Bernard Durkan (Kildare North, Fine Gael)
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Question 193: To ask the Tánaiste and Minister for Health and Children her proposals to address the shortage of nursing staff; and if she will make a statement on the matter. [15713/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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According to the most recent Health Service Executive-employer representative division survey of nursing resources, recruitment remains well ahead of resignations and retirements. Employers reported that 765 vacancies existed at 31 December 2004. The vacancy rate now stands at 2.25%. 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.

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 nurse 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. This is in addition to a capital investment programme costing €240 million for the establishment of purpose-built nursing education facilities on the campuses of 13 higher education institutions around the country. Nursing continues to be regarded as an attractive career. Provisional data indicates that overall CAO applications for nursing in autumn 2005 are 8,155, with 4,869 first preferences, an increase of 3.5% over first preferences in 2004.

A comprehensive range of financial supports have also been introduced to support nurses in pursuing part-time degrees and specialist courses, including "back to practice" courses. The cost of these supports will be €10 million in 2005. 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. Almost a quarter of all nurses now job share or work part-time hours.

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. There have been substantial salary increases for nurses over the last number of years. Between 1997 and 2004, the basic salary of a staff nurse increased by 57.5%. In the same period, the salaries of clinical nurse managers increased by between 73% and 89%.

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 1,650 clinical nurse specialists and 24 advanced nurse practitioner posts have been created.

The measures I have outlined have produced very positive results. Since 1997 there has been a net increase of 7,000 nurses. This represents a 25% increase in the nursing and midwifery workforce in the public health service. Turnover of nursing staff has also declined. The most recent turnover study covered the years 1999 to 2003. The results of this study showed that nationally turnover had decreased by 40% over the five year period.

Ensuring that there are sufficient nursing resources in 2005 and 2006 is a priority for the Health Service Executive. This will be the transition period between the diploma and the degree programmes. The final group of diploma students graduated in late 2004 and the first group of degree students will graduate in autumn 2006. A national steering group inclusive of nurse managers and HR specialists has been established by the HSE to examine and address the issues involved in ensuring there are adequate numbers of nurses in 2005 and 2006. This group is overseeing the work of a project office tasked with running local and overseas recruitment campaigns. Additional funding has been provided to the HSE for nurse recruitment in 2005. Work is well under way on the tender process for overseas recruitment. Registered nurses in Ireland, who are not practising are being targeted for recruitment and nurses working flexible-part-time hours are being asked to increase their hours. Improved skill mix will also assist in addressing the problem.