The Department of Health is to commission a review on whether the programme to make nursing a degree-entry profession has represented value for money for the taxpayer.
A spokesman for Minister for Health Mary Harney said yesterday that more than €700 million had been spent on the project since the Government decided in 2002 that nursing students in Ireland should be educated to degree level. About €250 million has been invested in capital facilities while revenue costs are running at €120 million.
Details of the planned value- for-money review are set out in the submission made last week by the HSE to the public service benchmarking body which is examining pay levels for nurses.
The Irish Times revealed last week that nursing unions have sought increases of more than €6,000 a year under the benchmarking process to bring the salary of a staff nurse into line with therapy grades in the public health service.
The unions agreed to bring their pay claim to the benchmarking body as part of the settlement to the recent dispute.
In its submission to benchmarking, the HSE said part of the rationale for the introduction of the degree programme was to put in place a sound educational infrastructure capable of supporting emerging changes in practice that would drive a more efficient and effective healthcare system.
"Any evaluation of the pre-registration nursing degree programme will require criteria to test the aforementioned assumed benefits to the health service," the submission states.
The spokesman for the minister said the value-for-money review, to be commissioned later this year, would examine whether the programme had achieved what it had been designed to do.
He said the review had been set out in the Department of Health's business plan for the year and was not linked to the recent dispute.
Among their claims to the benchmarking body, the Irish Nurses Organisation (INO) and the Psychiatric Nurses Association (PNA) sought parity of pay between nurses and therapeutic grades such as physiotherapists, occupational therapists and the introduction of a special allowance for those working in Dublin.
The unions also sought the elimination of the pay anomaly between nurses and some social care grades.
The unions said nurses and midwives were professionals who required fair recognition and reward for the qualifications they possessed and the work they carried out. They said nurses today not only carried out the traditional levels of care but could also be regarded as therapeutic practitioners "with, in some situations, the ability to diagnose and to refer to appropriate other specialists and services".
The unions said it was clear that pay for nurses and midwives was out of line with peers in the private sector who were required to hold honours degrees.
Health service management told the benchmarking body that the future direction for nurses and midwives would involve empowering them to work in new ways and making better use of their skills while ensuring that "developments encompass holistic care and not substitution of medical tasks".
"While the aspirations as expressed by the unions on an expanded role for nurses and midwives are not inconsistent with the thinking of management on the same topic, nevertheless any such developments must be driven by service needs and clearly contribute to greater efficiencies within the health service as a whole," health service management said.
"However, expanding the role of the nurse/midwife will require service analysis to determine need, investment in educational preparation and skill development, integration of new work practices with the multidisciplinary team, development of appropriate clinical governance arrang-ements and evaluation of the expansion in terms of patient and service benefit," HSE management stated.
