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Given the problems the country faces in housing people and in recruiting sufficient staff for the health service, it was only a matter of time before someone suggested the same solution for both challenges.
That moment seemed to arrive when Minister for Health, Stephen Donnelly, intimated at the recent Irish Nurses and Midwives Organisation (INMO) annual conference that hospitals are drawing up plans to build or buy houses for nurses and other key health staff.
Money could be made available from the health capital budget to fund this entry by health into the property market, the minister added.
The problems faced by health staff in finding accommodation near their place of work has been bubbling under for some time and is recognised as contributing to difficulties in HSE recruitment.
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Almost 60 per cent of staff leaving one Dublin hospital for jobs overseas or elsewhere in Ireland cited cost of living pressures, leases ending or a lack of affordable housing as factors in their decision, exit interviews found.
A newly qualified nurse in Dublin or Cork with a rent of €1,800 a month is paying about 77 per cent of take-home pay for somewhere to live in, the INMO has estimated.
The union has gathered testimonies from hard-pressed members: the staff nurse commuting from Ballinasloe to Limerick every day because she can’t find accommodation near her place of work; the graduate midwife forced to move back with her parents in the west after her landlord in Dublin upped the rent to €1,600; the Indian nurse whose family has to share an apartment with another family due to the cost of living.
Health staff aren’t the only ones bearing the brunt of the housing crisis, of course, but many are further exposed because they are in training and have to change their work location frequently and because home-working is not an option.
“Providing accommodation for nurses would certainly make their recruitment much easier,” Jimmy Sheehan, founder of the Blackrock Clinic, points out. “At the moment, newly-qualified nurses can be paying out more than half their salary on rent, if they’re working in one of the big cities.”
“Based on previous experience, though, building new apartments would take a very long time if the State is behind it so it might be better to look at buying up existing premises.”
[ Hospitals plan to build or buy housing for staff in bid to retain nurses ]
As Sheehan points out, nearly every hospital used to have an attached residence for nurses, before this model of accommodation came to be viewed as outdated because most of it was for single women. As HSE boss, Bernard Gloster, cautioned, “life has moved on” since this type of on-campus accommodation was being provided for nurses.
You can still see the vestiges of this accommodation around Dublin. Off Baggot Street, the old nurses’ home is now a hotel. On Cork Street, in the Liberties, the former home is now social housing. At St Vincent’s University Hospital, the nurses’ home was blown up in 1999 to make way for a car-park.
In other health services, accommodation is often available for hospital staff, especially for new arrivals.
Great Ormond Street Hospital in London, which competes directly against Irish children’s hospitals to recruit international nurses, says it has a variety of residential accommodation for staff, which is let on six-month tenancies.
The accommodation, largely flats in converted Georgian houses, is available to new starters who have joined the staff in the previous nine months. Eligibility is determined by a points system, with salary and existing travelling distance among the main criteria.
The rent is set according to the employee’s salary band and includes the cost of all utilities.
In Northern Ireland, the South Eastern Trust, which run health services in Co Down and adjoining areas, provides temporary accommodation for medical students, locum doctors and overseas nurses at three sites. Cumulatively, 107 staff can be accommodated on a short-term basis only. Medical students on placement are also housed in student accommodation at Queen’s University and Ulster University.
An alternative to building new accommodation for health staff would be to pay workers living in more expensive areas an allowance to reflect their increased living costs.
As far back as 2000, at the height of the Celtic Tiger, the INMO lodged a claim for an annual Dublin allowance, as a way of alleviating the problems the health service faced then in recruiting and retaining staff. An official report on the capital’s hospitals recommended serious consideration be given to an additional pay allowance to nurses in all clinical areas within the Dublin teaching hospitals.
The idea went nowhere and was parked during the economic downturn but returned to the agenda as the economy went into overdrive.
Last year, the union passed a motion at its annual conference calling for the introduction of a “cost-of-living” allowance for nurses working in “high-density cities”.
In London, key workers such as NHS staff qualify for a “high cost area supplement”, depending on how centrally they are located. For those living in inner London, the supplement is 20 per cent of salary or a minimum of £5,132 and a maximum of £5,436. Those in outer London get 15 per cent of salary and health workers residing in the fringe of the city are paid an extra 5 per cent.
Government sources have pointed out that health salaries are generally higher in Ireland than in the UK.
It is also hard to see how a Dublin weighting could be confined to one group of workers. The Irish National Teachers Organisation has already called for the introduction of a special allowance for Dublin and other cities for its members. It is likely other groups will follow suit.
[ Nurses caught in housing crisis: ‘Within six months many think about leaving the country again’ ]
Senior health sources say there are no concrete proposals in gestation and no capital funding provision. The new national children’s hospital will continue to wolf up most of the capital budget in the coming years, leaving little for other projects.
Those familiar with construction say one way of progressing specific health accommodation would be by working with an approved housing body (AHB).
One such body, Clúid, told The Irish Times it has not been consulted on any plan of this type and current funding streams would not allow the development of accommodation earmarked for a particular profession. “For AHBs to provide housing of this nature, we would require a new form of funding along with any corresponding legislation needed to limit allocations to a specific cohort,” a spokesman said.
“We would certainly be interested in working with the relevant Government departments to develop a viable model to provide accommodation for healthcare staff. However, without more detail on what is being proposed, it is difficult to estimate the potential impact on the wider market or how long it will take to deliver such a product.”
In his remarks, Mr Donnelly said he had been in contact with the Mater hospital in Dublin and Galway University Hospitals on the issue. Neither would comment this week on their intentions.
No formal submissions have been made by hospitals to the HSE in respect of staff accommodation, one senior health source stressed.
“Everyone recognises that there are real challenges in finding accommodation and we are particularly sympathetic to healthcare workers arriving from abroad, non-consultant hospital doctors who rotate regularly and students doing clinical placements.”
“Hospitals are free to develop and submit proposals and all will be assessed on their merit. However, it is a fact that we have recruited record numbers of staff to work in our health service so claims there is a widespread national recruitment crisis are inaccurate.
“We also need to prioritise key healthcare infrastructure in the first instance.”