The health services are facing a major shortage of nurses that is expected to last at least three to five years, according to senior trade union leaders. It is already affecting staffing levels in some major acute hospitals and in the psychiatric services.
The Dublin region is particularly affected by the shortage. The Mater Hospital has had to delay reopening one of its winter wards because it cannot recruit suitable staff. Other major acute hospitals in the city say that it is increasingly difficult to maintain adequate staffing levels.
A spokeswoman for the Eastern Health Board says that staffing levels in its hospitals and long-stay institutions are adequate. "But we are finding difficulty filling places, and there is a significant drop in the number of applications for posts."
The staffing crisis comes as the Commission on Nursing prepares to publish its interim report tomorrow. The report is expected to express considerable concern at continuing low morale in the profession, particularly at the prevalence of bullying in the health services. Inadequate promotional opportunities and failure to compensate nurses for additional qualifications are also expected to feature, although major industrial relations issues are not expected to be dealt with until the final report is completed next March.
Members of the commission declined to comment on its contents yesterday. But Mr P.J. Madden, who is also general secretary of the Irish Nurses' Organisation, confirms there is a growing shortage of nurses in the system and that increasing numbers appear to be leaving the profession, either to emigrate or work elsewhere.
SIPTU's national nursing officer, Mr Noel Dowling, says that the psychiatric services have even begun to experience difficulty recruiting students to required standards.
Mr Madden says there are several factors causing the staffing shortage. One is the change-over in student nurse training from a certificate to diploma course. Nursing students once supplied up to 50 per cent of ward staff in the teaching hospitals. They will now be college-based and will be supernumerary when on work experience placement in the wards.
Students are supposed to be replaced by a combination of extra staff nurses, nurses' aides and administrative staff. The Department of Health says this system should be adequate to meet staffing needs.
But hospitals say they cannot recruit enough staff nurses. One reason is that the casual pool from which they are drawn has been reduced by the need to honour agreements with the unions to make up to 4,000 nurses in parttime temporary positions permanent.
Mr Madden predicts that the nursing shortage will last three to five years. Even when the new student nurses begin to come on stream, he says, shortages could continue, because the annual intake of students is being cut back to about 70 per cent of the prediploma system.
A further factor aggravating the problem is increased demand for nurses in Britain. While basic pay rates are similar, Mr Madden says that British nurses have better promotion prospects.
Mr Dowling says that in psychiatry there are already severe staffing problems. Fewer men are entering the profession, which creates problems where safety and security issues are involved.
This year only half of the 120 students originally offered places came forward to take them up. The next 60 applicants on the list had to be interviewed hurriedly to fill the gaps. In the past, nursing courses have always been oversubscribed.
Mr Dowling says the Department of Health should have carried out an evaluation of staffing needs before presenting unions with changes in nurse training as a "fait accompli".
Unlike gardai and prison officers, nurses are not entitled to overtime pay. The modest unsocial hours premiums available are inadequate to make working extra hours attractive.
Nursing unions may raise the issue of overtime with the Department. Mr Madden says that "on call" and "out of hours" payments need to be substantially increased. Mr Dowling thinks "there is a case for overtime to be paid, but it must be within set limits. We don't want nurses working all the hours God sends, like junior hospital doctors".
Further confirmation of the shortages comes from the Alliance Nursing Agency. This is the largest supplier of casual nursing staff to hospitals in need of short-term cover. One of its proprietors, Mr Gerry Dempsey, says "the demands placed on us have gone through the roof".
"It used to be a case of just providing cover for staff out sick or on leave, but now hospitals need us to staff wards on an ongoing basis." He also confirms that nurses have become increasingly mobile and are more willing to go wherever rates of pay and conditions are best.