QUESTION NO: 16
DÁIL QUESTION addressed to the Minister for Health (Leo Varadkar)
by Deputy Bernard J. Durkan
for ORAL ANSWER on 09/07/2015
To ask the Minister for Health the degree to which he has identified a shortage of nursing staff throughout the public health service as a contributory cause of overcrowding at accident and emergency throughout the public hospital system; if the various initiatives he has taken or proposes to take will adequately address this issue in the short and medium term; and if he will make a statement on the matter.
Bernard J. Durkan T.D.
The Emergency Department Task Force that reported earlier this year identified a number of factors that contributed to the increase in overcrowding at accident and emergency departments in 2014, including growth in delayed discharges, difficulties in attracting and retaining senior clinical decision makers and long average length of stay due to an increase in very elderly patients. Challenges in recruiting nursing staff can mean that some beds have to be closed, although this is not amongst the most important contributory reasons in overall terms.
The HSE is committed to increasing nursing numbers and to the conversion of agency to permanent posts where feasible. The development of capability within nursing to take on senior decision making roles in relation to delegated discharge is also a priority. The Minister for Public Expenditure and Reform announced in the last budget the delegation of greater autonomy to Departments and Agencies to manage their own staffing levels. The change from the application of a rigid employment control framework, with its particular focus on a moratorium on recruitment and compliance with employment ceilings and targets, to one operating strictly within allocated pay frameworks will allow for recruitment where it is determined that this can achieve more economical service delivery.
An extra 475 nurses and midwives have been employed between May 2014 and May 2015. In addition, the HSE is planning to recruit over 600 nurses across a number of nursing disciplines. There is significant work being undertaken to achieve this. This includes recent and ongoing national and local interviewing of General Nurses, Mental Health, Intellectual Disability, Registered Children’s Nurses and Midwives. The HSE has also developed an International Nurse Recruitment Project for filling posts. This initiative is a targeted recruitment drive in the UK primarily focused on Irish trained nurses who left during the moratorium. In order to facilitate this the services of a recruitment agency has been secured. It is hoped that the first of the interviews will commence in the coming weeks in a number of UK cities with the first nurses due to commence duty in August.
With regard to workforce planning, Action 46 of Future Health (DoH, 2012) provides for the Department to work with the HSE to implement an effective approach to workforce planning and development with the objectives of: recruiting and retaining the right mix of staff; training and upskilling the workforce; providing for professional and career development; and creating supportive and healthy workplaces. In 2015, the Department of Health will develop a national integrated strategic framework for health workforce planning, on a cross-sectoral basis. A cross-sectoral Working Group will be convened to develop the framework in the near future. The Group’s deliberations will take into account issues including population ageing. Consultation with key stakeholders will form part of the Group’s work.