Tuesday, 21 June 2016
I thank the Minister of State for her attendance. On behalf of the nurses, midwives, medics and health care staff, I welcome the Minister of State to her post and hope to work collaboratively with her and the Minister for Health, Deputy Simon Harris. I am raising the issue of the pending first phase of industrial action next week by the Psychiatric Nurses Association. I ask the Minister of State to intervene.
The dispute concerns the 30% shortage of psychiatric nursing staff, which means there are no community services and a chaotic health care system in our inpatient units. According to A Vision for Change, the community input has not been implemented but that is for tomorrow's debate. In fact, more than 75% of its recommendations have not been implemented. The approved centres which are the inpatient centres need to be staffed so there is nobody in the community to carry out modern health care services for our people, taking us from the Victorian age to fit-for-purpose services for the young, the old and new-borns. There is not one mother and baby bed in the entire country for women. Post natal depression or post natal psychosis, which has a huge impact on the nurturing and bonding of mother and child is prevalent among women.
I am aware the Minister, Deputy Simon Harris, is meeting the Psychiatric Nurses Association tomorrow with a view to implementing A Vision for Change. I hope the Minister of State can intervene and set out a meaningful programme to build up our staff to stop the chaos in our hospitals and the overcrowding where beds are booked 120% of the time. When somebody is sent on therapeutic leave and is doing well they are telephoned on Sunday and asked not to come back and then somebody else is taking the bed.However, they are all registered as using that one bed. We need the sharing of bunk beds at this stage. I would appreciate the input of the Minister of State in that regard. We need to bring our nurses home from abroad and respect them and give patients the quality of care they deserve.
I thank the Senator for her question and contribution and wish her the best in her role. I will touch specifically on the planned industrial action this week. It is timely, therefore, that the Senator has asked the question. While it was directed to my colleague, the Minister for Health, Deputy Simon Harris, it falls within our collective remit. The Minister sends his apologies for being unable to be here.
As the Senator pointed out, the Minister met representatives of the Psychiatric Nurses Association earlier this month prior to the completion of the ballot on industrial action. Unfortunately, I was unable to attend, but I hope to meet them tomorrow or later this week. At the meeting representatives of the association outlined the concerns of their members about current and pending staff shortages and the need to focus on recruitment, retention and service development issues. The Senator has outlined many of these issues. Since the result of the ballot was announced there has been engagement between the HSE and the Psychiatric Nurses Association with a view to averting the industrial action which is due to commence on 29 June. Following contacts between the parties, an initial meeting took place last Friday and another is scheduled for tomorrow. Obviously, representatives of the Department of Health will attend that meeting. At last week's meeting the representatives of the association again emphasised the significant recruitment and retention challenges mental health services faced, given the age profile of psychiatric nursing staff. They also expressed concerns about the capacity of the system to implement A Vision for Change.
I emphasise that the Government is committed to providing additional resources for mental health services. As I mentioned in my previous address, this is shown clearly in the increase in funding for mental health services from €785 million to €826 million this year, an increase of 5.2%. The Government is also committed to reinstating the full 2016 provision of €35 million in new development moneys to enable service priorities in the mental health service to be progressed in line with A Vision for Change. The additional funding will enable further recruitment to priority posts throughout the mental health sector and the ongoing development of community mental health teams.
We face a genuine implementation difficulty in some areas, a point which has been acknowledged. It does not relate primarily to a lack of funding and is far more a question of sourcing staff and reconfiguring services and structures. Only this morning I spoke to officials about a particular post in respect of which there had been three recruitment drives, one of which was international. Despite this, it has been difficult to fill the post. There are, therefore, major challenges in this area. Having said that, some 1,550 new posts have been approved, of which 1,150 have been filled since 2012, but there are still have many gaps that we need to fill. The HSE is experiencing significant challenges in recruiting suitably qualified nurses in this area, with a significant gap between the number of nurses who are graduating and the positions that need to be filled. In that context, the HSE has made provision for the rehiring of retired mental health nursing staff. Some nurses have been rehired. I realise there are a number of issues about the pay scale, something the Department and the HSE are addressing with nurses. The HSE is focusing on facilitating the retention of these nurses and engaging to ensure this will happen. It is also focused on streamlining recruitment processes, increasing the number of student places available, recruiting graduating nurses and ensuring permanent contracts can be offered to all eligible psychiatric nursing staff. It is in the best interests of patients and nursing personnel that the parties engage constructively on the key issues involved in order that industrial action can be avoided at all costs.
The Senator and I share the same objective, that is, improving the delivery of services to ensure the health service delivers the services it is supposed to deliver. I am satisfied that the Psychiatric Nurses Association and the HSE are committed to continuing positive engagement and I will certainly do whatever I can to play my part in that process.
I do not want to be negative, but I have been involved in this game for a long time. In the 1990s the level of funding for mental health services was 14%. It is now somewhere in the region of less than 6%. I become cynical when I hear that it will be increased by 5.2% and when talk year after year of the figures of €41 million and €35 million. We never actually get our hands on that money, but it is announced as a new input every year.There is a cynicism in this regard but I hope the Minister of State will be able to write down in black and white where this money is coming from and where it will be allocated and confirm that it will be handed over as opposed to being retained. There was outrage when the €12 million was diverted from the mental health budget and lost in the other services that are seen as being less in the background than the Cinderella that has always been mental health services.
The Health Service Executive recruitment drive in recent years has been miserable. At the most we have attracted one or two psychiatric nurses from abroad. Most of them are too angry to come back. They were forced to leave, and that is a quote from the HSE, as were other medical staff and doctors. They were forced out by the yellow pack, degrading contracts. There is not one of those in the country now, and we are very proud of that. The then Government realised its faux pasin this regard.
Hiring retired staff is a possibility but I can tell the Minister of State that most of them cannot wait to get out the door due to burnout. It is a physically, mentally and emotionally demanding job. We try to do our best but when one is working in chaotic, understaffed conditions and watching the effects of those on patients and their families, it burns one out. We too are human but it is to be hoped there will be some thinking outside the box that will allow us improve the health service, especially in the area of mental health, to ensure it serves the needs of the people.
Gabh mo leithscéal. There seems to be a problem, which I believe is at departmental level, even though Senator Ó Clochartaigh submitted last week the matter he wished to raise. I accepted it in good faith and rejected five others. I could not take them today. There is a debate today and tomorrow on health and we might be able to find another way of raising the matter but if the Senator resubmits the matter either this week or next week, I will try to give him priority.
I thank the Cathaoirleach and the Minister of State. I can appreciate that a mistake has been made. I will resubmit the matter. I will talk to the Cathaoirleach or the Seanad Office about when it is most appropriate to do that.
Briefly, only last week I signed off on €18 million of the €35 million development fund and we are clear on where it is going, namely, to new posts but also to develop older services to ensure the environment in which the staff working is modern and appropriate to the work they do. There is much more work to do. More emphasis needs to be put on recruitment and we must ensure the places available in colleges match the number of places we need to fill. I look forward to working with the Senator and I will engage with her on every matter, where possible.