Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)

I thank Senator Ní Chuilinn for raising this important topic and again apologise for the problem last week.

The Government remains committed to providing continued investment in the health workforce, including public health nurses, and ensuring this incredibly important service is available for those who need it. Public health nurses are employed by the HSE to deliver safe, quality and person-centred community nursing care across a person's life. As of May this year, there are 1,493 whole-time equivalent, WTE, public health nurses employed and a further 27 whole-time equivalent posts provided for in budget 2025.

In response to the very significant concern the Senator and others have raised, especially in her constituency where I have observed this has been a particularly acute problem, we have tried to expedite those posts to areas where child health developmental assessments are most impacted. More broadly, as of March 2025, 83.4% of 9- to 11-month child developmental assessments were completed on time or before reaching 12 months of age.

As we are aware, the HSE recruitment pause ended in July 2024. There is no impediment to normal recruitment or replacement of staff within agreed WTE limits. Each regional executive officer will continue to prioritise, recruit and replace staff within his or her approved number as appropriate, including public health nurses.

The Senator and I both know there have been known challenges with the recruitment and retention of public health nurses, especially within parts of Dublin and in particular in the area the Senator represents. A community nursing oversight group was established by the HSE specifically to identify those challenges related to recruitment and is progressing the recommendations from that work. Short-term temporary solutions to prioritise resources and service provision have been put in place, including prioritising birth notification visits and post-natal assessments.

As of March this year, 13 local health offices nationally, including Dublin south-west, are using the national caseload prioritisation framework. That assists with providing care to people within the areas in greatest need of services. Child health developmental assessments have, in some instances, been impacted by that approach. However, and this is so important, the HSE advises that the Dublin south-west integrated healthcare area, IHA, which covers the area of Dublin 12, is working to address service provision. Efforts under way include the development of partnerships between acute hospitals and community partners to provide graduate nurses with an opportunity for a clinical rotation to the community and to initiate a similar opportunity for experienced registered nurses working within hospitals. That development is in the initial stages and is one of a number of measures that will improve the public health nursing workforce into the future.

Of the additional public health nurse posts allocated in budget 2025, six whole-time equivalents were allocated to Dublin south city west and Dublin south-west IHA’s, which are areas with a significant mismatch between demand and capacity as the Senator correctly identified. Recruitment for these positions has been prioritised. Candidates have been selected and are scheduled to commence their roles through the public health nursing sponsorship scheme in September 2025. That is six additional WTEs for that area commencing in September 2025. Reconfiguration and integration of services, reorganisation of existing work and redeployment of staff will continue to underpin broader contingency plans. I absolutely fully acknowledge the very important concerns of parents when access to these important public health nursing services is limited. They provide reassurance and comfort as well as an early identification system for difficulties at a most vulnerable time of both a mother and baby's life. My Department is working with the HSE to address those challenges and I will continue to do so. I appreciate the Senator raising this issue and the opportunity to be able to provide an update to her today.