Health service pay not hindering recruitment, commission finds

No generalised problem recruiting and retaining nurses and midwives, report says

The Public Service Pay Commission recommended a 20 per cent increases in some nursing allowances and improved access to some promotional posts. Photograph by Frank Miller
The Public Service Pay Commission recommended a 20 per cent increases in some nursing allowances and improved access to some promotional posts. Photograph by Frank Miller

Current pay arrangements for nurses, midwives and doctors are not a significant impediment to recruitment in the health service, the Public Service Pay Commission has found.

In a report published on Tuesday it maintained there was no generalised recruitment and retention problem in respect of nursing and midwifery but some difficulties existed in specific areas.

The commission found there was a general difficulty in recruiting hospital consultants. It said certain locations and specialties were experiencing significant problems.

The report said psychiatry, in particular, appeared to be experiencing recruitment challenges.

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The commission also highlighted the high number of non-specialist doctors appointed to consultant posts in emergency medicine.

It recommended a 20 per cent increases in some nursing allowances and improved access to some promotional posts.

However it did not back across-the-board pay rises.

The commission had been asked by the Government to examine recruitment and retention difficulties in the health service.

It said some unions had urged it to recommend increases in basic pay as a means of resolving recruitment and retention problems.

However, the commission said it was not persuaded, based on the evidence available, that current pay arrangements were in themselves “a significant impediment to recruitment”.

It said an international pay comparison carried out indicated that current pay rates did not appear to be unduly affecting the number of nurses, midwives and doctors applying to work abroad.

The commission said it remained of the view that remuneration was not the main issue impacting on recruitment and retention where difficulties existed.

“It is apparent to the commission that where some recruitment and retention difficulties have been identified the causes of such difficulties are multifactorial,” it said.

In relation to nurses and midwives, the report said the available evidence suggested staff turnover rates were not significantly out of line with those in the private sector.

Incentives

However, it said there was a case for providing additional incentives for qualified nurses and midwives to remain in the public system. It said these should be targeted at those who acquired additional qualifications and those who accrued long continuous service.

It recommended that a location allowance paid to nurses in 13 parts of the health service including emergency departments and theatres should be increased by 20 per cent, with similar increases to apply to those with specialist qualification allowances.

It said the additional benefit of these measures to nurses would be between €279 and €558 a year.

It said the location allowance should be extended to those working in maternity services and that this would result in a pay boost of €2,300 a year.

The commission also recommended that nurses and midwives should be eligible to attain the grade of senior staff nurse/midwife after 17 rather than 20 years of post-qualification experience.

It said it was left in no doubt that nurses and midwives were “seriously aggrieved” at what they saw as anomalies in current pay structures relative to other professions in the health service. There was no mechanism in place to deal with these issues in isolation, it said.

It suggested unions and the Government should consider arrangements for a general review of pay adequacy to be put in place at an appropriate time and without compromising the stability of the public-service pay bill.

For consultants, the commission said a current initiative between the Government and public-service unions on dealing with the two-tier pay structure may not address the scale of pay differential in place between newer entrant consultants and those with longer service.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.