Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

In our service, more than two in every five nurses and doctors were not trained in Ireland and without them we could not provide the essential care people need. To all our healthcare workers, I say thank you for everything you do day after day for patients and their families. To all who have come here from another country, I say you are welcome, you are valued and we will stand with you to resist any form of abuse, assault or attack. I say to people who are perpetrating these attacks on our healthcare workers, you need to stop. The person you are attacking or abusing is the person you are relying on to treat you or a loved one when you or they need that care most.

Ensuring the safety of our health and social care workers is a priority, for me, the Government and for the HSE. While even one assault on our staff is too many, it is important to note in tonight's debate that the HSE has reported that incidents of assaults across the health service have reduced by more than a fifth since 2018. The HSE constantly endeavours to mitigate risks to its staff from violence and aggression. Training in respect of this - rightly called for in the motion - is in place and it is particularly welcome that the HSE is prioritising a review of policies in this regard to ensure they are fit for purpose and as effective as possible. Four teams of specialist health and safety advisers are in place to support managers and staff in respect of occupational safety and health. In addition, other supports are in place, such as the employee assistance programme and the occupational health team which provide assistance and support to any staff member who is impacted by an assault. The HSE’s national health and safety office is working to develop a violence and aggression training strategy and to roll out a work positive tool to assist staff.

Under-staffing and a crisis in recruitment were referred to in the motion and in this evening's debate. I will speak about that directly. This Government has been committed to the large-scale expansion of the health and social care workforce since the beginning of the pandemic. Today, there are 18,000 more healthcare professionals in our health service than there were when Covid-19 arrived here at the beginning of 2020. This includes 4,400 additional nurses and midwives; 3,000 more health and social care professionals; 1,800 more doctors and dentists; and many more healthcare assistants, home helps and other staff. It is simply incorrect to say that we have a recruitment and retention crisis. Can we do more? Of course we can. Are there parts of the system where things are particularly difficult? There are. I meet staff who work in emergency departments and other parts of the system who are under sustained intense pressure.There are particular parts of the system, therefore, that we need to staff up more and to provide with more supports.

It is also important, however, to acknowledge what is happening. There are 18,000 more staff. This year will be the fourth in a row of record recruitment into the HSE. We must acknowledge this. Health and social care workforce planning is also rightly referenced in the motion. We are looking to ensure there is an appropriate pipeline of qualified healthcare professionals. We know we need to keep increasing the workforce, which is why I have said we need to double the number of college places for healthcare professionals in the coming years. As Senators will be aware, we are making inroads in this area.

Additionally, the HSE has been engaging in the programme of work to attract essential talent to meet the needs of the health service now and in future. In recent years, the HSE has worked in partnership with service areas to enhance recruitment capability and retention. Again, there is a way to go. The HSE needs to get quicker in terms of retention and hiring consultants. Improvements need to be made in the panel system, concerning health and social care professionals and others. A range of initiatives is currently available to graduates. These include the opportunity to work in and across speciality locations, professional development and mentorship programmes, additional career pathways, such as the significant increase in advanced nurse practitioner roles and advanced midwifery practitioner roles, and the introduction of an enhanced nurse contract. We are now looking at rolling out advanced practice in health and social care professionals as well.

The motion correctly refers to safe staffing and calls on the Government to implement the safe staffing framework and we are doing that. We have put significant public funding into the framework for nurse staffing and skill mixes. More than €30 million in new development and hiring funding has been allocated since 2020. An extra 470 whole-time-equivalent registered nurses and healthcare assistant positions have been created in phase 1, which is focused on general and specialist medical and surgical care settings. Some 62% of these positions have been filled and recruitment is ongoing for the remaining posts. Recruitment of a further 101 registered nurses for phase 2, focused on accident and emergency departments, is also under way. A quarter of these staff are now in post, with recruitment for the rest fully funded and under way. Phase 3 of the safe staffing framework includes three distinct care settings. Development has commenced in long-term residential care settings for older persons and will commence this year in community care settings, followed then by step-down rehabilitation settings.

Reforming our health and social care services is critical for the services we are delivering today and the care needs of the next generation. Our ambition is universal healthcare. What this means for people is that when they need healthcare, they will be able to access it quickly, it will be of consistently high quality and it will be free or affordable. This is one of the most important unfinished projects of our Republic and it is now within our grasp. A significant programme of ongoing reform is under way and is making progress. My aim is to make our health service one of the most attractive places around the world for healthcare professionals to work in. We commenced negotiations on a new contract with consultant bodies in April 2021. I expressed confidence then that we would deliver a remuneration package that would rival healthcare systems around the world, and I am glad to say that we have, by any measure, delivered such a contract. We will introduce it shortly.

The implementation of RHAs is also well under way. Transition to these population-based health services is taking place through this year. The population profiles of the six regions are being used to guide and inform the strategic workforce planning and the capital projects. The development of integrated care pathways, based on delivering the best outcomes for patients, means greater integration between care settings at national, regional and local levels. The pathways are agreed between GPs, primary community care providers, community specialist teams and hospital-based specialists who can provide better links across these care settings. These also ensure that resources are used to provide the best care for patients and that services are provided to patients more rapidly. A total of 2,400 healthcare workers have been recruited to the enhanced community care programme. This is a big change in our approach to care. It allows for more care to be delivered at or near home. Some 94 community health networks, 21 specialist teams for older people and 21 specialist teams for chronic disease management have now been established across the country.

This Government has invested more in our health service than any of its predecessors. The health budget allocation is now at an historical high of €23 billion. Almost 1,000 additional acute beds have been delivered since 2020, while we have increased our number of critical care beds by 26%. Our greatest investment is in the people who deliver care and in ensuring they can do so in a timely, safe and effective way. I again take this opportunity to recognise the remarkable work of the staff in our health service, including those who have been there for many years and those more recently recruited under the initiatives I mentioned.

My Government colleagues and I commend these staff on their dedication, professionalism and commitment to delivering health services to patients. We will continue to invest in our workforce. We will continue to grow it and we will continue to provide additional opportunities for learning and advancement in our workforce. I, this Government and the HSE take very seriously any threats to the safety of everyone working right across our health service. Many of the asks in this motion are being met, in terms of the reviews I spoke of, safe staffing levels and ongoing recruitment and retention across our healthcare services. I again thank the proposers of the motion for this opportunity to discuss what is an extremely important aspect of ensuring our healthcare staff are looked after and protected and that we continue to invest at significant levels in our workforce.