Ireland’s reliance on nurses coming from abroad rises further

Hundreds of Irish-trained nurses sought certs allowing them to practice abroad in 2017

The number of new nurses and midwives registering to work in Ireland has reached record levels, as has Ireland’s reliance on staff coming from abroad.

Fewer than 30 per cent of the 4,684 newly-registered nurses and midwives in 2017 were trained in Ireland, according to the annual report of the Nursing and Midwifery Board of Ireland (NMBI).

Almost 33 per cent were trained outside the EU and 37 per cent in other EU states.

While our health system becomes increasingly reliant on overseas staff, there are indications that Irish nurses and midwives are leaving in greater numbers.

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Some 1,234 nurses and midwives last year applied to NMBI for a certificate of current professional status, the third year in a row this figure has increased. The certificate, which is required to practice abroad, is generally seen as an indication of a person’s intention to leave though they may not, in fact, go.

Two-thirds of those requesting certificates were Irish-trained, while 12 per cent were from India and 10 per cent trained in the UK.

One in five of the Irish-trained nurses seeking certificate had registered with the board in the previous year, indicated that many of those leaving may be younger nurses and midwives early in their careers.

About 70,000 nurses and midwives are registered currently, of which 59 per cent are Irish-trained and 20 per cent are UK-trained. Eight per cent were trained in India and 6 per cent in Philippines. A further 30,000 nurses are on the register but are considered inactive.

Complaints

The number of complaints about nurses almost doubled in 2017, to 127, according to the report. About one-third of these will progress to an inquiry.

In contrast to previous years, when most complaints were made by employers or work colleagues, 63 per cent of the complaints in 2017 came from the public. Some patients made complaints against multiple staff – up to eight.

Medication management and an alleged failure to assess a patient’s condition were the more frequent cause of complaint, but other complaints related to verbal and physical abuse and drug abuse, including theft of drugs, forging of prescriptions and being on duty in an unfit state.

Five nurses and midwives who had been convicted of a criminal offence were referred to the board, of whom one has been struck off so far. Three more nurses and midwives had their registration cancelled for professional failings.

‘Dysfunctional’

Three years ago, two consultancy reports into the NMBI found the organisation was “dysfunctional” and failing to carry out many of its official responsibilities. Arrangements for dealing with fitness-to-practise complaints against nurses were “unfit for purpose” and were “swamping” employees, it was found.

The latest annual report shows 27 hearings were held in 2017, when almost €3 million was spent on legal fees relating to the fitness-to-practise process.

The report says the board is “on a journey” of reform, “maintaining the trust and confidence of the public and professionals in us as regulator, becoming more efficient and effective to deal with, and having an organisation that is appropriately equipped will not be achieved overnight”.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.