Review states no exodus of nurses, while pay competitive

Evidence implies nursing and midwifery pay in public health system ‘high comparatively’

There has been no mass exodus of nursing staff from the Irish health system, the Government’s spending review has argued.

It also maintains that pay for nurses and midwives in Ireland is competitive. The document, drawn up by the Department of Public Expenditure, asserts that outflows of nurses and midwives from the Irish public health system are "modest in both an Irish labour market context, and compared internationally".

The paper contends international evidence suggests that nursing and midwifery remuneration in the Irish public health system is “high comparatively”.

It says “inflows into the nursing and midwifery grades remain strong indicating a continued attractiveness as a career choice”.


Pay issues

The department's paper comes as the Public Service Pay Commission is finalising a review of recruitment and retention difficulties in the health services which nurses have maintained are linked to pay issues .

"Compared to a new entrant nurse in the English NHS, a new entrant nurse in Ireland earns 21 per cent more in basic pay based on current exchange rates. While allowances and promotional opportunities differ across jurisdictions, a nurse at the top of the HSE staff nurse scale would earn 39 per cent more than a nurse at the top of the NHS England B and 5 scale.

"More broadly, OECD nursing remuneration data show that, in purchasing power parity terms, Irish nursing pay (including allowances and premium payments) between 2007 and 2017 was consistently on a par with Australia and higher than New Zealand, Canada and the UK," notes the spending review.

It also maintains that 82 per cent of all nurses and midwives are on basic salaries of more than €40,000 exclusive of allowances or premium payments.

It says that nursing and midwifery allowances and premia payments “are estimated to contribute an additional 20per cent on top of basic salary”.

It says the HSE estimates an average staff nurse and midwife earns €11,264 per year in allowances and premium payments.

Public system

The review states that whether retirements are included or excluded, overall turnover rate of nursing and midwifery staff is low and well within normal parameters.Moreover, it also notes that there has been a 10.5 per cent increase – or a rise of 3,560 – in full-time equivalent nurses and midwives since the recruitment moratorium was lifted in 2014.

“Between Q4 2013 and Q1 2018, on a like for like basis, the number of nurses and midwives in the Irish public health system has increased from 33,768 to a total of 37,328 FTE.”

However the paper notes that the increases in nurses and midwives directly employed since 2014 “have not resulted in a reduction in the HSE expenditure on agency nurses and midwives which remains 85 per cent above 2007 levels. Expenditure on agency nursing has increased from €54 million in 2007 to €100 million in 2017. This represents an estimated additional 639 agency nurses. Continued reliance on agency staffing is a concern.”


Phil Ní Sheaghdha, general secretary of the Irish Nurses and Midwives Organisation, described the report as “wildly inaccurate to the point of being grossly misleading”.

She said it exaggerated pay for nurses and midwives in Ireland by including allowances which did not universally apply and treating shift pay in respect of night and weekend working as if it were basic pay.

“This report represents a department in denial. If any of it were true why did the HSE’s ‘ Bring them Home’ campaign fail so miserably. Why are our wards and services continually working understaffed? Why are Irish nurses and midwives leaving our shores for better conditions elsewhere and why is our health service so dependent on foreign recruitment,” she said.

Martin Wall

Martin Wall

Martin Wall is Washington Correspondent of The Irish Times. He was previously industry correspondent