Colm Burke (Fine Gael)
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I thank the Minister for coming into the House to deal with this matter. The issue I raise concerns the training courses available for nurses who have trained abroad but who now wish to return here. I am led to believe that the number of courses available in recent years has been cut back and that the number available is inadequate. Currently, Irish nursing homes have over 500 vacancies for nurses and they are finding it difficult to recruit nurses to fill those vacancies. Some nurses who want to return are finding it difficult to go on the adaption courses and unless they do that, they cannot become registered. There is also an issue in regard to delays in registering with An Bord Altranais, but that is a different issue.

Hildegarde Naughton (Fine Gael)
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Sorry Senator, you can discuss only what is on the Commencement Matters list.

Colm Burke (Fine Gael)
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I am aware of that. The issue that must be dealt with is increasing the number of places on the adaption courses for nurses who have trained abroad but who wish to work here to allow them go through the training process and then become available to work in Irish hospitals and nursing homes.

The other issue facing nursing homes is that many of the nurses working in them are taking on jobs in the Health Service Executive, HSE. The HSE can now recruit for the first time in a number of years and some of the people who have been working in nursing homes for a number of years are returning to work in HSE hospitals or community hospitals. The nursing homes are facing that problem from both sides. On the one side they are losing nurses and on the other side they do not have an adequate number of training places for those who want to come and work in this country.

Leo Varadkar (Dublin West, Fine Gael)
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I thank the Senator for raising this matter. The background to this issue is that nurses who trained in a country outside of Ireland and wish to work in Ireland are required to apply to register as a nurse with the Nursing and Midwifery Board of Ireland, NMBI The NMBI, following assessment of qualifications by an applicant, may require an applicant to undertake a six-week period of adaptation and assessment. A period of adaptation is designed to make up for differences in education and ensure competence for working in the Irish health service. If this adaptation is required it must be successfully completed as a prerequisite to registration.

In 2014, the HSE facilitated 151 nurses to complete a period of adaptation for the private nursing home sector. In 2015, as part of a pilot project, the HSE has scheduled additional clinical adaptation programmes. These will take place in April, June and August for the private nursing home sector. A maximum of 197 places will be offered on these programmes for which there are currently 60 nurses identified. The pilot project is due to finish in October 2015. In addition, separate initiatives to meet the demand for adaptation programmes for the public health sector have recently been commenced, and these are being co-ordinated and managed by the hospitals concerned.

I am advised there is currently an anticipated need for 272 clinical adaptation placements based on projected workforce needs outside the planned 2015 provision for the private nursing home sector. At present, there is no capacity for additional placements onto the nationally co-ordinated clinical adaptation programme developed for private nursing homes. There are 42 health service locations approved by the NMBI for the provision of clinical adaptation programmes. Current difficulties do not relate to the number of sites but rather to the pressure on front-line services to facilitate clinical adaptation, such as the availability of clinical facilitators to co-ordinate and manage clinical placements and oversee and monitor the assessment process.

I understand alternative approaches for the provision of clinical adaptation are currently being explored. However, any options that may arise from this initiative will not bring any benefits in the short term. Therefore, there still remains a requirement to provide adaptation programmes. Discussions on the issue among Nursing Homes Ireland, the HSE office for nursing and midwifery services and the Chief Nursing Officer's office are scheduled to discuss this matter in the coming weeks.

Colm Burke (Fine Gael)
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I thank the Minister for the reply. I note there is an acceptance that there is a need for additional training positions. It is a major problem within nursing homes. It is also a major problem within hospitals. Some Irish nurses contacted me recently who trained in the United Kingdom and who returned to Ireland. They applied in early December to register but ten weeks later they were still not registered with An Bord Altranais. That is an issue that needs to be resolved also. On the one hand we have the shortage and on the other hand we are not responding fast enough to that shortage. The Minister's reply is open and honest in terms of dealing with the issues but it is a problem that must be given priority to make sure we do not fall into a situation where beds in nursing homes cannot be filled because we do not have the nursing staff and, as a result, there is a backlog in our hospital system.

Leo Varadkar (Dublin West, Fine Gael)
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As I understand it Irish trained nurses do not have to do an adaption course but they do have to re-register with the NMBI if they allow their registration to lapse. There have been some delays in processing applications for all sorts of reasons, not entirely administrative delays, but I am certainly aware of that. It is the case that we are in quite a different position than where we were a year ago and thought we would be at this point in time. The HSE will increase the total number of general nurses working for it by 500 this year and at the same time the nursing home sector is growing also so there is a greater demand for nurses than was the case this time last year, and more so than had been expected. That is causing difficulties but it also means that in some cases the HSE is hiring nurses off the nursing homes. The nursing homes are then trying to take nurses off the HSE, and the agencies are involved in the whole show as well. It is something I am aware of, as is the Minister of State, Deputy Lynch. We are meeting with Nursing Homes Ireland on Thursday to try to discuss solutions. We are aware of it but like many of these issues, the solutions may not be as straightforward as they may appear. However, we will find them.

Colm Burke (Fine Gael)
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I appreciate the Minister's response.