Nurses, midwives regulatory body ‘dysfunctional’ - report

The regulatory body for nurses and midwives in Ireland is "dysfunctional" and is failing to carry out many of its official responsibilities, a report into the organisation has found.

The report into the Nursing and Midwifery Board of Ireland (NMBI), to be published today, also maintains that existing arrangements for dealing with fitness-to-practise complaints against nurses are "unfit for purpose".

It says the Government urgently needs to review legislation underpinning the management of fitness-to-practise cases involving nurses and midwives as well as corporate governance in the nursing board.

It says the organisation, which sets standards for education and professional conduct by the country’s 40,000 or so nurses and midwives , is in need of significant reform and investment.

The report by consultants Crowe Horwath was one of two from outside experts commissioned by the NMBI.

Consultancy report

A separate consultancy report, also to be published today, raises concerns that the NMBI did not follow official guidelines on procurement and the employment of non-permanent staff.

It says that in one case, an increase in salary was awarded “without a clear and documented justification”.

The board of the NMBI said on Wednesday it accepted the findings of the reports and acknowledged mistakes were made.

It said it regretted that, in the past, “appropriate standards and procedures were not always applied to operational and governance matters”.

President of the NMBI, Essene Cassidy, said the board of the organisation was committed to addressing the shortcomings identified and that recommendations in the reports were being actively implemented.

"We have begun a transformation process to help us avoid any such similar situation arising again and to enable us to continue to meet the needs of our stakeholders. While the reviews did identify significant shortcomings, the NMBI's regulatory functions were always appropriately discharged. We continue to meet regularly with the Department of Health to review progress."

The Crowe Horwath report says that over the last few years the nursing board did not have a “productive working relationship with the Department of Health”.

‘Beyond repair’

At executive level within the NMBI, it maintains that over recent times some relationships have not been “productive or collegiate” and in some cases “appear to have broken down beyond repair”.

The report says the financial position of the NMBI is also “of serious concern”.

It suggests the NMBI internally expected that the Department of Health would make up the financial shortfall after planned increases in the fees nurses pay to keep their names on the nurses register were reversed on foot of protests by nurses and midwives.

However the report says: “We did not get the impression that this matter was being addressed urgently within NMBI.”

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