Maire Devine (Sinn Fein)
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I thank the Minister of State at the Department of the Environment, Community and Local Government, Deputy English, for coming to the Seanad to address my nursing colleagues' extreme concern at the proposed changes to their working rosters at Cloverhill prison. These changes, if implemented, will lead to the halving of nursing cover on a nightly basis. My colleagues are extremely worried about the repercussions of this decision on staff welfare and safety and similarly the welfare and safety of prisoners to whom they have a duty of care as professionals registered with An Bord Altranais.

Cloverhill prison is an extremely volatile working environment. It receives committals from Leinster courts plus emergency committals from Donegal to Kerry where homicide charges are made. It gets all Garda national immigration bureau committals from the airport for deportation. Many of those committed have ingested drugs and require 24-hour observation. A total of 60% of committals from the Bridewell Garda station have drug and alcohol addiction requiring immediate intervention for withdrawal. Prisoners are accepted into the prison throughout the day and night. This situation therefore requires 24-hour triage cover within the institution. To suggest otherwise would be irresponsible and asking for trouble. The prisoners who arrive at Cloverhill are of an extremely volatile nature. Many are suffering from underlying physical and mental illnesses, abuse illegal substances and in most cases are addicted, pose a high suicide risk, are extremely vulnerable and have various other problems. Deterioration in health due to these issues and more place an acute demand on the expertise of the nurses and one nurse simply could not meet the needs as outlined in the proposed new roster.

Suicides are an ever present risk within the prison population. To suggest one nurse could attend a suicide attempt and meet the needs demanded by this situation is impractical and reckless. An incident which happened in 2014 was highlighted to me by the nurse concerned who attended the scene. The nurse had 26 years nursing experience, but the scene she attended during that night was something she had never seen before. She described it as a "bloodbath". Her priority and that of her nursing colleague on that night was obviously the prisoner. She vividly remembers the scene in the cell and says that were a similar incident to arise again, one nurse simply could not cope with the pressures. We need two nurses for competent cardiopulmonary resuscitation, CPR. A great deal of CPR is administered in the prison following overdose and attempted suicide. In some cases there are completed suicides.

The nurses' concerns have been consistently highlighted to prison management through their union but to no avail. The responses and lack of acknowledgement of their concerns are extremely worrying. In recent days, staff have become aware of rumours that the proposed roster changes will be shelved. If this is the case, it is to be welcomed from all angles. However, I would like to respond to my nursing colleagues and provide certainty to them that from here on, double cover will remain in place, that their safety and welfare, along with that of the prisoners, will remain more secure and the cloud of doubt resulting in a fraught atmosphere between staff and management can now lift. I would appreciate if the Minister of State can provide me with that certainty this morning.

Damien English (Meath West, Fine Gael)
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I apologise on behalf of the Tánaiste, who could not be here to take the debate. The Tánaiste wishes to emphasise that the provision of health care is a statutory obligation of the Irish Prison Service, as defined in the prison rules of 2007. She assures the Senator that the care and rehabilitation of persons in custody is a core aim of the Irish Prison Service. The IPS health care standards outline its commitment to provide equivalence of care to the prisoner population in custody. In this regard, the prison health care service seeks to provide prisoners with access to the same range and quality of health care services as are available under the medical card scheme in the community.

Nursing care in the prison service has, historically, been provided by a group of staff referred to as medical orderlies, who are prison officers with some basic first-aid training. In 1999, qualified registered nurses were first introduced to the Irish Prison Service. The drivers of this development were mainly external and came from the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment, the Penal Reform Trust, the Olden report and others. The introduction of professional nursing services into the prison system greatly improved the quality and standard of care. A prison nurse will generally work under the direction of a chief nurse officer and in partnership with prison doctors, while overall responsibility for the management of a prison or place of detention rests with the governor of the institution concerned.

In recent years, the Irish Prison Service has experienced difficulties in recruiting nurses to work in prisons. The 2015 competition conducted by the Public Appointments Service has resulted in 15 nurse appointments to date, and the IPS has been advised that the panel will not generate any further nurses for Dublin prisons. Notwithstanding these difficulties, the IPS has recently concluded a comprehensive health care review which will provide for the deployment of nursing resources to prisons throughout the estate on a more consistent basis.

The Tánaiste advises the Senator that the IPS worked with the review partners to ensure that nurse resourcing in all Irish prisons is commensurate with the population of the prison, the profile of prisoners and the health care needs of the prison population. The revised level of night nursing cover is considered appropriate in the context of demands for health care provision during the night shift. Cloverhill carries out the bulk of its health care activity during the day, and night-time nursing activity tends to be concentrated between the hours of 8 p.m. and 11 p.m. Following analysis, a proposal to enhance nursing resources at Cloverhill Prison was approved between IPS management and staffing representatives. A prison nurse is responsible for maintaining a safe and clean clinical environment and will function as a primary health care provider. The role of nursing staff encompasses not only general nursing care but also other services such as counselling, health education and promotion, and preventative medicine. A prison nurse is required to maintain the highest standard of nursing care and to participate in a multidisciplinary team while also having regard to, and a clear understanding of, safe custody of an offender. In addition, the prison nurse helps to create and maintain a therapeutic environment within the prison as a whole and works with doctors, other nurses and prison staff as a professional member of a therapeutic team.

The Tánaiste reiterates that the review of nursing at Cloverhill Prison enhances our resource allocation in that institution and is wholly appropriate in the context of demands in the prison during the night shift.

Maire Devine (Sinn Fein)
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I am very disappointed, and nurses are going to be very disappointed. The night shift is the most volatile shift and no other members of the multidisciplinary team are available. The onerous responsibility for providing the necessary care and the appropriate clinical environment falls on one nurse, and it is too much. Not many nurses would apply for such posts, but I will bring back the Minister's response to the nursing members at Cloverhill and we will engage with the unions to consider what further action should be taken. I am extremely disappointed, but I thank the Minister for his response.