Barry Ward (Fine Gael) | Oireachtas source

This is a difficult motion in many respects. I have great sympathy for the issues that are raised in it. They are serious issues and at a time when recruitment in our health service is such a massive issue for the Department of Health and for hospitals throughout the country, they are vital.

I heard what Senator Sherlock said about the two-tier system, and I agree with her, but I see two different tiers. On the one hand, I see front-line workers and on the other hand, I see management and administration. One of the difficulties we face is that the administration, who are back from the front line and do not face many of the problems that have been discussed in the course of this debate, are the ones who are the upper tier and are somehow given a greater value than the front-line workers, be they porters, nurses, doctors, laboratory staff or whoever else, who are actually delivering services to people. Those are the people who actually do what the health service has to do. To my mind, they are the most vital cog in the wheel that keeps us all safe and alive. The difficulty I have is that as I look at the health service, which is a behemoth, it seems as if greater value is placed on management and administration. Those people, in a strange way, are not difficult to recruit in the same way that front-line staff are. They are not suffering the same difficulties as front-line staff.

As the justice spokesperson for Fine Gael, I am particularly concerned about the situation healthcare workers are facing in patient-facing roles where they are at risk, assaulted and abused. I agree with measures that we can put in place to stymy that in whatever way possible. I am not sure that specific offences will do that. It is an enforcement issue rather than a law issue. It is an order issue rather than a law issue. It is about having people in the hospital or any other healthcare setting who can deal with those patients. Some people who are committing those offences do so because of difficulties they have that are beyond their control. I have sympathy for those people but we cannot allow a situation where the behaviour goes unchecked. Others are behaving in a way that is simply unacceptable and has no legitimate excuse. In either case, the reality is that our front-line healthcare workers are not properly protected or insulated from the dangers that come with being front-line healthcare workers. That is an issue. As long as it remains an issue, we are going to have difficulty recruiting people and encouraging them to come and work in that environment. That is one issue. To an extent, I agree with Senator Sherlock and in another way, I see the situation slightly differently.

I also wish to raise the attractiveness or otherwise of working in the health service. A couple of issues arise. I live and work in Dublin. I have friends who are nurses, medical staff and doctors who work in hospitals in Dublin. They are paid at the same rates as their colleagues in hospitals outside Dublin but the costs for them are massively higher because of the higher cost of living, particularly the higher cost of accommodation, in Dublin. It seems to me that nothing is being done in that space. Back in the day, there would have been nursing homes, accommodation options and other ways to help people who were working in the health service to make ends meet or to facilitate them somehow. Many of the people I am talking about are not from Dublin but come to the city for work and go home when they are not at work. I see the Department and the HSE as administratively the same thing, even though I know legally they are not. Between them, could they come up with a suite of measures to make it easier for people to come to work in the health service? We need to make the health service more attractive. Leaving aside the first issue I discussed, we must address the simple economics. It is not an attractive enough job, as we know. I know people who have returned from Australia and other countries to work here but they find it difficult. It is a choice they make not because it is an attractive job but because they want to come back here for other supports and to be close to family. Perhaps they have young children they wish to raise in Ireland or whatever the case may be. It is certainly not the pay and conditions in the health service that are bringing them home from Australia, America or anywhere else. Until we address that, the reality is that we are going to have difficulty in making it attractive and bringing those people back. I have suggested two approaches. Whatever we can do in respect of either of those issues should improve the situation.