The new National Children's Hospital will not be able to open all its beds when completed due to shortages of nurses, an Oireachtas committee has been told.

The Irish Nurses and Midwives Organisation (INMO) said the new hospital would need 300 additional nurses to operate.

INMO general secretary Phil Ni Sheaghdha said "we are already short, we are down below that 300 number".

Hospital Report

“That means when the children’s hospital begins to open its service, it cannot open all its beds. It simply will not have the nursing numbers.”

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Representative bodies for doctors and nurses told the committee that the Government needed to increase the number of undergraduate and specialist training places.

Organisations also said the process for recruiting medical and nursing staff needed to be streamlined.

Chief executive of the Irish Medical Organisation (IMO) Susan Clyne said it could currently take 20 months or even up to two years to recruit a consultant.

Ms Ni Sheaghdha said where a nurse left a post it could take eight weeks for a director of nursing to receive approval to advertise for a replacement and up to six months for a post to be filled.

The INMO said there was a worldwide shortage of nurses and Ireland must aim to become self-sufficient.

The IMO said an additional 2,000 medical specialists will be needed if a consultant – provided hospital service is to be introduced.

Shortage of consultants

President of the Irish Hospital Consultants' Association Prof Alan Irvine said there was a severe shortage of hospital consultants and the results for patients were very damaging.

“In Cork about 35 per cent of all acute trauma cannot get listed in orthopaedics because they do not have (sufficient) consultants to do it. In Cork and Kerry there are the same number of opthalmologists as they had in the mid 1970s ,” he said.

The INMO said while it welcomed the Government’s commitment in the Budget to increase significantly capacity in hospitals, the additional beds that were promised “must be adequately staffed by nurses and midwives”.

It said the additional 67 critical care beds planned would require about 435 whole time equivalent nursing posts.

Ms Ni Sheaghdha criticised what she described as “exploitation “ of student nurses working in hospitals.

“There are currently 3,400 (approximately) students on placements in hospitals across Ireland. These students are facing additional Covid risks and are effectively being asked to work as staff.”

“Before their final year internship, most students get either no payment or an allowance of just €50.79 per week. A HSE scheme to pay many students healthcare assistant salaries was used at the start of the pandemic in March, but it is no longer operating.

“The reality of service provision currently is that inadequate registered nurse staffing levels are requiring students throughout their clinical placements to undertake work over and above that expected of their undergraduate status and the failure to remunerate them amounts to exploitation.”

The INMO said for two decades Ireland had relied heavily on international recruitment of nurses and midwives but now faced strong competition internationally for this workforce while travel restrictions would impact on the movement of such personnel.

Nurse retention

“Ireland must become better at retaining Irish trained nurses and midwives in our public health service. Self-reliance, in this crucial workforce area, is essential against the background of the global shortage of nurses and midwives and is an internationally recognised ethical imperative.”

“We currently have under 1,800 undergraduate places, but over 5,000 Leaving Cert students put nursing or midwifery as their first preference in the 2019 CAO. We have both a need and demand for these courses, which would guard against future shortages.”

Ms Clyne said 600 GPs were due to retire in the coming years. She said it was imperative that 350 GP training posts were funded.

She said 50 per cent of public health specialists were also scheduled to retire in the next five years and there were insufficient trainees to match this level of retirement let alone to deal with any expansion of the workforce.

In the current pandemic public health specialists were "like gold dust", Ms Clyne said . She said Irish public health specialists were being offered positions, particularly in Wales and Scotland that would allow them to continue to work from Ireland.

The INMO also told the committee that there were 50 nurses in the Irish health service per week contracting Covid-19.

The union said that as of October 17th there were 9,917 cases of Covid-19 among health care workers and a quarter were nurses.

The union urged the Government to put in place “a review of the occupational health supports required and the removal of the policy introduced, which allows managers to derogate health care workers to return to work, although they are a close contact”.

It said despite the current pandemic affecting every aspect of our health service, nothing had been done over the last year “to address the contractual issues and working conditions that have left us unable to recruit and retain doctors across our system”.