Bernard Durkan (Kildare North, Fine Gael)
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Question 138: To ask the Tánaiste and Minister for Health and Children the degree to which the number of general practitioners, hospital doctors, consultant physicians and consultant surgeons is adequate to meet requirements or is in line with European norms in this regard; and if she will make a statement on the matter. [4426/05]

Bernard Durkan (Kildare North, Fine Gael)
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Question 144: To ask the Tánaiste and Minister for Health and Children the extent to which nursing, medical and surgical staff complements here compare with the norms throughout Europe; and if she will make a statement on the matter. [4432/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 138 and 144 together.

The responsibility for the management of the workforce in a given Health Service Executive, HSE, area lies exclusively with the chief officer of that area. However, in order to improve recruitment and retention prospects, my Department has put in place a number of important initiatives to meet the human resource needs of the health services.

Specific human resources initiatives in key areas such as pay rates, improvements in career structure and enhanced opportunities for professional and career development have and will play a part in increasing staffing levels. Overseas recruitment by health agencies has, over recent years, also contributed significantly to meeting the workforce needs of the health services, particularly in the medical, surgical and nursing professions.

There is a wide variation in the numbers of nurses employed in the health services of developed countries. Figures on a consistent basis are not readily available for cross country comparisons. Research by the OECD, OECD Health Data 2004, 1st Edition, in which the most recent comprehensive comparison between European countries was 2002, suggests that Ireland has one of the higher ratios, although countries profile their data in different ways.

The Irish health care system has traditionally been based on a large number of nurses. Other European countries tend to have systems where there is greater skill mix and grade mix involved in the delivery of health care services; therefore the ratio of nurses to patients is lower. The Irish health service is also moving in this direction and in coming years there will be a higher proportion of support workers, including health care assistants, involved in the delivery of care, freeing up nurses and midwives to concentrate more of their time on higher level duties and expanding the scope of their practice.

Nurse recruitment is a priority for the Government. The HSE reported that in the year ending 30 September 2004 an additional 561 nurses were employed in the health service and since 1997 over 6,300 additional nurses have been recruited.

The Department of Health and Children has made substantial investment in consultant numbers in recent years. The current number of permanent consultant posts stands at 1,947. The OECD does not collate statistics specifically relating to consultants but does, however, provide statistics under the heading of physicians which encompasses any doctor who is fully registered with the Irish Medical Council. In 2002, Ireland had 2.4 physicians per 1,000 population — OECD Health Data 2004, 1st Edition. Government policy is to substantially increase the number of consultants throughout the next decade. There are currently 4,034 non-consultant hospital doctors training posts in Ireland, the occupants of which are given the opportunity of proper skills development on the basis that many in this category will become the consultants of tomorrow.

According to the Irish College of General Practitioners there are approximately 2,600 GPs working in Ireland. According to the GMS payments board annual report of 2003, 2,181 of these hold a GMS or other public contract. My Department has been in consultation with the Irish College of General Practitioners and the HSE on the subject of addressing future manpower needs in general practice. In this regard, it was agreed that the number of trainees should increase by a total of 66 in order to conform with the recommendations of the Irish College of General Practitioners. This will be achieved on a phased basis over a three year period.

Given the large numbers of staff employed and the unique nature of the services being delivered, a coherent, strategic approach to workforce and human resource planning needs to be developed further. This should be aligned closely with strategic objectives and the service planning process. Planning for the development of new and existing services in the future must be soundly based on a robust and realistic assessment of the skill and human resource needs to deliver these services.

Enhanced skills mix by matching skills to service needs benefits patients and empowers health personnel to reach their full potential. This optimises their contribution to quality care. The continued implementation of the "Action Plan for People Management" has a crucial role to play in improving retention and reducing the turnover of skilled staff. The Health Service Executive will be centrally involved in the development of an integrated workforce planning strategy for the health sector.

Bernard Durkan (Kildare North, Fine Gael)
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Question 139: To ask the Tánaiste and Minister for Health and Children the precise shortfall in terms of nursing staff at present; the plans she has to bring numbers up to the required levels; and if she will make a statement on the matter. [4427/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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In the most recent Health Service Employers Agency survey on nursing resources, employers reported that 794 vacancies existed at 30 September 2004. The vacancy rate now stands at 2.34%. This could be considered to be a normal frictional rate, given that there will always be some level of movement due to resignations, retirements and nurses availing of opportunities to change employment and locations. There were 33,739 whole time equivalent nurses employed in the public health service at the end of September 2004. This is an increase of almost 6,400 or 23% on the 1997 figure of 27,347 nurses, wte.

The recruitment and retention of adequate numbers of nursing staff has been a concern of this Government for some time. A number of substantial measures have been introduced in recent years. The number of nursing training places has been increased by 70% since 1998 to 1,640 from 2002 onwards. In excess of €90 million revenue funding is being provided in 2005 for undergraduate nurse training. Nursing continues to be regarded as an attractive career. There were 8,300 CAO applications for 1,640 places in the autumn 2004 intake.

A comprehensive range of financial supports has been introduced to support nurses in pursuing part-time degrees and specialist courses, including "back to practice" courses. Since 1998, nurses have been paid for overtime. Previously they had been given time off in lieu and the introduction of payment represents a further significant financial incentive for nurses. My Department introduced a scheme of flexible working arrangements for nurses and midwives in February 2001. Under the scheme, individual nurses and midwives may apply to work between eight and 39 hours per week on a permanent, part-time basis.

The promotional structure within nursing, including the introduction of a clinical career pathway, has been substantially improved on foot of the recommendations of the commission on nursing and the 1999 nurses' pay settlement. The National Council for the Professional Development of Nursing and Midwifery has been especially active in this area and, to date, over 1,600 clinical nurse specialist and advanced nurse practitioner posts have been created.

I am confident that the extensive range of measures I have outlined, including the substantial increase in training places, the recruitment of overseas nurses, the more effective utilisation of the professional skills of nurses and midwives, in addition to close monitoring and assessment of the situation on an ongoing basis, will continue to prove effective in addressing the nursing workforce needs of the health services.

Bernard Durkan (Kildare North, Fine Gael)
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Question 140: To ask the Tánaiste and Minister for Health and Children the total number of nurses available in the various hospitals throughout the country in both the public and the private sector; and if she will make a statement on the matter. [4428/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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There were 33,765 whole-time equivalent nurses employed in the public health service at the end of 2003. Of these, 23,794 were employed in 140 hospitals in the acute, district, psychiatric and geriatric services. I will forward the Deputy a breakdown of the number of nurses by hospital. While my Department does not collect data on employment in private hospitals, it has been estimated by the FÁS skills and labour market research unit that there are approximately 8,500 nurses employed across the private health care sector.