Hospital Staff

I want to speak to the Minister of State, Deputy Dillon, about some emerging issues in Naas General Hospital. I have spoken to the Minister of State previously about the context of County Kildare and the population growth in the county since the early 1990s, when it had a population of approximately 100,000 people. Now we are in a situation where we have 250,000 people and, if we keep growing at the rate at which we have done for the next 20 years or so, we will have a population of half a million by 2050. I say that to set the scene because, as we know, such a significant population increase places significant pressure on our critical infrastructure. Understandably, people want to live in County Kildare. Nowhere is the pressure more acute than at Naas General Hospital right now. Last week, we were invited to a meeting by the Irish Nurses and Midwives Organisation which was attended by nurses and consultants who spoke really honestly about the reality of working in Naas General Hospital right now. Their experience and stories about what they are facing are very concerning. They spoke about significant increases in presentations at the accident and emergency department without any increase in the numbers of nurses and consultants. We also heard from the head of the physiotherapy department, who said patients face a four-and-a-half-year wait from referral to engagement when it comes to physiotherapy. That essentially means many people will never receive a service. We also heard from Lakeview, which is one of the busiest psychiatric and mental health services in the country. It is desperately underfunded. We heard a comparison made with a Border region that has one third of the population of the HSE catchment area in which Lakeview is situated, but receives four times the mental health services funding, specifically for acute care and inpatient care, which are very important areas of care. My concern arises from the fact that we still have not met the 2024 allocation of staff. Sanctioned posts have not been filled despite numerous attempts by those responsible. We now find ourselves in a position where the management team and the HSE cannot hire. Responsibility comes back to the Department of Health to sanction posts in Naas General Hospital. However, two weeks ago at the public accounts committee, of which I am a member, the same Department's officials told me after questioning that it needs to find a reduction of €100 million in its staffing bill this year alone. We have a situation where we simply do not have adequate or safe staffing levels in Naas General Hospital to the point where we see the real prospect of bed closures, while the Department says it needs to reduce its human resources bill by €100 million. How do we get around this? We do not need appeasement. Kildare needs proper representation and to be catered for. We are continuously being forgotten when it comes to health services, school places and public transport. We need, at the least, a commitment that Department officials will travel to Naas hospital to meet staff members and patients in order to understand that this is not simply a matter of being over budget but, rather, under-resourced.

I thank the Deputy for raising this Topical Issue, which I am taking on behalf of the Minister for Health, Deputy Jennifer Carroll MacNeill. As he outlined, Naas General Hospital plays a vital role in providing acute hospital services to the people of Kildare, west Wicklow and the surrounding areas. The Government recognises the importance of ensuring the hospital has the staff, resources and capacity needed to provide safe, high-quality care for a growing population. That commitment is reflected in sustained investment. The hospital’s budget for 2026 is €131 million, an increase of almost 60% since 2022. Its workforce has grown by almost 42% since January 2020, with a further 52 whole-time equivalent staff added between December 2025 and August 2026. Staffing growth at Naas has exceeded growth across acute hospital services nationally over both periods. Alongside this investment, inpatient bed capacity has increased. However, growth in funding and staff numbers is only part of the picture. Workforce planning must also have the right mix of staff and skills available to meet patient needs, cover absences and support services as demand changes. Recruitment is continuing across a range of staff disciplines at Naas. The wider HSE approach includes supporting healthcare graduates into employment, strengthening domestic and international recruitment and encouraging healthcare professionals working abroad to return home through project home. The development of a national staff bank is also being progressed to provide greater flexibility and reduce reliance on agency staffing. Retention is equally important. Staff need predictable working arrangements and a working environment that supports them to remain in the service. At Naas, a new 22-week rota for emergency department non-consultant hospital doctors provides greater certainty about work schedules and reduces the need for short-notice roster changes. This is a practical example of how workforce planning can support both staff and service delivery. There has also been progress under the framework for safe nurse staffing and skill mix. The latest information provided confirms that baseline staffing under the framework has been achieved across inpatient wards and in the emergency department. The supporting TrendCare system has been fully operational at Naas since July, helping the hospital assess nursing requirements against patients’ care needs in real time. Alongside this progress, reducing reliance on agency staffing must remain a clear priority. The latest nursing information confirms that agency staff and overtime hours continue to cover permanent vacancies and temporary absences. Agency staff play an important role in maintaining services, but ongoing staffing needs should increasingly be met through direct employment. Targeted recruitment, conversion of appropriate agency roles to direct employment and better rostering should support that transition, while protecting patient safety and continuity of care. Workforce planning is also about making the best use of the staff and capacity already available. Naas has demonstrated the benefits of this approach as an early adopter of the outpatient improvement toolkit. By June this year, that work had added more than 4,000 new outpatient appointments since 2025 through to 2026. Building on this progress, better scheduling and co-ordination of staffing, outpatient clinics, theatre sessions and diagnostics can help more patients receive timely care and ensure that investment delivers the greatest outcome. The Department of Health and the HSE will continue to work with hospital management to keep workforce and resourcing requirements under review. The objective is to ensure that investment at Naas supports staff in delivering safe, timely and high-quality care to the communities and the hospital itself.

I thank the Minister of State for that reply on the behalf of the Minister and the Department. For the record, the piece of the reply I will draw attention to is the figure of 52 additional staff in Naas General Hospital between December 2025 and August 2026. Of those 52, only five are nurses. The Minister of State told us that we had 52 additional staff members in Naas but he provided no detailed breakdown as to who they are. We do not know whether they are healthcare workers or administrative staff. What we know, however, is that five of them are nurses. Equally, we know that we also lost five nurses between July and August of this year, so we are at a break-even point. That manifests itself when people present to the accident and emergency department, wait for hours and watch on as overburdened staff try to fight fires in every corner of the room. I have witnessed it first hand. I commend, as everyone in this House does, including the Minister of State, their Trojan commitment. I looked in people’s eyes last week – I do not try to overstate this – and saw the despair of professionals at risk of burnout and walking away from a career they love simply because it is unsustainable, given that they leave with worry or the on-call system places even greater demands on them. I do not get any reassurance from the reply that there are not any problems in this regard and that is a concern. It is something we will all continue to raise. We all know that, right now, negotiations are under way to try to stave off the prospect of bed closures in Naas. With a population of 250,000, we have to avoid that. I ask the Minister of State to convey the sincerity by which we tried to raise this Topical Issue with the Minister and the Department to see if we can avoid that situation.

I thank the Deputy for his contribution and for highlighting the challenges facing staff and patients in Naas General Hospital. We are all in agreement that healthcare workers are the backbone of our health service. Every doctor, nurse, healthcare professional and support staff member who comes to work every day plays a critical role in delivering care to patients. I know the Deputy has delivered that with sincerity. We, as a Government, recognise that recruitment and retention remain significant challenges not just in Naas, but across the healthcare service in Ireland and internationally. That is why considerable investment has been made in staffing, workforce growth and hospital resources over recent years. Increasing staff numbers alone is not enough. We also need to retain experienced staff, as the Deputy said, improve workforce planning, provide more predictable workforce arrangements and reduce our reliance on temporary staff. The issues the Deputy raised today regarding recruitment, retention and workforce pressures in Naas are important. They deserve continued attention. As I said earlier, I will bring these points back to the Minister. I will ensure the concerns the Deputy has expressed this morning are conveyed and that the Department of Health and the HSE continue to keep staffing requirements under review so that patients in Naas, Kildare and across the country receive safe and timely care. Everyone in this House will agree that we need a strong hospital service and better outcomes for patients and communities. We are very much dependent on the staff to deliver that.