Róisín Shortall (Dublin North West, Labour)

I thank the Senator for raising this issue and it presents an opportunity for me to make a number of comments on the future of the public health nursing service, particularly the service in Roundstone, County Galway, and in the wider area of Connemara and the Aran Islands.

The public health nursing service is a structure within the HSE, which consists of a director of public health nursing, assistant directors of public health nursing, public health nurses and registered general nurses and midwives. A small percentage of specialist posts are filled by clinical nurse specialists and advanced nurse practitioners. Registered general nurses work alongside the public health nurse in the community and assist with clinical nursing and caseload management. This involves the delivery of nursing care to various patient groups, including children and families, palliative care, the young chronic sick, those with disabilities and older people in the community. Care of children and families includes a universal child health screening and surveillance programme for children up to the age of three and a half years.

The changing demographic profile of Ireland, a rapidly growing older population, increases in the birth rate, increases in the number of people suffering with chronic conditions, reductions in length of hospital stay, technological advances in care delivery and increased demand for health promotional activities have impacted on the organisation, management and cost of the delivery of the public health nursing service.

The delivery of a sustainable community nursing service that effectively meets the health needs of the population within a primary care setting is the primary aim of the public health nursing service.

The HSE's primary, community and continuing care service in County Galway, which has responsibility for public health nursing services in the county, continues to make every effort to protect and maintain front-line services. Thanks to significant staff commitment and as a result of redeployment and revised arrangements for cross-cover, Roundstone will be covered by the primary care team nurse based in Clifden.

In the wider context of Connemara, a level of locum cover will be provided to ensure that essential public health nursing services are maintained throughout the area. The Aran Islands have public health nursing cover at present and it is the HSE's intention that this cover will continue to be provided. Individual staffing situations will be considered in light of existing resources and the challenges imposed by the recruitment moratorium.

Contingency planning is ongoing to ensure quality safe services can be delivered following the retirement of staff from services at the end of this month. The HSE is currently carrying out a review of public health nursing services, which is expected to be completed shortly. This review will inform national HSE policy in order to facilitate the integration of services and the delivery of efficient and safe care to patients in the community.

I want to give the Senator an assurance that I see a very bright future for community nursing and public health nursing in particular. I believe they will become the mainstay of primary care services. I look forward to receiving the report from the review group and to restructuring the way in which we deliver public health nursing services but I see them as being an absolute essential in terms of the rollout of enhanced primary care services.