There is just one nurse remaining in the Defence Forces following a decision to let the service collapse and replace it with private contractors.
That is despite an internal 2012 report warning that outsourcing the Army Nursing Service (ANS) would be prohibitively expensive and less effective.
Nursing is the most depleted medical service in the Defence Forces but there are also severe shortages of other medical professionals. just six military doctors out of the required 28 and three dentists out of a required seven. There are 22 military doctors out of the required 28 and four dentists out of a required seven.*
The ANS was established 101 years ago, shortly after the foundation of the National Army. According to a history of the service published by the Defence Forces, it has had an average of 50 members over the decades but was as high as 200 during the second World War.
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Duties of army nurses include occupational care, injury treatment and the vaccinations of troops going overseas. They are also involved in health education for military personnel and conducting various medical tests.
Figures show the ANS has been in long decline. In 2008, there were 28 nurses in the service. However, in the 1990s, it became policy to allow them to resign or retire without replacing them.* According to figures from the Department of Defence, the ANS is down to one nurse.
In 2012, a civil-military working group was established to examine the future of the service.
After visiting all brigades and formations, it was determined the Defence Forces needed to reform the ANS and grant it more authority.
There should be an initial allocation of 18 nurses across the country and a “lying-in facility” for soldiers recuperating from illness or injury should be reintroduced in St Bricin’s Hospital, a large military medical facility in Dublin, the group found.
It said to maintain resilience, the Defence Forces required its own health service “independent of the national health system”.
The ANS occupies an unusual space within the Defence Forces. Members are military personnel but they are not part of the rank structure and not usually subject to military law.
The working group recommended that the ANS be incorporated into the chain of command and that nurses be given authority commensurate with their level of responsibility.
Each ANS member provided €1,668 worth of services to the military per day, the group said in 2012.
Replacing nurses with agency staff would cost more than building up the ANS, it argued. Furthermore, any “potential efficiency was not worth the loss of effectiveness, continuity and the loss of the occupational health role that the current ANS provide.”
Contracting all military nursing out to a single private service provider would also be “exorbitantly expensive”, it said.
The Defence Forces and Department of Defence had been due to complete an updated review of military medical services by the start of 2025, however it has yet to be published.
“The [Defence Forces] strives to offer a professional healthcare service, but this has been dogged by a chronic shortage of clinical professionals such as medical officers, but more acutely through the absence of any employed military nurses,” said Lieut Col Conor King, secretary general of the Representative Association of Commissioned Officers (Raco).
“They care for patients and help them get back to work as quickly as possible, enhancing operational effectiveness.”
He said he hoped the Government’s latest review would recommended “the re-establishment of this critical service within the [Defence Forces] for the benefit of all personnel.”
A Defence Forces spokesman said the latest report, which was carried out by external consultants, “has made recommendations regarding the establishment of the future nursing service and its capabilities.”
However, as the report is awaiting ministerial approval, he declined to provide further details.
** This article was corrected on August 18th to state there are currently 22 military doctors out of a required 28, rather than six as previously reported; and to say the Defence Forces policy on allowing nurses retire without replacement was introduced in the 1990s, not “following the economic downturn” as had been reported.
