Nicky McFadden (Fine Gael)
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I apologise to the Minister of State for the mix-up last week and thank her.

At present, while nurses are retiring in abundance due to pension incentives and having achieved full years of service, they are not being replaced. For example, in Longford-Westmeath hospital, of the 11 nurses who are retiring this year, two are doing so on grounds of ill-health while the rest are leaving simply because they are coming to their natural retiring age. Although budgets are inadequate in all hospitals, a ban now is in place on the use of agency nurses. It had been the case that when a nurse retired, the money would follow and an agency nurse could be used to fill the breach. However, this no longer is the case. Only minimal overtime is being approved. How can patient care not be compromised if nurses are not being replaced? Most hospitals were short-staffed to begin with and matters are steadily worsening. I ask that the Government revisit the moratorium on the recruitment of nurses because there will be casualties and people will die. Staff morale is at an all-time low. I have spoken to nurses in urban and rural areas.

A number of weeks ago, I raised the issue of a service in Mullingar. Owing to the industrial action, the Minister of State could not get a response, which is in itself a dismal response. The matter pertains to the same issue in that there are 245 service users in St. Mary's day care centre in Mullingar. Due to the retirement of a staff nurse, there are serious concerns about whether the service will continue.

A fantastic new building attached to St. Vincent's care centre for the elderly in Athlone, the Athlone hospice, was built through local fund-raising and money from the lotto. It is a beautiful, state-of-the-art centre. I warmly welcome the commitment by the Minister, through Deputy O'Rourke, that the hospice will open, but I am concerned it will be consequential on events in the day care centre and Loughloe House, a centre for the elderly. I was told today that the number of beds at St. Vincent's Hospital, Athlone, is to reduce to 30 and that the nurses have been offered positions elsewhere in the county. Closing community beds for the elderly is not a good move. We need to keep them open. Some 15 nurses will be required to open the hospice unit in Athlone.

I have serious concerns. Mullingar hospital is in the same situation in that nurses are not being replaced. The population is growing and the same number of people are getting sick. I ask that this matter be revisited. Managers are being appointed in the HSE, so it is crazy not to look after the front-line staff doing the work. I am not saying that managers do not work, but surely the people caring for the sick are the most important.

Áine Brady (Kildare North, Fianna Fail)
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I thank Senator McFadden for raising this issue and for giving me an opportunity to clarify the position in respect of the operation of the moratorium in the health services. To implement savings measures in terms of public service numbers, the Government decided that, with effect from 27 March 2009 to the end of 2010, no post in the public sector, however arising, may be filled by recruitment, promotion or payment of an allowance for the performance of duties at a higher grade. The decision applies to all grades of permanent and temporary staff, including nurses, notwithstanding a number of specific exemptions, some of which I will highlight.

Employment control frameworks have been used for a number of years in the health sector to give effect to Government policies on the numbers employed therein. The 2009 framework gave effect to the Government decision on the moratorium on recruitment, promotion or payment of an allowance for the performance of duties at a higher grade. A HSE circular issued to give effect to the Government decision in the public health services and other specific aspects of the employment control framework for those services.

The Government's decision was modulated to ensure key services were maintained in so far as possible in the health services, especially in respect of children at risk, older people and persons with a disability. The 2009 framework specifically exempted a number of front-line grades in the health sector from the moratorium. The focus on these key grades was in line with existing Government policy on the prioritisation of certain development areas for which significant funding had already been provided. The overall result was to assist in the re-orientation of health employment to services delivered in primary and community care. This would mean re-organising and restructuring work to minimise the impact on essential service delivery.

The redeployment and reassignment of staff will be an essential part of this process. The draft agreement reached in recent days between public sector unions and management will play an important role in this regard. The draft agreement provides for greater flexibility, an extended working day and redeployment of health sector staff. This will have a positive impact on the provision of health services and will allow for the transformation agenda to continue.

The 2009 employment control framework also provided for a process whereby a limited number of exceptions to the moratorium were approved by the Department of Health and Children with the consent of the Department of Finance. The exceptions approved included a number of nursing posts, for example, 23 mental health nurse posts at the Central Mental Hospital and 36 mental health nurse posts at St. Loman's Hospital, Lucan. These exceptions were approved on the basis of the two hospitals making better use of their staffing resources, leading to overall efficiencies in the delivery of services.

A 2010 employment control framework is being finalised between the Departments of Health and Children and Finance. Although this framework is not yet finalised, I expect that, in 2010, it will again provide the Department and the HSE with the ability to deal with critical exceptions to the moratorium as long as the overall reduction in health employment numbers, as agreed by the Government, are met.

Nicky McFadden (Fine Gael)
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I thank the Minister of State. According to her, the Government's decision allows for key services to be maintained, specifically those relating to the elderly. Will she investigate the two issues I have raised concerning St. Vincent's Hospital, the hospice unit and St. Mary's centre in Mullingar?

Áine Brady (Kildare North, Fianna Fail)
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I have noted those issues.

Nicky McFadden (Fine Gael)
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I will leave it at that. I thank the Minister of State.