Martin Conway (Fine Gael)
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Cuirim fáilte roimh an Aire Stáit. Gabhaim buíochas leis an gCathaoirleach for taking this Commencement matter. Over the years many Irish people, including a very good friend of mine, have emigrated to the United States for economic and other reasons. I know of a number of examples of people who have gone to the United States, who have qualified and worked as nurses for many years there and who want to relocate back to Ireland. They find that the regulations, requirements, qualifications and so on that are required for nurses in Ireland mean their qualifications from the US are not recognised here.

We have a problem in respect of nurses in this country. We do not have enough of them. Many of our nurses are going abroad. Many of them are young people who want to travel and to live life abroad for various reasons. When they qualify as nurses, they find they have to go abroad. We have a significant shortage of nurses. We are opening the doors and welcoming nurses from many other countries but there seems to be a difficulty or problem with recognising nursing qualifications from America. It is probably because of some small technical issue but I believe that, if we were to deal with that particular issue and recognise their qualifications, a number of nurses would enter the HSE system very quickly and be available for work in this country, even if they had to prove five years' experience of working in hospitals as nurses in various disciplines in the United States.

I know of one particular lady who came back to Ireland to be with her elderly mother and to look after her. She is a qualified nurse who worked for years in America but because of the regulations she cannot work as a nurse in Ireland. She can work in many other disciplines but not as a nurse. Will the Minister of State tell me what specifically is the problem? Are we going to address it? If not, why not?

Jim Daly (Cork South West, Fine Gael)
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Gabhaim buíochas leis an Seanadóir as ucht an t-ábhar seo a ardú anseo inniu. I thank Senator Conway for raising this issue. An Bord Altranais, the Nursing Board, was established under section 6 of the Nurses Act 1985. This Act was repealed in 2011 under section 4 of the Nurses and Midwives Act 2011. The Nursing Board was renamed the Nursing and Midwifery Board of Ireland, NMBI, under section 6 of the Nurses and Midwives Act 2011 and has two main objectives. One is to protect the public and the other is to ensure the integrity of nursing and midwifery practices.

The NMBI is an independent statutory organisation that regulates the nursing and midwifery professions in Ireland. The main functions of the NMBI are maintaining the register of nurses and midwives, evaluating applications from Irish and overseas applicants who want to practise as nurses and midwives in Ireland, supporting nurses and midwives to provide care by developing standards and guidance they can use in their day-to-day practice, setting requirements for nursing and midwifery educational programmes in higher level institutions, investigating complaints made by patients, their families, health care professionals and employers and holding fitness to practise inquiries. Section 48 of the Nurses and Midwives Act 2011 enables the board of the NMBI to register an applicant, if satisfied that the person meets the relevant criteria, in the division or divisions of the register of nurses and midwives, which is considered by the board to be appropriate. I have been advised by the NMBI that applicants who trained outside the EU-EEA are individually assessed against current Irish standards of education and training to include a full review of the applicant’s education and training programmes. This review includes all pre-registration and post registration nursing education programmes. American and Australian nurses must provide the following documents in advance of their application being individually assessed: a completed application form; identity documents, transcripts of training from their university school of nursing; professional employment reference; and verification of registration and good standing from all competent authorities with which they held their registration.

Some American and Australian applicants unfortunately do not meet NMBI standards and requirements in terms of the nursing programmes they undertook when compared to Irish standards and requirements. Many programmes fall significantly short of the hours required for registration with NMBI or to be offered a period of adaptation aptitude test and unfortunately these applicants are refused registration. An applicant has the right to appeal this decision within 56 days of the date on the decision letter.

I am happy to inform the Senator that my Department recently received correspondence from the NMBI regarding a change in registration process for non-EU applicants. The new process takes into consideration post qualification experience as part of the assessment process for qualification recognition. The change was instigated in the hope of widening access to non-EU trained applicants who apply for registration while maintaining the standards for access to the register of nurses. The NMBI has informed the Department of Health it will also be publishing an updated guide to registration and making all of the information regarding registration available on its website. It is currently in the process of updating the registration application forms and guidance which it hopes will assist applicants in submitting their documents.

I have been advised by the NMBI that as of 14 February 2018, a total number of 236 individuals who undertook their training in the United States are registered on the active register with NMBI. The vast majority of these registrants would have had to undertake either an adaptation placement or aptitude test as a pre-requisite to registration.

Martin Conway (Fine Gael)
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The NMBI has advised the Department that it is updating its guidelines. Is there a timeline for the work of updating the guidelines to be completed?

I do not expect the Minister of State, Deputy Daly to have the answer at his fingertips, but will he revert to us with it?

Jim Daly (Cork South West, Fine Gael)
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It is in the process of being updated and we expect that will be completed very shortly.