Maire Devine (Sinn Fein) | Oireachtas source

I am sharing time with Senator Warfield.

I welcome the Minister of State. I wish to record my dissatisfaction with having statements on this because they appear to prevent action. Yesterday in my local hospital, St. James's Hospital, there were 15 patients left on trolleys. The national number was 428. One does not often think of this with respect to children but in 2016 Our Lady's Children's Hospital in Crumlin had the highest number of children on trolleys. By the end of this year it will have had more than 1,000 children on trolleys. Up to November, almost 10,000 elderly people have been left waiting for over 24 hours for accident and emergency treatment.

These problems and a myriad of others, and I can give many examples, are directly linked to the fact that overall public health service employment has decreased since 2008. Recruitment and retention in the public health service are the core reasons the sector is on its knees. I wish to focus on that and I seek clear answers from the Minister of State on the Government's plan to tackle these issues. In November 2014, Dr. Stephen Thomas of Trinity College Dublin's centre for health policy and management said that we had experienced the biggest proportionate drop in health care across Europe as we had lost almost 20% of our health funding and at least 12% of our staff.The IMO quoted that we have a "manpower" - maybe it meant woman power - crisis within hospitals. It rightly acknowledged that the HSE is no longer an employer of choice, and the skills of a growing number of doctors, nurses and midwives are actively sought by European and international health organisations.

Some facts that the IMO has identified about this issue include that at any one time there are up to 400 vacant consultant posts. Those posts, when advertised, often attract no applicants. Nursing is the backbone of the health service. A total of 78% of final year nursing and midwifery students have already been offered full-time permanent posts in other countries. They have more attractive terms than those available here. Pay, training supports and career progression, along with poor working environments, are the key factors in decisions to emigrate. The shortage of doctors, nurses and midwives is leading to unsafe work practices and negatively impacting on patients. We are not replacing those staff who leave and young nurses without experience are being left to cope.

In a recent response to a parliamentary question from the HSE we learned that the number of nursing students has increased since 2008, which I welcome, but the number of staff nurses has decreased by 10%. We are not striking the balance well in terms of recruiting those who are newly qualified and retaining the experience and expertise required to keep the health service running smoothly. We have a brain drain and we have a massive haemorrhage in the experience we need.

Many times in my nursing career my experience served me well and that is then passed on to younger nurses who will then take over the helm, but that is not happening at the moment. It is part of the informal training and sharing with the newcomers and shaping all the talent they have into being a good practitioner. However, if we are not fostering conditions to incentivise experienced nurses to stay in their posts we will end up with a young nursing workforce left with no elders from whom to learn. That compromises the duty of care and endangers the lives of patients.

The reality is that Ireland cannot compete with the UK, Australia and others to retain new graduate nurses. The offer a few years ago of the insulting yellow pack graduate scheme began the exodus of nurses who said they had enough. We also have incentives and bonuses provided by private companies of between €3,000 and €5,000 for signing up with them. The impact of the shortage of staff is enormous and results in the curtailment and closure of services. I invite the Minister of State to comment on the proposed closure by the end of this month - we have two weeks - of the high observation unit in Tallaght Hospital. Cappagh hospital has a nine-bed unit but six of those beds are permanently closed, although there is a massive waiting list because of staff shortages.

There is a curtailment in the development of psychiatric services. I ask the Minister of State to also explain why we do not even the basic maths involved in our spending on the child and adolescent mental health service, CAMHS. The HSE does not do budgetary oversight.

In order to work as a nurse or a midwife in the Republic of Ireland one must obtain a certificate of registration from An Bord Altranais, the governing body, but there is a real problem with highly skilled experienced staff. More than 100 nurses unsuccessfully tried to obtain registration. I raised the issue previously and it has been discussed. I spoke to those nurses who are now working in non-health care settings because of the inflexible criteria of hours that must be divided between theory and practice by An Bord Altranais. We must examine the issue and add flexibility that does not compromise patient safety or care. It is a short-term objective and it is doable. The Minister of State should meet with An Bord Altranais to progress the issue.

Sinn Féin seeks to propose increasing nursing numbers by adding 500 each and every year over a five-year period, bringing the total to 2,500 which would be followed by further recruitment. The more people one has that are active and excited about working in pleasing and satisfying conditions the more people will want to join. Sinn Féin is often unfairly and wrongly accused by other nasty Senators of not offering solutions to problems. We have given several solutions, including the comhlista initiative and this morning Deputy Louise O'Reilly launched on our behalf an approach to the trolley crisis, which sets out comprehensive proposals and analysis on tackling the problem. I ask the Minister of State to outline in detail the Government's approach to tackle the issues I have addressed. I also urge him to work with the trade unions on staffing so as to make the health service fit for purpose.