Budgets being put ahead of patient safety by Government, claims INMO

Nurses’ union’s annual conference at Croke Park in Dublin hears HSE recruitment embargo affecting safe staffing levels

The HSE’s recruitment moratorium is having the effect of putting balancing budgets ahead of patient safety, INMO general secretary Phil Ní Sheaghdha said as the union’s 105th annual conference got under way at Croke Park in Dublin.

“The last time the budget became prioritised over staffing and safety, we lost a huge number of nurses and midwives to other countries who are now able to implement safe staffing,” she said. “Many of them are dependent on Irish nurses and midwives to do that.

“In our country, we’re looking at things through the narrow prism of one-yearly budgets. But without your staffing levels being correct in the first instance, you’re never going to have a safe service.”

Ms Ní Sheaghdha was scathing in relation to the HSE’s failure to produce a pay and staffing strategy document for the year, with the proposed contents said to be still under discussion between Minister for Health Stephen Donnelly and key Cabinet colleagues. “It’s May and they still haven’t produced it for 2024. Think about that,” she said.

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In the meantime the embargo is holding up recruitment even where key needs are identified, she said, with nurse managers suggesting there can be a four-month delay in obtaining the derogation required to overcome the block on hiring. “And then in many instances, the contracts offered are very short term. And that simply is not attractive,” she said.

Ms Ní Sheaghdha’s suggestion that overall numbers have failed to keep up with population growth over the past 15 years brought a swift response from the Department of Health, which pointed to OECD figures putting the number of nurses in Ireland per 1,000 people at 15.18 in 2022, compared with 13.63 in 2007.

On those numbers, Ireland scores very highly by comparison with other countries, but comparisons remain tricky because the precise nature of the data varies from country to country.

The OECD does, however, suggest its numbers for Ireland over time are at least a like-with-like comparison, showing a roughly 10 per cent improvement in the nurses per head of capita ratio during those 15 years. The department argued the increases have continued with, it says, 9,614 more nurses and midwives working in the health service in March of this year as compared with the start of 2020.

Still, the union insists, significant problems persist. Addressing delegates at the conference on Wednesday, the INMO’s director of professional services, Tony Fitzpatrick, cited University Hospital Kerry where he said a need for an additional 20 nurses had been identified under the terms of the agreed safe staffing framework but the positions could not be filled because of the embargo.

Shortages across the wider system, the union argues, are impacting on existing staff, with a survey of its members conducted in advance of this conference finding that more than a fifth of respondents – 21 per cent – had visited their GP because they were suffering with stress.

Almost 70 per cent of respondents said they believed their work is impacting on their general health, with 55 per cent suggesting they were always or very often physically exhausted as a result of it.

One of the issues, the research suggests, is pressure felt to work additional hours, with more than half – 54 per cent – saying this is something they experience.

Ms Ní Sheaghdha also said nurses have not yet received the initial increases due under the new public sector pay deal and one employer, she suggested, had indicated it might not be able to pay any increases this side of November.

In response, the HSE said the first phase of the deal will be paid, with arrears, in June and that it was not aware of any location in which the possibility of a delay until November had been raised.

Emmet Malone

Emmet Malone

Emmet Malone is Work Correspondent at The Irish Times