NMBI tensions have been simmering for some time

The Nursing and Midwifery Board of Ireland (NMBI) is charged with carrying out a number of extremely important functions in the Irish health system.

It must provide for the registration of the 40,000 or so nurses and midwives working across the country. It sets the standards for education and professional conduct by nurses, and advises on how they should provide care.

At the same time, and perhaps most crucially, it is responsible for protecting the public and handles and considers fitness-to-practise complaints made against nurses and midwives.

However, over the past couple of years it has become increasingly apparent that all has not been well in the NMBI.

The Irish Times reported in November 2014 that a whistleblower had raised concerns with the Department of Health about the NMBI.

Separately, the NMBI became embroiled in a lengthy row with nurses and midwives after it sought to raise the annual retention fee they must pay. Ultimately, in the face of widespread protests, this plan was reversed.

The NMBI also faced criticism over delays in processing applications for registration for nurses seeking to work in Ireland, a serious issue given the difficulties faced by hospitals in securing trained staff.

Earlier this year it emerged that the NMBI had paid €105,000 to the Revenue Commissioners to settle a liability related to VAT, covering the period 2011-14.

Now two consultants' reports into the NMBI, details of which are published today by The Irish Times, show in damning detail the extent of the problems faced by the organisation in recent times.

In essence, the reports maintain that the NMBI is dysfunctional and that its key fitness-to-practise arrangements are “unfit for purpose”.

There are also serious concerns raised about expenditure, remuneration and procurement which would seem like material to be teased out by Oireachtas committees in the months ahead.

The reports paint a picture of an organisation that had significant internal difficulties, strained external relations with the Department of Health and a board burdened with the onerous requirements of its role in dealing with fitness-to-practise cases.

Tense

While the tension reported between the NMBI and the department may well have been due to its prodding of the organisation on governance and other issues highlighted by the whistleblower, questions are likely to be asked about the extent of its oversight and how problems reached such levels as identified in the reports.

For its part, the NMBI board accepted there were significant organisational and financial governance shortcomings identified and said it was committed to addressing these. It argued that despite the shortcomings set out in the reports, the NMBI’s regulatory functions were always appropriately discharged.

It said it had begun a transformation process “to help us avoid any such similar situation arising again and to enable us to continue to meet the needs of our stakeholders”.