Seanad Éireann debate -
Thursday, 15 Feb 2018

Vol. 256 No. 3

Commencement Matters

Registration of Nurses

Senator Martin Conway

Cuirim fáilte roimh an Aire Stáit. Gabhaim buíochas leis an gCathaoirleach for taking this Commencement matter. Over the years many Irish people, including a very good friend of mine, have emigrated to the United States for economic and other reasons. I know of a number of examples of people who have gone to the United States, who have qualified and worked as nurses for many years there and who want to relocate back to Ireland. They find that the regulations, requirements, qualifications and so on that are required for nurses in Ireland mean their qualifications from the US are not recognised here.

We have a problem in respect of nurses in this country. We do not have enough of them. Many of our nurses are going abroad. Many of them are young people who want to travel and to live life abroad for various reasons. When they qualify as nurses, they find they have to go abroad. We have a significant shortage of nurses. We are opening the doors and welcoming nurses from many other countries but there seems to be a difficulty or problem with recognising nursing qualifications from America. It is probably because of some small technical issue but I believe that, if we were to deal with that particular issue and recognise their qualifications, a number of nurses would enter the HSE system very quickly and be available for work in this country, even if they had to prove five years' experience of working in hospitals as nurses in various disciplines in the United States.

I know of one particular lady who came back to Ireland to be with her elderly mother and to look after her. She is a qualified nurse who worked for years in America but because of the regulations she cannot work as a nurse in Ireland. She can work in many other disciplines but not as a nurse. Will the Minister of State tell me what specifically is the problem? Are we going to address it? If not, why not?

Minister of State at the Department of Health (Deputy Jim Daly)

Gabhaim buíochas leis an Seanadóir as ucht an t-ábhar seo a ardú anseo inniu. I thank Senator Conway for raising this issue. An Bord Altranais, the Nursing Board, was established under section 6 of the Nurses Act 1985. This Act was repealed in 2011 under section 4 of the Nurses and Midwives Act 2011. The Nursing Board was renamed the Nursing and Midwifery Board of Ireland, NMBI, under section 6 of the Nurses and Midwives Act 2011 and has two main objectives. One is to protect the public and the other is to ensure the integrity of nursing and midwifery practices.

The NMBI is an independent statutory organisation that regulates the nursing and midwifery professions in Ireland. The main functions of the NMBI are maintaining the register of nurses and midwives, evaluating applications from Irish and overseas applicants who want to practise as nurses and midwives in Ireland, supporting nurses and midwives to provide care by developing standards and guidance they can use in their day-to-day practice, setting requirements for nursing and midwifery educational programmes in higher level institutions, investigating complaints made by patients, their families, health care professionals and employers and holding fitness to practise inquiries.

Section 48 of the Nurses and Midwives Act 2011 enables the board of the NMBI to register an applicant, if satisfied that the person meets the relevant criteria, in the division or divisions of the register of nurses and midwives, which is considered by the board to be appropriate. I have been advised by the NMBI that applicants who trained outside the EU-EEA are individually assessed against current Irish standards of education and training to include a full review of the applicant’s education and training programmes. This review includes all pre-registration and post registration nursing education programmes. American and Australian nurses must provide the following documents in advance of their application being individually assessed: a completed application form; identity documents, transcripts of training from their university school of nursing; professional employment reference; and verification of registration and good standing from all competent authorities with which they held their registration.

Some American and Australian applicants unfortunately do not meet NMBI standards and requirements in terms of the nursing programmes they undertook when compared to Irish standards and requirements. Many programmes fall significantly short of the hours required for registration with NMBI or to be offered a period of adaptation aptitude test, and unfortunately these applicants are refused registration. An applicant has the right to appeal this decision within 56 days of the date on the decision letter.

I am happy to inform the Senator that my Department recently received correspondence from the NMBI regarding a change in registration process for non-EU applicants. The new process takes into consideration post qualification experience as part of the assessment process for qualification recognition. The change was instigated in the hope of widening access to non-EU trained applicants who apply for registration while maintaining the standards for access to the register of nurses. The NMBI has informed the Department of Health it will also be publishing an updated guide to registration and making all of the information regarding registration available on its website. It is currently in the process of updating the registration application forms and guidance which it hopes will assist applicants in submitting their documents.

I have been advised by the NMBI that as of 14 February 2018, a total number of 236 individuals who undertook their training in the United States are registered on the active register with NMBI. The vast majority of these registrants would have had to undertake either an adaptation placement or aptitude test as a pre-requisite to registration.

Senator Martin Conway

The NMBI has advised the Department that it is updating its guidelines. Is there a timeline for the work of updating the guidelines to be completed?

I do not expect the Minister of State, Deputy Daly, to have the answer at his fingertips, but will he revert to us with it?

An Cathaoirleach

One would never know, he is a shrewd Minister.

Deputy Jim Daly

It is in the process of being updated and we expect that will be completed very shortly.

Social Welfare Scheme for Artists

Senator Fintan Warfield

I thank the Minister for coming to the House. I fully support the concept of a social welfare scheme for artists. This is important and long overdue. We need to shape the scheme so that it appreciates the work of artists and supports them to produce work during a meaningful career.

It has come to my attention that the number who have availed of the pilot scheme has been quite low, some 13 artists as of September 2017 and 24 as of 24 January 2018. That is a rate of around four successful applicants per month. I acknowledge that this is a pilot scheme.

As the Minister will know, the scheme is open only to visual artists and writers and not performing artists. As a musician, I wonder, as do other performing artists, why we are excluded from the scheme. Given the nature of their work, visual artists do not produce work with a quick turnaround. Works of art such as books of poetry, novels, sculptures, paintings, etc., can take years to produce. Under the scheme, the artist will have to be registered as self-employed with the Revenue Commissioners and be able to demonstrate that at least 50% of his or her income has been derived from his or her art in the preceding year to be eligible for the pilot scheme. The artist's status as self-employed under the scheme is reviewed every year. When one considers this condition in the context that visual artists do not necessarily produce completed work every year and the lack of artist focused copyright legislation, which of itself does not produce much of a long-term income in terms of royalties, it means that the chance of generating 50% of one's income from one's work is unrealistic. The model also works on the notion that there are full-time, secure jobs available for visual artists. That simply is not the case and has never been a reality in the sector in our time. That may have been the case at a time when painters or musicians were employed by the elite of society, but not today. Work in the arts in Ireland can be precarious by nature, on a contract or project basis, rather than secure long-term contracts.

The model of the pilot scheme treats artists as jobseekers who should be seeking employment and, therefore, consistent incomes. That would mean that artists, after a year without producing works, should take any employment offer and training courses offered by INTREO, including classes such as CV preparation, job-searching or referral to JobPath, Tús and jobs clubs.

Most, if not all, of Ireland’s notable writers and visual artists, such as Joyce, Wilde, the Yeats brothers, Beckett and so on, all produced works that took longer than one year to create or write. I reassert that I am fully in support of the notion of a social welfare scheme for artists. It is commendable that such a pilot scheme has been launched. However, has the Minister considered why the participation rate is so low? I genuinely believe, from discussions with writers and visual artists, that this pilot scheme is not fit for purpose and a future scheme would need to be restructured.

Minister for Employment Affairs and Social Protection (Deputy Regina Doherty)

I thank Senator Warfield for raising this matter.

The jobseeker's benefit and allowance schemes provide an income for periods when people do not have employment to support themselves. This pilot scheme is different. The aim is to support artists with a view that the artists would provide their own enterprise. Senator Warfield's figures are slightly different from mine. My figures go up to the end of February, and there are 32 artists on the scheme. That figure is still incredibly low. There is a reason that only 32 artists are on the pilot scheme and I need to find that out.

I welcome Senator Warfield's support and I think he knows there is a willingness both in the Department of Culture, Heritage and the Gaeltacht and my Department to recognise the special nature of works of art. I would also be curious as to why performing artists were not included in the scheme because I would say we would have many more performing artists than visual artists or writers.

I need to wait until the end of the 12 month period to look at the operation of the pilot scheme and to adjudicate on it, warts and all. That 12 month period will end in June 2018, which seems a long time from now. However, as a favour, would Senator Warfield write to me, outlining his ideas on what is wrong and what we could change to put it right from his experience with his fellow artists who have interacted with the pilot scheme, either successfully or unsuccessfully? I will ask for the review to be brought forward with a view to shaping the scheme so that it reaches more artists than the 32 people who have availed of it.

I agree with Senator Warfield's point that the work of a visual artist or a writer does not happen with a certain flow and we need to consider that point. Perhaps performing is different, one will get a gig this month but one might not get a gig next week. Let us agree that I will try to bring the review forward and that he will help me feed into the review by speaking to his friends and colleagues and providing data on what is wrong and what we could do to improve the scheme. Ultimately, we want a scheme that we can roll out not just on a pilot basis, but across the country that will support our creative Irish citizens to do what they do best, and have that cushion to support them in their creativity.

An Cathaoirleach

That is a very fair offer.

Senator Fintan Warfield

I thank the Minister. We will feed into any review. The ideas are for an extension of the scheme to performing artists and a longer review time for self-employment. Sweden, for example, has three years compared to our one. An exemption from non-relevant training courses or reactivation schemes would also be welcome, as would robust copyright legislation that allows artists to make a living from royalties and takes into account the precariousness of self-employment in the field of cultural activity. The pilot scheme is welcome and it should be a permanent initiative.

Deputy Regina Doherty

Would the Senator send me the details of the Swedish model? I am not aware of it but if it works it is worth looking at.

An Cathaoirleach

Perhaps the Minister could give the Senator a job in her Department.

Sitting suspended at 10.51 a.m. until 11.30 a.m.