Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank the Senator for raising this matter. As he may be aware, the Nursing and Midwifery Board of Ireland, NMBI, voted on 17 September 2014 to increase the annual retention fee of each registered nurse or midwife to €150 from €100. The annual retention fee in 2013 was €88. The registration fee is set by the NMBI, which is a self-funding organisation. I recognise that the board must meet its obligations within the financial resources available to it. At the same time, this demands that obligations are met on the most economic basis possible and all planned expenditure can be demonstrated as necessary.

It was made clear on the enactment of the Nurses and Midwives Act 2011 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 one-off sum of €1.6 million would be granted by the Department to the board to cover its 2013-14 costs, but that the board would have to increase its income in 2015 to undertake its commitments under the legislation.

The staff associations have undertaken a campaign of non-payment in respect of the new annual retention fee of €150 and have advised their members to pay the 2014 fee of €100 instead. Any nurse who does not pay the appropriate fee may be removed from the register. If a nurse or midwife is removed from the register, he or she will not be permitted to practise from the date of de-registration. However, the commencement of any de-registration process is an administrative matter and at the discretion of the NMBI. The NMBI has advised that it is committed to making its best endeavours to resolve the impasse with the staff associations.

I met the president, vice president and chief executive of the NMBI on 29 January to discuss the dispute. I again requested that the board re-engage in discussions with the staff associations as a matter of urgency. I expressed my concern regarding the implications for the health service and patient safety should the current impasse over the annual retention fee continue. I have asked the board to arrive at an outcome that secures its minimum financial operating requirements and avoids a scenario whereby nurses may be removed from the register for non-payment of fees, with potential consequences for service availability and continuity of care.

Since meeting the board's representatives, I have been informed that it has engaged in discussions with the nursing unions with a view to holding further talks, possibly facilitated by a third party, on the means by which the board and staff associations might come to an agreement on the fee structure for the future. The NMBI has indicated that it will consider amending the fee at a meeting scheduled for 3 March. Furthermore, it has indicated that it will withhold issuing reminder notices to registrants until after the review takes place at that board meeting.

As of 12 February, 25,980 nurses had paid the full €150 fee.An additional 8,000 have paid the €100 fee and some 30,000 have paid nothing so far. The 1,245 graduates of 2014 who registered with the NMBI and paid prior to December 2014 have registration certificates which are valid until the end of this year. I will continue to monitor the situation closely over the coming weeks and I again encourage all parties to take the necessary steps to reach a resolution to this issue. It should not be insurmountable. In the event of any nurses being de-registered for non-payment of the fee I am confident the HSE will take appropriate action to ensure that patient safety and continuity are maintained. It appears that a process is under way involving a third party so it will not be the case that anyone will be de-registered in six weeks time. A process has to be gone through before any nurse is de-registered and that process has been suspended during the current talks.