John Kelly (Labour)
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I welcome the Minister to the House. We have a serious problem within the nursing home sector in retaining and recruiting nursing staff. This has been brought about by the current Health Service Executive, HSE, recruitment plan drive. As we know, nursing homes are central to our health service and in one nursing home last October they had 12 nursing staff. Six of them have now left, two are set to leave and two are due to leave later in the year, leaving the operators in the lurch. In addition, the HSE is looking for two weeks notice from those staff who are employed in the nursing home sector and the operators of the nursing home require four weeks notice. It is leaving them in an impossible position. They cannot recruit locally, and we have the ridiculous situation where it takes over a year if they try to employ an Indian or a Filipino nurse. They must undergo an international language test, even if English is their first language, and in most cases they fail it. On the other side of the coin, one can employ European Union nurses who might have no English, and there is no requirement for them to have it. The only problem is that the Department aims to process their visa applications within 90 days but it takes four months for them to get a PIN. That is a serious anomaly.

We need to consider, first, as a matter of urgency, fast-tracking Indian nurses' visa applications. Second, we need to retain our Irish nurses for at least two years post-registration. Third, Indian nurses have to complete an adaption period, which is normally done in a general hospital, but there is no need for that as it can be done in nursing homes. These Filipino nurses have the same degree as Irish nurses. Why is this six week adaption period necessary?

All of these issues have serious Health Information and Quality Authority, HIQA, implications for nursing home operators, and some may be forced to close unless we can address the shortage of nurses in the system.

Paudie Coffey (Waterford, Fine Gael)
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I thank Senator Kelly for raising his concerns about a very topical issue. I am taking this debate on behalf of my colleague, the Minister for Health, Deputy Varadkar, who is on Government business elsewhere and who sends his apologies. However, I am happy to respond on the Minister's behalf.

The nursing home public and private sectors are collaborating with the Department of Health and the HSE in sourcing several solutions to meeting the issues arising in regard to nurse recruitment and retention.

Currently, there are two areas under active review regarding these recruitment and retention issues. First, there is the issue of recruitment of nurses educated and trained in Ireland. The HSE office of the nursing and midwifery services director has been supportive in allowing the nursing home sector meet with graduate students in the universities to discuss employment opportunities.

In addition, the chief nursing office in the Department has been engaged with the public and private nursing home sector in promoting nursing the older adult as a career choice. The office has facilitated ongoing discussions, spoken at conferences and engaged with third level colleges on seeking solutions to the recruitment and retention issue. These discussions have involved exploring and reviewing career pathways within older people services to encourage more staff into this area of nursing practice.

The second area under review relates to the undertaking of initiatives for the recruitment of global nurses. The background to this issue is that nurses who trained in a country outside Ireland and who wish to work in Ireland are required to apply to register as a nurse with the Nursing and Midwifery Board of Ireland. The board, following assessment of qualifications by an applicant, may require an applicant to undertake a six to 12-week period of adaptation and assessment. A period of adaptation is designed to make up for differences in education and to ensure competence for working in the Irish health service. If this adaptation is required it must be successfully completed as a prerequisite to registration.

There are two remaining HSE adaptation courses available this year in June and August. These courses are six to 12 weeks in duration. They facilitate the integration of global nurses into nursing in an Irish context. It may be of interest to the Senator to learn that since the nationally co-ordinated pilot adaptation programme commenced in June 2014 as many as 151 candidates have completed the programme, 58 candidates are undergoing assessment, and 126 candidates are due for assessment up to the final programme in August 2015. Outside of the current provision for placements in 2015, there are 293 requests for placements by employers. These numbers do not reflect a national total as some hospital sites have also run independent adaptation programmes.

There is a collaborative group which includes representatives from the Department of Health, the HSE and Nursing Homes Ireland. The group continues to explore options to facilitate adaptation. In this regard, some hospitals will respond to local needs from local nursing homes and this has been encouraged within the hospital group structures. Some hospitals will continue to support placements pending funding from NHI though not at peak undergraduate student times. Some are withdrawing from the provision of clinical placements in order to facilitate their own internal international recruitment initiatives. It was also agreed, in these discussions, that the NHI would consider options for it to co-ordinate the adaptation programme. This depends on and awaits the NMBI's approval of such a decision. The NHI has also been advised to contact some private hospitals to explore options to assist with facilitating such courses. In addition, options are being explored with an Irish university to offer a one day programme of assessment through an examination format. It is hoped that the pilot of this programme will be complete and results available in the last quarter of this year.

I am sure that the Senator will agree that all appropriate steps are being taken by the key stakeholders to maximise recruitment and retention options that arise in the nursing home sector.

John Kelly (Labour)
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I thank the Minister of State for his reply. The issue is the speed at which we deal with adaptations and visa applications and it is speed which is crucial for solving this problem. I appreciate the answer which has given me hope that something might be done by the end of the year but I remind the Minister of State that this is an urgent crisis, as we speak.

Paudie Coffey (Waterford, Fine Gael)
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I thank the Senator for bringing the matter to the attention of the House and that of the Minister for Health. I agree that adaptation assessments and the turnaround of competent people to act in this area is very important. I also take on board the view expressed about visa applications. This is something which we will bring to the attention of the Minister and that of the officials in order to see if further improvements can be made. I thank the Senator again for raising this matter.