogarty (Dublin Mid West, Independent)
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I am in solidarity with the ambulance workers but I want to take the opportunity to praise the fantastic work of our nurses on what is International Nurses Day. There are over 92,000 registered nurses and midwives in Ireland who all do a fantastic job, but their working conditions are far from optimal. They have raised issues like unsafe staffing numbers, high levels of burnout and pay that has failed to keep up with the cost of living.

Ireland relies to a much greater extent on internationally educated nurses compared to many other high-income countries. According to a 2024 ESRI report, 46% of the workforce had been educated abroad while 69% of all new entrants had been trained internationally. That means that over the past two decades, more than half of all nurses registered in Ireland were migrants and we are increasingly reliant on the great work they do. At the same time, Irish nurses continue to move abroad, and many do not come back. Even if they did not emigrate, we still train too few of them in any event, with a 2023 OECD report finding that we produce 31 nursing graduates per 100,000 people compared with 58 in the Netherlands and 109 in Australia. There have been some improvements, but we need to keep our Irish nurses and retain the international ones by paying them better and improving their working conditions, bringing in the likes of a Dublin allowance, because having a vocation only goes so far.

John Lahart (Dublin South West, Fianna Fail)
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When I think of nurses, male or female, I think of the stereotypical attributes that we associate with them: kindness, gentleness, warmth, a reassuring smile or word, but also their dedication and professionalism, as well as world-class qualifications, ability and professional capacity. It is appropriate that every year on this day, International Nurses Day, Parliament recognises and thanks those nurses for the extraordinary care that they provide to our communities every day. Those nurses include advance medical practitioners, and I am conscious of the National Ambulance Service and its strike action. I hope that the Government can assist in resolving this via the HSE as soon as possible.

I am fortunate enough to have the national ambulance training centre in Tallaght in my constituency as part of a broader expanding health campus adjacent to Tallaght University Hospital. The national ambulance training centre is an interesting place to visit. I recommend it to anybody who is involved or interested in health. Its staff are always delighted to facilitate Deputies to see exactly how it works in terms of how calls are taken, distributed and responded to.

International Nurses Day, as we know, is marked on the birthday of Florence Nightingale, the figure we associate with modern nursing and who understood something that remains as true now as it did then. She is attributed with the words "A cure is not always possible, but care is always possible". I do not think that anyone understands that truth more deeply or lives it more fully than the nurses in our hospitals, both private and public.

Nurses understand that care is not secondary to cure. It is not an optional extra or a premium people pay for on their health insurance. It is an essential foundation of any humane health system, and it is our nurses who bring that foundation to life every day. They stand with patients and families during the longest nights and the hardest conversations, offering support when medicine alone is not enough. They are present not only in moments of recovery but also at moments of fear, uncertainty and loss. They are the beating heart of our health system.

It is not enough for this House to simply recognise that their work is important but to ensure that those who deliver care in healthcare settings outside of hospitals in our cities, towns and villages are properly supported in their work.

We heard from the president of the Irish Nurses and Midwives Organisation last week that nursing is a safety critical profession. Patient safety depends on having a sufficient number of skilled and experienced nurses and midwives and that they be respected and retained within our health system. That is a truth that all of us in this House agree with regardless of party affiliation.

Despite criticism, it is also an area where the Government has made solid progress. Since the beginning of 2020, there are nearly 11,000 additional nurses and midwives working in our health services, bringing the total number to 93,000. This achievement represents a 3% increase on the previous year, and it also represents the highest number of registrants to date. Progress has also been recognised internationally. Recent data from the OECD shows that Ireland is now among the leading countries in Europe for nurses per capita.

These statistics represent real progress, but they do not give us licence, as previous speakers have said, for complacency. Staffing levels on paper do not always reflect the pressures that are felt on the ground, and many nurses continue to report workloads that are difficult to maintain. For example, I read an interview with the chairman of the board of University Hospital Limerick at the weekend about the frustrations and overwhelming pressures on the nursing staff at the hospital. Unfortunately, it is a story that keeps repeating itself.

The safety and health, including the mental health and physical safety, of our nurses is critical. In a previous contribution, Deputy McGuinness mentioned the impact of long Covid on nursing staff. I have constituents, as many of the people in this House would have, who are nurses who suffer from long Covid and have seen their entitlements come to an end. They have had to add that stress to the stress of having a tedious, unrecognised illness and all the symptoms associated with that.

I urge those in charge of the systems that offer protection and pay to people in this situation to look on this with an empathetic eye and remember the days and nights when we applauded our nurses who stood between us and a pandemic. They were very much at the front line of that pandemic.

I read recently in the newspaper that in Northern Ireland - I hope I have this correct - nurses' unions are considering that nurses wear body cameras, such is the level of assaults and intimidation of healthcare staff. While we read about attacks in emergency rooms here, for now, the decision has been taken not to take that step because it would violate patient privacy. The point is that no one in the health service - I have spoken to doctors, consultants and nurses in this regard - seems to be escaping the break down in the boundaries and barriers of respect and protocols that existed. This affects health professionals and everyone else who works in the health system, such as orderlies, ushers, caretakers and catering staff. All those kinds of boundaries appear to have broken down. On top of going into work and being overwhelmed by the demand on the wards, intimidation and physical violence is also part and parcel in some parts of our hospital system.

It is true that, last year alone, some 7,000 healthcare professionals left Ireland to work in Australia, at a time when we produce approximately 900 doctors and 1,600 nurses each year. That gap should and does give all of us pause for thought. It underlines that the training of more professionals, while essential, will never be sufficient on its own if we do not also create the conditions that encourage skilled staff to build their careers in Ireland and ensure that the people most affected by the change in conditions or the lack of accommodation are given a strong voice within the partnership system, or what used to be called the social partnership system in this country. Their voices must be heard and represented at the table for negotiations when discussions on their future take place.

We need to support nurses. We need to care for those who care for us. Personally, without going into any detail, I have been at the receiving end of that care on a number of times in my life, as have members of my family, both here and abroad. International Nurses Day should not only be a moment of celebration; it should also encourage us to recommit to listen, respond and keep raising the ambition of what we can do for the nurses in our health service and health system.

Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The 120,000 registered practitioner nurses and midwives across the breadth of the island are the backbone of our health service. As they care for us throughout our lives, those of us in public life, particularly those in government, have a duty to care for them but that has not always been the case. Our student nurses have been utterly failed, alongside other students, when it comes to student accommodation. There is a deficit of at least 39,000 student beds across Dublin, Cork, Limerick and Galway. The Government is delivering near naught in terms of purpose-built student accommodation. It is a drop in the ocean. As these nurses progress through their careers, they endure the burden of conditions that no one would wish for our healthcare system.

In the past week alone, it was reported that last month was the worst April on record for overcrowding in University Hospital Kerry. A total of 23 people waited 24 hours on trolleys in University Hospital Limerick where doctors warn that patient safety risks identified by HIQA last year remain unaddressed. In my constituency, 16 people were waiting on trolleys in Cavan hospital. Monaghan hospital should be fully operational. Is it any wonder that some 25,000 Irish-qualified nurses and midwives, excluding retirees, have left our health system over the past two decades? We need to do better for our nurses. They are highly trained, qualified and dedicated but we need the Government to put in place conditions that both nurses and patients need and deserve.

The same holds true for many of our other healthcare professionals. Given the events of today, it is apparent that there has been a failure by the Government to properly recognise the modern role of ambulance personnel as prehospital care professionals. There have always been severe issues of workforce planning, driving overtime and burnout. In some cases, there have been issues of resourcing. The Government cannot say it was not warned, however. I have raised resourcing issues within our ambulance service in Monaghan with the Taoiseach, the Tánaiste, the Minister of Health, Deputy Carroll MacNeill, and many others to no avail. This Government is just not listening. What is needed? The Minister must intervene directly and genuinely listen to the grievances of our hardworking nurses and ambulance service workers.

Barry Heneghan (Dublin Bay North, Independent)
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Gabhaim buíochas le gach Ball a labhair inniu. I welcome the opportunity to speak on International Nurses Day. I welcome all those in the Public Gallery. I sincerely thank all the nurses, midwives and my relations, both those in north Dublin and across Ireland, for the extraordinary work they do every single day. It is not just a profession for them; it is a profession built on compassion and skill. We have all seen, either through our experience or that of our family members, the brilliant work they do. They care for us when we are sick and they care for the vulnerable. I especially acknowledge the staff in Beaumont Hospital who cared for me when I fell sick as a teenager. They showed professionalism and kindness, bringing me chocolate and cheering me up when I was down. It definitely helped me get through it.

Like many families I represent across north Dublin, I know personally the difference they can make. As they support us, we too need to support them. Since I have been elected, I have raised on the floor of the Dáil nearly 16 times the current accident and emergency department in Beaumont Hospital. The nurses, healthcare workers and all the hardworking men and women in Beaumont Hospital are under enormous pressure. I welcome the €27 million that was announced at the start of this year for the initial works and improvements in Beaumont Hospital but these hardworking men and women are the ones dealing with the burnout and rise in demand. When the infrastructure in the hospital they are working in is not sufficient, they are the ones who bear the cost. I welcome the Minister, Deputy Jennifer Carroll MacNeill’s visit to the hospital and what she has implemented, as well as the brilliant work of the new CEO of Beaumont Hospital, but we need to give workers safe staffing levels, fair pay and conditions, investments in training and improved hospital capacity.

Speaking as someone from a younger generation – this was mentioned across the House today - a lot of my friends who studied nursing, midwifery and a lot of other occupations are feeling the financial pressure, especially those living in Dublin. It is more financially viable for them to leave or emigrate. We need to encourage them back, and I know there is work being done on that. One thing I have raised is the need to have financial packages for those critical workers in high-cost areas, particularly at the beginning of their careers. I thank every single nurse and midwife.

Danny Healy-Rae (Kerry, Independent)
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I am glad to get the opportunity to raise my satisfaction and appreciation of all the nurses in Kerry and around the country, especially the nurses with whom I have had the occasion to deal with many times, both in the past and recently. I am especially thinking of staff in University Hospital Kerry but also those in the district hospitals in Killarney, Listowel, Cahersiveen, Dingle, Valencia and Kenmare and the hospitals that Kerry people go to, such as the one over the head in Bantry. Many Kerry people also use the hospitals in Cork, including Cork University Hospital, South Infirmary Victoria University Hospital, Bon Secours Hospital, the Mater Private Cork Hospital and so forth. The standard of nursing we have in this country is massive.

I do not think they have it in any other part of the world. I had occasion to be in the hospital the other night with a patient at around 3 a.m. The nurses there were working the very same as if it was the middle of the day. They were doing their duty and they knew every patient by name. They had such an understanding of everyone's needs on the ward I was in. It is great to have that when we need it. We must look after them.

I had occasion to meet a young girl who is 18 years old and training to be a mental health nurse. She has to go to Mayo from Milltown in Kerry to further her studies. She is determined and she will do it as she wants to be a nurse. I admire her for the determination she is showing. We need these nurses and we need them seen after, and paid and remunerated properly.

I feel for the ambulance drivers who have to go out on strike. I met one of them the other evening who had actually given up. He was a young man of only 45 years of age. He could not stick it any longer. That is the gospel truth.

To go back to the nurses, I appreciate them. We adore the ground they walk on and we appreciate them so much for the effort they put in on that roster every time they appear.

Máire Devine (Dublin South Central, Sinn Fein)
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Thanks, Deputy.

Verona Murphy (Wexford, Independent)
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Thank you, Deputy Healy-Rae. It is greatly appreciated.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank all the TDs who contributed today. Nursing in Ireland is a modern and highly skilled profession built on education, research and continuous professional development. This evening we heard from across the Chamber a shared understanding and deep appreciation of the vital role that nurses play across our health service. There is also a shared commitment to ensuring they are supported. My own daughter is a nurse and I am very proud of her. As a mother and as a Minister of State in the Department of Health I understand and appreciate the importance of our nurses. In supporting our health and well-being, nurses are present at every point of care and at every stage of our lives. They bring skills, care and humanity in an absolutely brilliant way. They do so in the most complex clinical environments while also shaping new ways of working that respond to patients' needs, demographic pressures and changing models of care.

I want to acknowledge the nurses within my own remit, those working within addiction services, social inclusion healthcare and sexual health clinics, and the nurses who support Healthy Ireland in its work. I thank all the nurses for their work, often with our most vulnerable people and in some very challenging settings. They are crucial to so much of what our health services do. They are the backbone of our health services.

I reaffirm the Government's firm commitment to ensuring that Ireland has a strong, sustainable and future-focused nursing workforce. The actions we are taking are not short-term measures; they are a long-term investment in the health and well-being of our people. We do not, however, underestimate the challenges that nurses continue to face in their day-to-day work. The reality of heavy workloads, staffing pressures and the complexity of modern healthcare is well understood. Addressing these issues requires long-term planning and investment. To address these issues we are expanding the supply of nurses. Ireland now has 14.3 practising nurses per 1,000 head of population, one of the highest ratios in Europe. Over 93,000 nurses and midwives are registered with the Nursing and Midwifery Board of Ireland, the highest number ever recorded. This growth is the result of sustained investment, with €28.5 million allocated to fund more than 1,100 additional healthcare training places every year for the next three years. Nursing places have increased by 23% since 2020, with a further 275 places secured in Northern Ireland. We continue to work closely with the higher education sector to expand domestic training capacity across all health professions.

Increasing numbers is only part of our responsibility to our nurses. We have also introduced supports for student nurses, acknowledging the amount of training time that is spent learning in clinical environments. We recognise that they are learners and students first of all, not employees. It is important that student nurses get the full college experience, immersing themselves in knowledge, research and learning through practice. The Government has strengthened the financial support available to student nurses and midwives. There is an enhanced travel and subsistence scheme, a targeted €500 annual meal allowance and additional uniform and laundry supports. We have reinstated the final year internship pay at 80% of the first year staff nursing salary. These measures ensure that no student is left behind because of financial pressures. Everyone who wants to become a nurse and has the skills and dedication should not be held back by costs.

We have also delivered the most reforms in nursing education in decades. We have huge reforms. The new NMBI undergraduate standards reflect the reality of modern healthcare, whether it is digital enabled, integrated or community based, and this also aligns with Sláintecare.

As mentioned by the Minister for Health earlier, the expert review body on nursing and midwifery continues to provide the blueprint for the future of this profession. Its 47 recommendations present an ambitious programme of reform to further empower nurses and midwives to deliver high-quality care across all settings. These positive impacts of the expert review body are clear. The workforce is benefiting from strengthening leadership and governance structures, from recruitment development to health regions, and from workforce planning based on evidence with a strong focus on staff health and well-being.

I also want to acknowledge that Irish nursing and midwifery has a respected and established global reputation. We know we have a huge global reputation. Our evidence-based approach to safe staffing and evidence-based practice is increasingly recognised across Europe and beyond, reinforcing Ireland's position as a global leader in nursing and midwifery reform. We are so well respected around the world and we are credited for the work that they do. I compliment all our nurses. Our evidence-based approach to safe staffing and evidence-based practice is increasingly recognised and reinforced. We are also making improvements in advanced practices. Over 1,300 nurses and midwives now work at advanced level. This represents 2.7% of the workforce. We are firmly on track to reach the target of 3% of nurses and midwives working at advanced level. We can also look forward to the findings of the national evaluation on the impact of evidence-based nursing and midwifery practices. Nurses in Ireland are central to reform, innovation and safety. Whether through new models of care, expanding scopes of practice or digital-enabled pathways, nurses are leading innovation across acute community and specialist settings. We are investing in education, supporting students, modernising training and expanding advanced practice.

The Government is aware of the challenges that nurses experience at work. Earlier, my colleagues the Minister, Deputy Jennifer Carroll MacNeill, and the Minister of State, Deputy Mary Butler, referred to the Irish Nurses and Midwives Organisation survey highlighting the high levels of burnout and stress and the exposure to growing levels of violence and aggression that nurses face. This is a concern for everyone. The survey is a timely reminder that we cannot take our healthcare staff for granted. They deserve a safe working environment and it is the Government's responsibility to support this. Nurses work every day in hospitals, community services, mental health, children's health, midwifery, disability, public health and specialist settings. They provide skilled care with compassion and grounded in professionalism. I am sure most of us can remember a time when a nurse provided reassurance and comfort to us in respect of a family member, whether at an appointment, during a hospital stay or ahead of an operation. Their role is truly invaluable and their work makes a profound difference every day.

It is important that we are mindful of and remain focused on implementation of policy change that supports a strong and sustainable workforce. This is an aim that we in Government, the Department of Health, the HSE, and representative bodies all share. Together we want to shape a health service that is resilient, modern and firmly centred on the needs of patients and communities. I want to take this opportunity on International Nurses Day to again place on record my sincere appreciation for the nurses across Ireland. Go raibh míle maith agat.

Verona Murphy (Wexford, Independent)
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I thank the Minister of State. That concludes statements on International Nurses Day. I too would like to welcome those in the Public Gallery who have listened to our debate and statements.