If we don’t keep nurses here, we’ll end up with the crippling shortages we had a decade ago
TEN YEARS ago this month, newspaper headlines chronicled the effects of staff shortages in healthcare facilities across the State – and the extremes to which hospitals were going to attract nursing staff. Beds and operating theatres were closed, elective surgery cancelled; managers travelled to far flung destinations such as the Philippines to attract nurses to work here.
Going into 2001 there were 1,315 nursing posts vacant, the then health minister Micheál Martin told the Dáil. He assured Oireachtas colleagues that recruiting from abroad would alleviate shortages. Since then, about 12,000 nurses from the Philippines, India and elsewhere have been recruited to work in Ireland, at great expense.
In tandem with this, more nurses were taken into training here. Course places increased from 968 in 1998 to 1,640 in 2002. Numbers have hovered around the 1,600 figure ever since – each costing around €90,000 to educate. This intake was deemed necessary to supply an expanding health service and replace nurses retiring.
Thus anyone applying for nursing through the CAO in recent years – and there have been more than 30,000 applicants for several years now – had a legitimate expectation that they would walk into a job on qualifying.
However, an embargo on recruitment in the public sector has dashed all such expectations. Nurses who graduated this year – having started their studies in 2006 when the boom was in full swing – are having to come to terms with the fact that there are few job opportunities for them in Ireland.
Even those who began a four-year degree in midwifery in 2006, set up at the time because of midwife shortages, are now graduating with poor prospects.
The Irish Nurses and Midwives Organisation (INMO) believes the majority will have to emigrate. Its general secretary Liam Doran warns that, unless current policies are reversed, in 10 years’ time we will be back to where we were a decade ago, dealing with severe nursing shortages “We will repent at leisure for the short-sightedness of what we are doing now,” he cautions.
Seamus Cowman, professor of nursing at the Royal College of Surgeons in Ireland, agrees the problems of the past could repeat themselves unless nurses we train now are used to greater effect. He suggests they could run the national bowel cancer screening programme, for example, something which would provide jobs and allow the programme to be established at a lower cost.
He also says we should be providing emigrating nurses with career guidance before they depart, advising them to go to the best centres in the world. Then, if and when they come back they will – like many returning hospital consultants – have gained the best experience possible. Like Doran, he doesn’t believe too many are currently being trained. “It’s not that we have an over-supply. We are just in a crisis now. We have to hold our nerve,” he says.
Doran points out that, with 22 per cent of nurses over 50 years old, graduates will be needed to replace those retiring – if the moratorium is lifted. He says it has already resulted in 1,900 nursing/midwifery jobs being lost from the health service over the last two and a half years. Some graduates were still getting temporary contracts over the past couple of years. But this year, following the cuts, hospitals have had to let temporary staff go.
The exact number of nurses emigrating is hard to establish. An Bord Altranais has to issue such nurses with Certificates of Current Professional Status (CCPS) to work abroad. “In 2009 we began to notice that a significant number of new registrants were requesting An Bord Altranais to issue CCPSs, mostly to the UK,” a spokeswoman said. “Of those who registered between September 1st and December 31st, 2009, 271 CCPSs were issued.”
Nurses, of course, aren’t the only graduates finding it difficult to get jobs. Physiotherapists and dentists – though in smaller numbers – are in the same boat. Fintan Hourihan of the Irish Dental Association says this year’s 60-plus dental graduates have all gone to England and Scotland. He adds that many established dentists have had to lay off staff due to drastic cuts in State subsidies for dental schemes in the last budget. “So we now see experienced dentists travelling to work in England two days a week . . . if they are having these difficulties, new graduates have very bleak prospects here,” he said.
Doran says nursing has been singled out for the harshest treatment under the moratorium. Even primary school teachers have been exempted from the moratorium, he says.
Some nursing graduates are likely to be getting agency work, but how many is unclear. There are occasional instances, too, where nurses may be taken on despite the embargo when a special case is made. Last year, for example, when a business case was made by Cork University Hospital more than 100 graduating nurses and midwives were kept on despite the embargo.
Third-year student nurse Aisling Maher from Killucan, Co Westmeath, says what’s happening is “crazy”. On work placement she can cover shortages on wards but hospitals can’t recruit extra staff. She loves her course but says she may have pursue a different career when she qualifies unless prospects improve, as she has no wish to emigrate.
The INMO wants Minister for Health Mary Harney to implement a recommendation in the report from the commission set up in 2007 to look at reducing nurses’ hours. It recommended that a two-year internship programme be offered to graduating nurses, allowing them gain experience on a smaller salary. It says this could be done on a cost-neutral basis. Last week, however, Ms Harney wasn’t entertaining the idea, stressing that saving rather than spending was the priority. With up to €1 billion to be cut next year, not just nursing jobs are likely to be on the line.