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Editorial - Irish staffing levels – The reality

In recent months, government ministers, senior management and commentators from outside the public health service, who know little about healthcare, have repeatedly stated that staffing levels in the Irish health service are very good and above that in other countries.

In response to this incorrect perception, the INMO conducted a comparative study between staffing levels in the UK and staffing levels in similar wards here in Ireland. In November, the INMO published the frightening results of this survey. The results confirmed the very low and dangerous staffing levels that are now the norm in units and wards across Ireland – the full details are contained on pages 6-7 of this issue of WIN.

These same commentators have repeatedly stated that Ireland has the highest ratios of nurses to population and doctors in the OECD, and that this needs to be reduced. However, the results of our staffing survey clearly confirm that the only ratio that matters (nurse/midwife to patient/client) is appallingly low in Ireland. As a result, our health system is compromising the care of sick people.

Our recent studies have also amalgamated all international research on staffing ratios and the value of the registered nurse. These studies, without exception, confirm that the presence of a registered nurse leads to improved patient outcomes, shorter length of stay, reduced cross infection and reduced hospital readmission rates.

In our survey findings, Dr Keith Hurst, an independent, renowned expert in staffing and its impact on patient care, clearly indicates that Irish staffing levels are much below that of the UK. This is despite the fact that UK staffing levels have been shown to compromise patient care – the starkest example of this was in Mid-Staffordshire.

The situation in Ireland is critical and unacceptable, yet government ministers and health service management continue to respond to the pressure of the ill-informed, outside commentators, who push for further reductions in staff and a downward adjustment of the existing skill mix. This effectively means fewer qualified, regulated professionals on ward rosters.

All of our acute hospitals have bed occupancy rates well exceeding 95%, and some exceeding 100%. When desired improvements in patients’ length of stay, length of admission and same day admission rates are considered, it is clear that patient acuity and dependency is much greater now than ever before. This reality is completely missed by those demanding more cuts and cost reductions in our hospitals.

The INMO will now approach all future discussions with health service management and the government armed with the compelling, robust and validated evidence provided by our staffing survey. We will resist any further reductions in staffing levels and demand risk assessments for all existing staffing levels. We will redouble our efforts to assist our members in providing safe care through safe practice in the interests of their patients and their own registration.

It is now incumbent upon everyone who cares about the Irish public health service to study the results of this INMO survey, to recognise its message, and to introduce safe staffing ratios nationwide. We must recognise the reality, underpinned by international research, which indicates that a nurse/midwife makes a qualitative and quantitative difference to patient outcomes.

We now know the reality about staffing levels in Ireland and this evidence should not be ignored if government really cares about patients and their return to good health.

Liam Doran
General Secretary, INMO

Editorial - Irish staffing levels – The reality
Dec 2012/Jan 2013 Vol 20 (10)
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