I welcome the opportunity to speak today on International Nurses Day. The theme is: “Our Nurses. Our Future. Empowered Nurses Save Lives”. I have just come from the new national children's hospital. I want to pay particular tribute to the nurses who are leading the charge there, as well as Lucy Nugent, the chief executive of CHI, and Julia Lewis, the head of transformation. It is wonderful to see so many nurses now coming into senior leadership roles across the health service, where for so many years, it was dominated by the other professions. I also pay tribute to the nurses I encountered in the Mater emergency department last night, when I was there with a friend, for the incredible professionalism and work rate that they bring every day to their jobs in what is a very difficult environment. We have seen a lot of commentary in recent weeks about violence and aggression. This is seen not only in the Mater hospital, but in many hospitals across the State. The reality is that many nurses go beyond the call of duty to deliver care across a variety of environments. It is important that when we talk about nurses today, we are not just focusing on the nurses who work in acute hospitals, who are incredibly important to the conversation, but we also recognise nurses in nursing homes, primary care clinics and GP practices, as well as community midwives and public health nurses. Some 15% of the nursing workforce in this country has come from other countries. Our health service, particularly our nursing workforce, would not be able to survive were it not for people from countries like the Philippines and India coming to this country year after year to join our workforce. We must be very thankful to them. We also need to mind them and look after them. Certainly, the increasingly racist commentary that we hear among politicians, but also the really crude discourse that exists out there online and in our communities, has put the fear of God into many migrant nurses and other workers. It is something the Government needs to act on in a much more comprehensive fashion. We were promised an information campaign on the benefits of migration. We see it in our hospitals, day in, day out, but we have yet to see that campaign. I impress upon the Minister of State, Deputy O'Donnell, that we need to see something specific to the health service and many other sectors to reassure those workers who have come to our country, but also to call out the racism that is out there. I have three questions. They are principally directed to the senior Minister for Health, but I know the Minister of State will take them on board. The first concerns safe staffing ratios. We know that in 2017, the then Minister for Health, Deputy Simon Harris, introduced the general scheme of the patient safety Bill. It went through pre-legislative scrutiny, but it has been gathering dust ever since. We have to ask why that is, and what are the Government's intentions in this regard. When we look at the reality on the ground, the INMO national conference last week and its annual survey laid bare the extraordinary strain that so many nurses are working under. Some 67% of staff believe their current staffing levels and skill mix do not meet the clinical and patient demands required in their work area. Over half of respondents said that patient safety was almost always put at risk, or certainly very often. Almost half were pressurised to work additional hours or shifts. Shockingly, a quarter of the nurses who responded to that survey said they had to attend a GP due to work-related stress. We know that those in other grades within the health service are similarly suffering enormous stress and strain, as seen, in particular, in the Fórsa survey produced earlier this year. We have to ask what the Government response to this is. I acknowledge that the number of nurses has gone up significantly in the past five years, by some 9,700, or just short of 10,000. That is significant. However, we know that when we benchmark Ireland against many of the other European countries and OECD norms, we are significantly short. That has to be part of the conversation on the future path for nurses working across our health system, and how we ensure that they and the patients are kept safe. That piece of legislation is vital. There are minimal staffing ratios in childcare and education, yet we do not have that within our hospitals, where nurses and other staff are providing a crucial service. We also have to look at the attitude of the Government and the HSE to commitments they have made to nurses and other health staff in recent years, particularly the WRC agreement in 2024. There were specific commitments with regard to agency, outsourcing and maternity cover, yet the unions had go to the Labour Court last November with regard to the non-implementation of the WRC agreement by the HSE. That is simply not on. It as a misuse of the HSE’s time that it has to go trekking down to the WRC. It committed to that agreement. Why is it not abiding by it? In February of this year, we saw nurses in Naas General Hospital going on strike because of unsafe staffing. This is a very real issue. We need the HSE and the Government to respond. I am alarmed that we now have a recruitment freeze. We have heard all the reassurances from the Government, but the reality is that it is going to hit front-line workers. The Minister said this week that an extra €300 million is required for the health service. That is going to impact outcomes and services. We raised these issues at the budget last year, and we were told we did not need to worry because the health service was properly resourced. We knew then it was not the case, and now that is bearing fruit. That is serious mismanagement by the Department of Health in its budgeting. The second question that I have for the Minister-----

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The other two questions I have relate to the strategic review of GPs. We have been promised this for a year and a half. It is late. Are we going to see a reference to GP nurses? They provide vaccines and smears. I refer to the new chronic disease management programme. Are we going to see a reference and proper provision for them in the new GP contract? The last thing I want to say is with regard to public health nurses. From what I can see, the number of public health nurses across the country is lower now than it was five years ago. I looked through every region. Every single region has fewer public health nurses than it did five years ago. Why are the HSE and the Department of Health showing such contempt to public health nurses and the delivery of nursing care in our community? That needs to change.

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