Richard Bruton (Dublin North Central, Fine Gael)
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Question 118: To ask the Tánaiste and Minister for Health and Children if she has assessed the problem of declining skill mix in the nursing staff in many Dublin hospitals; if she plans initiatives to reduce the reliance on agency nurses and overseas nurses; her proposals to develop new areas of responsibility within nursing that might offer a satisfactory career path and help retain Irish trained nurses within the system. [13893/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Improving skill mix in the health service is a priority for the Government. Sustaining Progress contains a commitment to enhancing skill mix and mainstreaming earlier initiatives in relation to health care assistants. Substantial funding has been provided in recent years for the upskilling of health care assistants. Health care assistants working under the supervision of nurses have been enabled to take on a wider range of duties currently done by nurses, thus allowing the nurses to take on enhanced roles and better utilise their training and education.

Agency nurses have always been a feature of the system. They are required to make up for unexpected absences and dealing with short term fluctuations in workflows. The Health Service Executive — employer representative division — reported in December 2004 that an average of 458 agency nurses were employed, which must be set in context against an overall whole time equivalent nursing workforce of 34,313.

There has been an increase in overseas nurses in the Irish health system over the last number of years. However, the Central Statistics Office estimates that overseas nurses make up just over 8% of the total nursing workforce in the public and private health services. This figure could not be considered excessive. The number of overseas nurses is likely to rise in 2005-06 due to the fact that there will be no nursing graduates in autumn 2005.

The retention of adequate numbers of nursing staff has been a concern of the Government for some time. A study published by the Health Service Employers Agency last October showed that nationally, turnover among nursing staff declined by 40% between 1999 and 2003. Among the measures taken to facilitate retention of nurses has been the introduction of improved promotional opportunities, particularly the introduction of a clinical career pathway. The National Council for the Professional Development of Nursing and Midwifery has been especially active in this area and to date 1,652 clinical nurse specialist and 24 advanced nurse practitioner posts have been approved.