Exodus of graduate nurses from Ireland resuming and must be addressed urgently
Thursday, 7 April 2022 - The Psychiatric Nurses Association (PNA) 2022 Annual Delegate Conference taking place in Co. Cavan was told today (7th April) that it is inconceivable that the budget for mental health services was reduced from 6% to 5% of the total health budget in 2020, and again in Budget 2022 at a time of unprecedented growth in demand for services.
Addressing the Conference, PNA General Secretary, Peter Hughes said the Covid pandemic had confirmed the historic under-investment in mental health services and facilities.
“Sadly, the pandemic has highlighted to us all how the infrastructure in a significant number of approved centres is simply not suitable to manage current demand levels for many reasons including to the number of shared bedrooms.
“It confirmed yet again that Government needs to urgently invest in a major capital programme to address these glaring inadequacies.”
Mr. Hughes said that from the point of view of the PNA and its members, who are working tirelessly at the frontline, it was difficult to recall a time when the demands on our mental health services and the challenges that these services face, has ever been greater or more acute.
“Of course, our training, our professionalism, and our commitment to what we do will help us face these challenges. But we will need the full support of the Government, the relevant ministers and the HSE to ensure that we have the investment in staffing and resources to deliver a mental health service that is fit for purpose and capable of responding to the surging demands being placed on it. I am determined that those responsibilities are delivered on.”
“Even as we went through Covid I felt it incumbent on me to write to Minister Donnelly on a number of occasions to point to an inevitable surge in demand for mental health services, and alert him to the fact that against that background and the ongoing crisis in mental health, it is inconceivable that the mental health budget should be reduced from 6% to 5% of the health budget as was the case in Budget 2020 and continued in Budget 2022.”
Cessation of Special Leave with Pay for Covid-19
Mr Hughes strongly criticized the decision by the Department of Public Expenditure and Reform to end the Special Leave with Pay for Covid-19 for frontline workers with effect from the end of June.
“This is a decision made in the absence of NEPHET but made by officials, sitting in safe, secure office/home settings well away from the Covid reality faced on the frontline of the health services.”
“It is absurd that in the current and ongoing stages of Covid that staff are being told to revert to standard sick leave arrangements which we know cannot cover the circumstances where people are sick and recovering from Covid.”
“This is totally unacceptable, and I will be seeking an urgent engagement with DPER, Dept of Health and the HSE to demand that the Special Leave arrangements are maintained in order for there to be some chance for Covid to be properly managed in the health services.”
Staffing and Retention
Mr Hughes said the health services were again seeing nurses attracted abroad by the prospects of better pay, better conditions, and better career advancement.
“Unfortunately, the end of the pandemic restrictions now creates an additional problem for the provision of services as we are once again holding ‘going away parties’ for our young nurses who are looking for opportunities abroad and emigrating to Australia, Canada, and the UK. “
“As we have witnessed so many times, this will again create an unsustainable reliance on overtime and agency workers. To counter this, it is imperative that all our new graduates are offered permanent contracts as soon as they graduate. This must be planned for at least six months prior to graduation in order to give these graduates certainty and stem the drift abroad.”
“We need a strategic workforce plan for mental health to be put in in place as a matter of urgency to address short-, medium- and long-term measures to alleviate the hemorrhaging of our nurses out of our services.”
Mr Hughes said the historic under investment in our CAMH services has consigned young people and their families to years of difficulties in accessing vital services and in many publicised instances children being left with no other options but inappropriate admission to adult services.
“The Maskey Report on the look back review into CAMHS in Kerry highlighted very serious concerns in relation to the governance and under resourcing of the service. Unfortunately, this is not unique and similar deficits have been highlighted by the PNA at conferences over the years and in a detailed submission to the Oireachtas Sub-committee on Mental Health in 2017 and yet very little has changed.”
“Staffing of Child and Adolescent Mental Health Service teams remains under resourced with less than 60% of the staffing as recommended in Vision For Change. There are only two-day hospitals despite 16 recommended in Vision for Change. In January this year Dr Niall Muldoon, the Ombudsman for Children, addressed the Oireachtas Sub-committee on Mental Health where he stated, “the mental health budget is miniscule”.
“He further goes on to state that the best guesstimate is that 20% of the mental health budget is spent on children which means that less than 1% of the overall health budget is spent on children's mental health. This abysmal funding is a long way short of addressing this ongoing crisis. The children of this country are the future of this country, and we must ensure the children who require mental health services are safeguarded and provided with quality, properly resourced therapeutic services.”
NASRA Campaign on Right To Union Membership
Mr Hughes said the heroic dedication and service of frontline staff during the pandemic was nowhere more evident than that shown by ambulance personnel, whose work during Covid has not been adequately recognised.
“From the PNA’s point of view, Covid of course meant that the NASRA campaign for the right to union recognition and for the right of workers to be members of, and represented by, the union of their choice had to be suspended. But the NASRA work on the ground, led by the resolute Tony Gregg, in representing members in work and disciplinary dispute cases has never stopped.”
“The NASRA campaign continues and PNA remains fully committed to NASRA and its members and I look forward to re-invigorating this campaign in the coming months.”
Addressing the war in Ukraine, Mr Hughes said the challenge of supporting refugees from the horrors unfolding in Ukraine will be felt in demands on our mental health services.
“We stand in solidarity with the people of Ukraine and of course as a country Ireland will extend our hand of comfort and support to the many thousands fleeing this horrific war who will find their way here.”
“The quick response of the Government in putting in place the practical measures to allow those seeking refuge to come here is welcome and we need to ensure now that our services, including our mental health services, are adequately resourced to ensure they can respond to whatever added demands and pressures arise from this unprecedented situation.”
“Those fleeing the horrors of the war in Ukraine and seeking refuge here, deserve nothing less.”