Seanad debates

Tuesday, 25 January 2022

Nithe i dtosach suíonna - Commencement Matters

Hospital Staff

2:30 pm

Photo of Victor BoyhanVictor Boyhan (Independent)
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I welcome the Minister of State to the House. I have always said this Government will be very much judged on its track record and delivery in health and housing. I think we all know that.

I will focus on one simple measure concerning health. It is in response to an email every Deputy, Senator and Minister received from the Neurological Alliance of Ireland, NAI, campaign for 100 extra nurses in neurology. Patients are waiting too long for diagnosis and treatment and I think the Minister of State and I, and everyone, agrees on that. As an example, consider St. Vincent's University Hospital, which is one of the bigger focuses and the key aspect of this campaign, albeit a national campaign. Based on the catchment area of St. Vincent's, national and international guidelines recommend there should be 22 neurology nurse specialists there but there are only four. Patients deserve better. I believe that and the Minister of State does too.

Investing in more neurology nurses is a cost-efficient way of improving efficiencies and outpatient clinics, reducing waiting times and ensuring patients have access to specialist supports they need to manage their conditions. Patients with access to neurology nurses have reported improved psychological well-being, improved sense of involvement in their care and in their pathways for care, and the preparation for the tests and the investigations that are especially necessary for this specific area of medicine. More neurology nurses will also ensure patients get quicker access to outpatient appointments, thereby reducing waiting lists, and based on their deteriorating condition. I support the NAI's campaign for 100 extra nurses specialising in this area, including 17 extra nurses for St. Vincent's. I ask the Minster of State to do the same.

There was a chart published of nursing numbers per hospital which makes for very interesting reading. I will read it into the record. The recommended number of nurses for Beaumont Hospital is 15 whereas it currently has ten. The recommended number of nurses for Cork University Hospital is 20 whereas it currently has four. The recommended number of nurses for the Mater Hospital is 14 whereas it currently has six. The recommended number of nurses for Sligo University Hospital is seven whereas it currently has three. The recommended number of nurses for St. James's Hospital is 14 whereas it currently has only four. The recommended number of nurses for St. Vincent's Hospital is 22 whereas it currently has only four. The recommended number of nurses for Tallaght Hospital is 20 whereas it currently has only 15.

University Hospital Galway will be of particular interest to the Minister of State. The recommended number of nurses there is 13 but only four are in place. The recommended number of nurses for the University Hospital Limerick is 11 whereas it currently has three. University Hospital Waterford is really disappointing. The recommended number of nurses is six and there are none in place. Those are the facts.I am happy to share that with the Minister of State.

We are all on board. It is a case of how we are going to achieve this and support them. I am only here today to shine a light on this issue on behalf of the Neurological Alliance of Ireland. I would be interested in the Minister of State's feedback.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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I thank Senator Boyhan for raising this particularly important matter. I am taking it on behalf of the Minister for Health, Deputy Donnelly. The script I will read was prepared by his Department. I also take the opportunity to acknowledge the work and the role played by neurological nurse specialists. They play an important role in triaging, assessing, and providing ongoing support to neurological patients. This in turn builds capacity within neurological services and allows for more timely access to efficient, equitable and quality care.

I am advised that the HSE's national clinical programme for neurology, NCPN, in conjunction with the Neurological Alliance of Ireland, NAI, completed an all-Ireland survey of neurological services in 2020. This survey confirmed that all neurological centres have access to a designated clinical nurse specialist or advanced nurse practitioner, recognising the value that skilled and highly trained nursing staff add to neurological services. The HSE has advised that plans will be developed to incrementally increase the overall numbers of nurse specialists.

The NCPN continues to engage regularly with patient organisations and the NAI to establish ways to promote neurology nurse specialists. It is focusing its current work streams and initiatives around nurse-led clinics, nurse-liaison services and outreach programs. Examples of this include the headache programme and the epilepsy outreach programme, both of which are funded under the Sláintecare innovation fund. These programmes reconfigure the management of these conditions, enabling clinical nurse specialists and advanced nurse practitioners to lead and co-ordinate the care of these conditions in the community. This reduces reliance on consultant neurologists and tertiary services, which, in turn, reduces waiting lists and allows more timely access to services and improves the overall quality of care.

The HSE has advised that the neurology department in St. Vincent's University Hospital provides regional services in all aspects of general neurology including migraine and epilepsy services in addition to tertiary services for people with multiple sclerosis, cognitive disorders, dystonia and movement disorders and Parkinson's disease. The neurology Department offers an inpatient, outpatient and consultation service.

The HSE has further advised that there are currently ten specialist nursing positions in neurology in St. Vincent's, of which nine are in post. It is hoped that the post of advanced nurse practitioner in multiple sclerosis will be filled very soon. The Government, along with the Department of Health, is fully committed to improving patient services and having patient-centred care in St Vincent's and across the country. That commitment is, I strongly suggest, reflected in the unprecedented level of funding that is being targeted right across the health service in recent budgets and again in budget 2022. Since the end of 2019 the health sector has grown by a total of 12,506 whole-time equivalents, WTEs. The largest area of growth has been in nursing and midwifery, with an additional 3,372 WTE posts.

I am assured that the HSE remains committed to the progressive development of neurology services and, specifically, to improving this service for patients of St. Vincent's University Hospital and the surrounding areas.

Photo of Victor BoyhanVictor Boyhan (Independent)
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With all due respect, I fully appreciate that the Minister of State, Deputy Rabbitte, is taking the matter for the Minister for Health. The reality is that we have to look at what is on the ground. Today, I have called out ten hospitals individually. We were told what was recommended and what is the current status. The reality is that currently there are 41.5 nurse specialists in those ten hospitals when the recommendation is that there would be 142. The simple ask by this association is for 100 nurses. We can have all the commitments, aspirations and hopes, and we can have lectures and history classes about what happened two years ago, but today in January 2022 I am standing here to make a strong case to the Government that we revisit this campaign and that we all take the time to engage. Everyone is being asked to sign up to the online petition in support of the campaign. The current status is that it is up there online.I can only take what these practitioners and this association is telling me. There is a shortfall. They want 100 specialist nurses. They do not want the promise of them or the HSE talking about goodwill, commitment and aspiration. We want them on the ground and we want them treating our patients. I know the Minister of State is committed to that. I do not doubt that. However, we need to keep the pressure on and then, in two months' time, to come back in here and ask the Minister if he can say he is delivering. It is not about money in place or resources but about staff, specialist nurses, being in place. I thank the Minister of State for taking the question on behalf of the Minister for Health.

Photo of Anne RabbitteAnne Rabbitte (Galway East, Fianna Fail)
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This is not a history lesson but I reiterate that the Department of Health is committed to improving services in line with Sláintecare. Covid-19 did bring a range of serious challenges to our health services and its workforce. The unprecedented level of investment in our health service in recent years is testament to the commitment of this Government.

I will go back to the Minister, Deputy Stephen Donnelly, and ask him what is the commitment on the bespoke recruitment campaign in order to ensure that while funding is in place, the staff can be put into their allocated posts. The question here for the HSE is around the recruitment but I know the Government's commitment in respect of its funding. It is no different to the situation with Alzheimer nurses some years ago. There were only four but that has grown and grown because a bespoke campaign was put in place. I will bring the Senator's sentiments to the Minister.