MINISTER FOR HEALTH Stephen Donnelly has spoken with staff at Temple Street Children’s Hospital who were harassed as they travelled home from work during a riot in Dublin on 23 November.
Taoiseach Leo Varadkar told migrant nurses yesterday that they were “valued”, after Donnelly expressed concern about a “notable rise” in racial harassment in recent years being reported to him by healthcare staff.
Speaking at an event on Wednesday celebrating the 20th anniversary of the Irish Nurses and Midwives Organisation’s international section, Donnelly said staff at Temple Street in Dublin’s north inner city told him that on the night of the riot “they were targeted walking home, and others were afraid to leave”.
Donnelly said that nurses, doctors and other staff from 65 different countries work in Temple Street, and that they and other healthcare workers have the right to feel safe in their workplaces, and on the streets.
The Taoiseach said that the response of healthcare workers on 23 November was “exemplary”.
“Yet I know many people were worried about making the journey home that night, when a violent and racist response erupted on our streets,” he said.
Three children and a care worker were injured in a stabbing incident on Parnell Square on 23 November, while the attacker was also seriously injured. A five-year-old girl and care worker Leanne Flynn are both understood to remain in a serious condition in hospital.
Varadkar thanked nurses from different nationalities working within the Irish health service for their commitment and hard work, and noted that often, international workers make “sacrifices” to come here.
He said that though the UK government has made the decision to change its immigration policy in order to make it “harder” for health and social care workers from overseas to bring their families and dependents with them, Ireland will not “be following suit”.
“As a country with a long history of migration, we understand the sacrifices people make when they choose to come here, and in the round I believe migration is a good thing in Ireland. Our health services and public services wouldn’t function without it,” Varadkar said.
He added that while he believes Ireland should remain open to migration, the government needs to be able to assure people that it is “rules-based” and that “there are controls, and it will be properly managed”.
Varadkar further said that it was essential that international nurses were not simply seen as “filling gaps” in the Irish system.
“We want you to stay, and we want you to build your careers here,” he said.
Donnelly told nurses from countries including Nigeria, India, and the Philippines that racism was wrong in “all its forms and guises”.
“When it comes to healthcare and a racist sentiment in Ireland, that is where bigotry and raw stupidity meet,” he said.
He announced that the HSE CEO is creating two senior, national level roles within the executive that will be responsible for promoting inclusion and combating workplace discrimination in Irish healthcare settings.
Speaking to The Journal at the event, when asked for his thoughts on the ongoing investigation into allegations of racist treatment towards Indian nurses at Cork University Hospital, Donnelly said that he couldn’t comment on an ongoing investigation.
“What I can say very clearly is that we must have a zero tolerance approach towards racism or discrimination of that kind, in our hospitals towards workers be that from the public, and we are seeing that, or, as is alleged, from other members of staff. We have to have that zero tolerance approach,” the Health Minister said.
Donnelly added that, based on his recent conversations with staff in the Mater and Temple Street Hospitals, he is highly concerned that health workers are facing an “increasing level of abuse at work”.
“After the riots, I was talking with healthcare workers about their experiences of abuse, which they said have notably increased in recent years,” he explained.
The Minister said that nurses told him in recent years, “members of the public coming into [emergency departments] are acting in ways that they just wouldn’t even a few years ago”.
He said that many hospital workers have told him of the role social media is playing in this rise in abusive experiences.
“Social media is having this corrosive effect and normalising behaviour which is just not acceptable. People are translating behaviour from the virtual world, where for some reason it is okay to be horrific to each other, and manifesting it in the real world,” Donnelly said.
He further said that he is having conversations about how to tackle the issue with Bernard Gloster, the CEO of the HSE.
Nurses from different countries spoke about issues they are facing when they come here to work in the health system.
Grace Oduwole is a Nigerian nurse who came to Ireland in 2001. She is the vice-chairperson of the INMO’s international section, and works in Dublin’s Cherry Orchard Hospital.
During a panel discussion, Oduwole explained that since she arrived in Ireland, nurses from overseas have been supported by the INMO in fighting many different obstacles they have faced.
These issues have included their spouses not being allowed to come here, having to pay international fees for their children to go to college, and being unable to leave the EU while pregnant to get maternity payment.
Oduwole said that nurses coming from overseas do not get enough guidance to help them integrate into the Irish health system.
“The truth is that the kind of training we have at home is totally different to the training here. For example, back home, we do not call for the doctor unless we have done everything we can to resolve a patient’s issue ourselves. Here, the scope of what a nurse does is much more limited.
“If you are a nurse from another country, you need to be guided on the scope of practice here, and if you don’t have a union backing you, you find yourself in trouble,” she said.
Oduwole said that the current six-week adaptation programme, and the alternative two-day aptitude test were not comprehensive enough to fully help nurses fully integrate.
Janet Baby Joseph, an Indian nurse from Cork University Maternity Hospital, said that recruits from overseas were facing real challenges in securing appropriate housing for their families here.
“In Cork we came together to found the Cork Indian Nurses Organisation, so we could help each other when we face challenges. It is not easy to come here as a nurse from another country, you need to do an English test, an aptitude test, you are away from your family for the first months, and you are experiencing complete culture shock,” she said.
Joseph said that every morning she wakes up to messages from newly arrived Indian nurses who are struggling to find somewhere to live once they leave the accommodation the state provides for the first month.
“I know nurses living in damp houses, who are taking their kids to the GP every week with respiratory problems, who have leaking toilets, broken roofs, but cannot leave because there is no other option,” she said.
Joseph said that she accompanied a nurse who had applied for hundreds of different houses to a viewing recently.
“You could smell the damp as soon as you walked in. I asked the agent if it would be possible for the house to be cleaned before the nurse walked in. You should have seen the sarcasm they showed us.
“They asked if we wanted it replastered as well. They know they can behave this way, because there is a queue of desperate people behind you, and they know someone will take it,” she said.
Dr Pamela Cipriano from the International Council of Nurses is involved in tracking the migration of healthcare workers around the world, and whether countries are abiding by the World Health Organisation’s code of ethics on recruiting health staff from abroad.
She told the INMO conference that globally there is an estimated nursing shortage of 8 million personnel. The WHO has a red list of countries with an exceptionally low density of nurses and doctors for their population size, which it asks source countries including America, the UK, Canada and Ireland to avoid recruiting from.
Fifty-five countries are on this list currently, including 37 African countries.
Earlier this year The Journal reported that the HSE continued to recruit nurses from three African countries facing nursing shortages for over a month after they were added to the WHO’s safeguarding list.
Recruitment of nurses from countries that aren’t red-listed has grown in Ireland in the last year. The Nursing and Midwifery Board of Ireland’s latest annual report showed that for the first time ever, the majority of newly registered nurses in Ireland came from non-EU countries.
Cipriano explained that nurses being mass recruited from developing countries that don’t have enough healthcare staff to meet their population’s needs can leave health systems depleted and understaffed.
She said that while these countries often have enough qualified nurses, their governments do not have enough money to fund the number of nursing positions needed. This results in unemployed nurses looking for opportunities abroad.
However, targeted recruitment campaigns by some developed countries have resulted in hospitals on the WHO’s red list without enough staff to run them.
“We need to ensure that recruitment is happening in an ethical way. We know many countries have staffing shortages and their health services are depending on international recruitment.
“We need to see investment in these source countries so that they can replenish their health systems, and so they have the technology and education resources in place to enable their services to progress,” Cipriano said.
She said that the International Council has found that while the idea of circular migration gets talked about a lot (workers going abroad and then returning to their home countries later), in reality, there isn’t much evidence to show that it is happening.
“On average, nurses being recruited from source countries have 12 years’ experience. They cannot be replaced by a graduate, and they leave a void in the system when they go,” Cipriano said.
She told the conference that it is of real importance that governments have “transparent” international healthcare recruitment policies.
“We currently have secret government to government agreements between developed countries and those on the red list of safeguarded countries, and that is a black box that we cannot get into. We don’t know what is happening, but we know that the remuneration the source countries who are losing health workers are getting is extremely low, and doesn’t enable them to replenish their health systems,” she said.
The WHO ethical code on international recruitment is adhered to by countries including Ireland on a voluntary basis.
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