Tuesday, May 16, 2017The IMO, INMO and PNA representing Doctors, Nurses, including Psychiatric Nurses, and Midwives, employed throughout our public health service, met today to consider the Public Sector Pay Commission Report, and, in particular, the issues highlighted by that Report in relation to the recruitment/retention of staff in the Health Sector. 

The issues of recruitment and retention of medical and nursing staff, in our health services, must be addressed in the context of the forthcoming public sector pay negotiations. 

The IMO, INMO and PNA are therefore calling on Government to ensure that there is sufficient flexibility within the talks, to deal with this problem, and to cease adopting a “head in the sand” approach to the manpower crisis within our hospitals, community and mental health services which have a significant negative impact on the delivery of care to patients across the country.

The three unions also endorsed, and support, the collective approach, of Public Service Unions, to seek restoration of pay and hours attacked in recent years.

Doctors, Nurses and Midwives, working in the public health service, have struggled through years of cutbacks to deliver the best care to patients in highly pressurised and under resourced working environments.  The HSE is no longer an employer of choice for a growing number of doctors, nurses and midwives whose skills are actively sought by European and International Health Organisations. Such organisations, not only offer better terms and conditions but also provide an environment that allows them to do the job for which they have trained.

We simply cannot ignore the facts of the situation any longer which include:

• At any one time there are now up to 400 vacant consultant posts. 
• These posts, when advertised, often attract no applicants.  Hospitals are now so desperate for medical cover they are, in some cases, hiring doctors who do not have the specialist registration required for the post.
• The health service is still 3,200 Nurses/Midwives short of the numbers employed in 2008 despite increasing activity by 20%.
• 78% of final year nursing and midwifery students have already been offered full time permanent positions, in other countries, on more attractive terms than those available in Ireland.
• 60% of newly qualified Doctors have already stated their intention to emigrate at   the end of their Intern Year.  45% of Doctors who qualified in 2011 no longer work in the Irish public health service.
• 14,000 Nurses/Midwives have sought Certifications of Verification which indicates their intention to emigrate and practice in other countries.  7,500 of these were for the U.K.
• International health organisations are actively targeting Irish Doctors, Nurses and Midwives with superior packages.
• Pay, training supports and career progression, along with poor working environments, are the key factors in decisions to emigrate. 
• The shortages of Doctors, Nurses and Midwives is leading to unsafe work practices and negatively impacting on patients in relation to access and waiting times for services, operations, outpatient appointments and impeding access to services as per Vision for Change.

The Public Service Pay Commission has correctly identified and accepted the overwhelming evidence that there is both a shortage of Doctors, Nurses and Midwives and major impediments to their recruitment and retention. On the 1^st of February 2017 the Minister for Health, in Daíl Eireann, identified the recruitment of Doctors, Nurses and Midwives as being his number one priority and in the same month the recruitment agency, Indeed, identified these professions as the hardest roles to fill in Ireland.

As recorded in the Public Service Pay Commission report, the shortages are leading to a pressurised work environment which impacts on the delivery of patient care. The shortage now experienced is chronic and waiting lists, hospital overcrowding and missed care are everyday occurrences.

The crisis is such that sustainable recruitment and retention measures, which work in the short, medium and long term, are now required as Ireland is competing in a European and worldwide market for professional Doctors, Nurses and Midwives. Irish patients deserve the quality care delivered by these key professionals.  The market conditions to recruit these professionals require special, and immediate, incentives if we hope to attract and retain our Irish based and trained professionals in the Irish Health Service.

The real test of the forthcoming pay talks is whether they are “fit for purpose” and capable of allowing special measures to address the perfect storm of a failing Irish health service unable to recruit the professionals required to deliver the level of care patients need. Unless action is taken now the reality is that whatever measures are taken by Government, to reform our health services, will ultimately fail as we will have insufficient, suitably qualified, Doctors, Nurses and Midwives to meet growing demand and deliver safe care.