Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank Senators Boyhan and McDowell for tabling this motion. I am responding on behalf of the Minister for Health, Deputy Stephen Donnelly, and the Government. Senators O'Donovan and Buttimer had a Commencement matter on this issue last week. It also has been raised by many other Senators and Deputies in the Houses.

The motion highlights the Patients Deserve Better campaign, promoted by the Neurological Alliance of Ireland and its partners, which is calling for an additional 100 neurology nurses in our hospitals. The Government is not opposing the motion, as it aims to support neurology services. However, it is incumbent on me to point out that, as with all health workforce expansion requests, bids for additional nursing and midwifery personnel will be considered and addressed in the context of the Department of Health’s ongoing workforce planning considerations as well as the annual Estimates and budgetary processes. These considerations aim to address, in an appropriate fashion, the many competing needs of the health and social care system. Many of the Senators have asked me, in my capacity as Minister of State in the Department of Health, to support this and I have no problem doing that within the Department.

I thank Senators Boyhan and McDowell and other Senators for the way they conducted this debate. There was no point scoring and it was very constructive and informative. That is a good way of addressing a very complex and important issue. The motion provides me with the opportunity to discuss the important work under way in neurology services. Indeed, many of the Senators have already highlighted that. Senator Clifford-Lee spoke about the great work that is being done in Beaumont Hospital in her area. She also appropriately referred to the many people who were here tonight who have a huge interest in health. Senator Craughwell spoke about being a ten-year-old many years ago. He said it was 50 years ago; I would have thought it was perhaps a little longer, but the Senator may answer that himself. He highlighted the great work that his family had done in the IMO and in many other areas.

Deputy Colm Burke held a meeting here over a week ago and it highlighted a very pertinent issue for Members of the Oireachtas. It is a very good way of informing Deputies, Senators and Ministers. Unfortunately, I was unable to attend it, but I followed the social media on it and I raised my support.

Senator Moynihan spoke about the briefings. A lot of the time there are people who can lobby. Over the years we have had the Irish Farmers' Association, the Irish Pharmacy Union and many others. This has been a very effective - I will not call it a lobby group - information campaign which has caught the imagination of Deputies and Senators. It should take a bow. It is a very good way to lobby. It was not confrontational; it was informative. If one wants something done, one should bring people along. That is very effective. Senator Kyne talked about the campaign, his family, issues in Galway and the personal experience. That was an interesting and emotive way of addressing this debate.

Senator Seery Kearney spoke about the importance of St. James's Hospital. Everybody is looking for extra nurses in their areas, and that is to be commended. Sligo was mentioned as well. We all want to get more nurses than we have, and the more placements we can have, the more areas will benefit. I thank Senator Warfield. We worked closely together in the Seanad and I thank him for raising these issues. Some Members talked about qualifications, people coming into the country and the choice of training. That is a pertinent issue. Mr. Darren Fitzgerald was mentioned as well, and the great work he did with his daughter, Caoimhe. Again, it certainly raised a lot of information on the issue.It is the right way to do it.

There is no doubt that neurology nurse specialists play a significant role in the triaging, assessment, treatment and delivery of care for ongoing support of neurology patients. Neurology is a very important branch of medicine dealing with disorders of the nervous system, including the brain, brain stem, spinal cord, root, plexus, peripheral nerves and muscles.

Importantly, the HSE's national clinical programme for neurology engages regularly with patient organisations, including the Neurological Alliance of Ireland, to identify service requirements and patient demand for neurology nurse specialists. In this regard, the executive's clinical programme is focusing its current workstreams and initiatives on nurse-led clinics, nurse liaison services and outreach programmes. Examples of this work include the headache programme and the epilepsy outreach programme, both funded under the Sláintecare innovation fund. These programmes reconfigure the management of the conditions, enabling clinical nurse specialists and advanced nurse practitioners to lead and co-ordinate the care related to the conditions in the community. This reduces demand on consultant neurologists and tertiary services appropriately and safely, which allows more timely access to services and improves the overall quality of care for patients.

With regard to workforce planning, ensuring an appropriate pipeline of suitably qualified healthcare professionals in Ireland is a top priority. However, it is important to recognise that this is set against a global shortage of healthcare professionals, including nursing and midwifery. The Department of Health is engaging with the Department of Further and Higher Education, Research, Innovation and Science and other relevant stakeholders regarding a strategic approach to workforce planning and future skills needs. Progress is being made on increased numbers of undergraduate places across many health care professions, including nursing. Senator Maria Byrne raised the issues in her area in Limerick last week. I thank her for doing so again.

The HSE is developing a strategic programme of work to enable the health services to attract, develop and retain the workforce needed to meet the demand both now and into the future. There is work under way on the recruitment of nursing staff, including specialist nurse campaigns launched nationally and internationally for clinical nurse specialists and advance nurse practitioners. This is supported by the policy on graduate, specialist and advanced nursing and midwifery practice, which provides a clear framework for the development of specialist and advanced roles.

The Department of Health has also commenced a project, Health and Social Care Workforce Planning in Ireland, to address the long-term workforce planning needs of the health sector generally. This work is being undertaken with the support of the European Commission Directorate-General for Structural Reform Support and is being undertaken to develop a health and social care workforce planning strategy and action plan and a planning projection model for Ireland.

The Minister of Health also published the Report of the Expert Review Body on Nursing and Midwifery 2022, which sets out a pathway for developing and strengthening the role of the nurse and midwife. The House may be aware that the Minister has accepted all 47 recommendations in the report. This will support nurses and midwives to continue to learn and develop in professional roles, enabling significant reform aligned with population health needs and ensuring that critical Sláintecare priorities are realised.

In terms of funding an increase in the healthcare workforce, I am pleased to inform the House that budget 2022 provides funding for a large expansion of the workforce, of up to an additional 11,369 whole-time equivalents, reflecting the ambition and desire of Government to invest in Ireland's health services and ensure services are fully and safely staffed. A total of 12,506 whole-time equivalents were hired in 2020 and 2021. The year 2020 saw the largest increase in staffing since the foundation of the HSE, and 2021 saw the second largest. The largest area of growth in 2020 and 2021 was in nursing and midwifery, with an additional 3,372 whole-time equivalent posts, or a 9% total growth in numbers.

The motion refers to the waiting list for neurology outpatient appointments. It is important to say that the 2022 waiting list action plan for the health services was published on 25 February last and is now being implemented. Through this plan, the Government has provided €350 million in 2022 to reduce waiting lists and waiting times for scheduled care. The plan includes several proposals from the HSE to address the outpatient neurology waiting list. This additionality is in the form of both once-off activity to address the backlog and proposals for recurring activity to meet ongoing demand for neurology services. It is significant that, in total, 3,230 additional neurology outpatient appointments will be delivered by the end of 2022 through once-off funding. An additional 9,140 appointments could be provided each year upon approval and the roll-out of improved patient pathways, in addition to linked recurring activity associated with the acute hospital waiting list plan. It is important to point out that these additional activity levels do not include HSE proposals for active clinical prioritisation, which will also help to improve waiting times for patients on neurology waiting lists.

With regard to the provision of neuro-rehabilitation services in the community, the HSE's implementation framework for the neuro-rehabilitation strategy was launched in February 2019. The aim of the implementation framework is the development of neuro-rehabilitation services that will improve patient outcomes by providing safe, high-quality, person-centred neuror-ehabilitation at the lowest appropriate level of complexity. The framework also describes a managed clinical rehabilitation network demonstrator project, which is currently progressing through the development of post-acute and community neuro-rehabilitation services, withfull-year funding of €2.29 million available from 2021. This funding will mean that approximately 40 patients per annum will have their rehabilitation needs met in an appropriate setting outside acute hospitals.

In spite of the many challenges facing the health services today, the workforce and budgetary planning under way in the Department aims to address, in an appropriate fashion, the many competing needs of the health and social care systems.

I thank the Senators again for tabling the motion. It was very constructive, as was the debate. We learned all about the issues in the mid-west. We heard from Senators Conway and Maria Byrne, who referred to Limerick, and we also heard about Galway, Beaumont and St. James's hospitals. I thank Senators Boyhan and McDowell for tabling the motion. I understand Ms Alison Cotter was mentioned earlier. I thank her for the work she has done with her colleagues. The campaign has been very interesting and informative. Work is under way in the neurology service, including on recruitment. There are many challenges. I thank the Senators for the opportunity to contribute and, most important, for their very constructive and challenging contributions. It is great to be back here in the Seanad. I have always found it a very sensible place where collegiality has always resulted in an effort to get the best result.