Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I concur with Senator Crown but doubt nurses are under-appreciated. As both the Senator and I know, they spend most time at people's bedsides in hospital, no matter what kind of traumatic event has occurred. Not only do nurses deal with the person in the bed but they usually deal with concerned relatives too so I do not think they are unappreciated. In different circumstances no Government would contemplate doing what we had to do - everyone had to take a share of the burden. Nurses are not unappreciated; they are hard-working and have had to do extra work due to the fact that the Government had to lower the number employed. The moratorium is being eased and we hope that in the near future we can convert some agency staff to the status of full-time staff, though many agency staff do not want full-time contracts, as the Senator knows. Some people prefer to remain as agency staff as that status can allow flexibility to deal with family obligations and the like. We hope to convert some graduate nurse contracts into full-time contracts as this is only right and proper. The measures we took were necessary due to the circumstances facing the country. I do not wish it to be thought that the Government does not appreciate nurses because it very much does.

I am responding to this matter on behalf of the Minister for Health, Deputy Leo Varadkar, and on conclusion of my formal reply I will convey to him the Senator's concerns on this issue. The Nursing and Midwifery Board of Ireland, NMBI, is a self-funding regulatory body with powers to charge such fees as determined by the board in accordance with the Nurses and Midwives Act 2011. As such it must generate its own income to meet its statutory requirements. The board is an independent body answerable to the Oireachtas. It has the responsibility to ensure that it has the financial capacity to undertake all its legal obligations. These costs include an enhanced regulatory process with supporting systems for continued professional development and certain education and training requirements for the professions.

The Department of Health is responsible for oversight of the governance of the Nursing and Midwifery Board of Ireland. The Department has no role in setting or approving registration fees. It was also made clear at the time of the legislation that the board would continue to be self-funding and needed to plan and cost how it would fulfil its legal obligations. Following detailed negotiations with the Executive and board members in 2013, it was agreed in October 2013 that an initial once-off sum of €1.6 million would be granted by the Department to the board to cover 2013-14 costs and that the board would have to increase its income in 2015 to undertake its commitments in the legislation.

On 17 September 2014 the Nursing and Midwifery Board of Ireland voted to increase to €150 the annual retention fee of each registrant nurse and midwife for 2015 from the retention fee level of €100 for each registrant in 2014. The annual retention fee in 2013 was €88 and this, as the Senator already pointed out, amounts to an 80% increase in two years. In a recent letter to all nurses and midwives the president of the board explained that the "decision to increase the fee was taken after a democratic vote and much debate" by the board. He stated that the increase was necessary "to ensure NMBI can continue to perform its regulatory functions effectively."

The Minister, Deputy Varadkar, is aware that a campaign not to pay the new fee is actively underway among the staff associations. His Department has written to the president of NMBI indicating concerns regarding the possible implications for the health service and patient safety should this action continue. It is therefore imperative that the board proactively engages with the staff associations at the earliest opportunity with a view to reaching a negotiated resolution to the current impasse. The necessity to avoid a scenario where non-payment of the fee will potentially become a serious matter for both publicly and privately-funded health services must be an urgent priority for the board.

The Minister has requested that the board give this matter very careful consideration at its meeting on 18 November, with a view to agreeing and implementing a course of action most likely to achieve a satisfactory outcome. It is understand that the staff associations have sought discussions with the board in this regard. We would ask the board and the staff associations to take appropriate steps to reach a satisfactory resolution to this situation in the interests of patient safety and continuity of care. Irish nurses are some of the best-educated and most sought after in the world and we also ask for such steps to ensure this reputation remains intact.