International nurses make up over 48% of staff... but only a fraction are now managers
Association says staff feel they are being ignored for promotion
A GROUP representing migrant nurses in Ireland say their crucial role in the health service is not reflected in management positions, despite almost half of HSE nurses now coming from overseas.
Figures provided by the Nursing and Midwifery Board of Ireland show that, of the 89,308 workers on its 2023 register, 43,227 – or 48.4% – were educated abroad.
Of the 6,257 first-time registrations last year, just 1,584 – one in four – had trained in Ireland.
The vast majority of the remainder came from non-EU countries, with most coming from India (3,272) or the Philippines (560).
However, Vinu Kaippilly, who is the national membership co-ordinator of Migrant Nurses Ireland (MNI), told the Irish Mail on Sunday: ‘You wouldn’t be able to see that kind of proportion [of internationally educated people] when you look at the managerial level or the people making the policies.’
Mr Kaippilly, a clinical specialist at an acute hospital in Dublin and originally from India, said he ‘loves’ his job, has ‘really good relationships’ with his colleagues and little trouble from patients.
But as a representative, he said he is ‘bombarded’ with problems from members, many of whom feel they are being overlooked for promotion or not being
‘Is the HSE doing everything possible to support us?’
given proper supports to integrate within the Irish health service.
The HSE this week said it was unable to provide figures for the number of internationally trained nurses in management positions.
Somy Thomas was one of the ‘first batch’ of nurses to be directly recruited by the HSE to come over from India 20 years ago.
She said that while she came from ‘a completely different background, completely different culture, different food and climate, everything’, practices in nursing were ‘almost the same’.
She estimates around one in 10 of her colleagues was foreign when she started in a public hospital, with that number jumping to around 40% by the time she left in 2019 to work in a private hospital.
‘But when you look at the management roles, it was very little,’ she said. ‘One or two per cent were from overseas.’
Ms Thomas believes she was discriminated against over 19 failed attempts at being promoted, with less experienced candidates – sometimes people she had trained herself – getting management jobs ahead of her.
Also a member of MNI, Ms Thomas said ‘many people have raised’ the problem of feeling unfairly overlooked for promotion.
‘I know a few nurses who left because they felt like they have no career prospects,’ she said.
MNI says there should be more supports to help people integrate and that there should be stronger training programmes for managers to show greater cultural sensitivity to migrant workers, without whom the health service would collapse.
‘There’s an expectation from the HSE and the managers for us to adapt into the system,’ Ms Thomas said. ‘But is the HSE doing everything possible to support us to adapt to the system, or trying to get their own managers or staff to know about where I’m coming from? There is no two-way process.
‘We left our families behind and, coming to a new place, there is a lot of support which is required for nurses to get through that transition period.’
She said the HSE’s equality, diversity and inclusion policy is ‘at the lowest level’ and should incorporate mandatory training, similar to countries such as the UK and Canada.
Mr Kaippilly also said: ‘The HSE employed a board of people to look at the equality, diversity, inclusion issue, but they are all white Irish men. So how are they going to come up with a solution? The
migrant perspective is missing across the board. And that’s like indirect discrimination.’
He said the lack of a cohesive policy on equality, diversity and inclusion is detrimental to ‘teamwork’ on the front line.
‘We should work internally to fix this rather than getting more resources and things like that. The policy-makers should understand this is a very key thing, because your frontline workers are scattered. They are not united. They are not working as a team.
Then what’s going to happen? Your quality of care, your quality of everything is going to be affected.’
A spokeswoman for the Irish Nurses and Midwives Organisation (INMO) said it is ‘very clear that the Irish health service relies heavily on internationally educated nurses and midwives’, adding: ‘They should be supported in the workplace.’
The spokeswoman said ‘extensive lobbying’ by the INMO had prompted Health Minister Stephen Donnelly to establish a
dedicated integration post for nursing and midwifery.
‘This is something that is very much needed and we don’t think one post is enough. We have continued to advocate for our members who have decided to make Ireland their home at both a political level and with employers.
‘As an ugly anti-migrant rhetoric begins to rear its head in Ireland, we want our internationally educated colleagues to be assured that they will be fully supported by their union and the integration post
announced by Minister Donnelly should only be the first of many such posts,’ the spokeswoman added.
The HSE said it is ‘committed to creating a culture where employees are valued and supported, and work in an environment free from discrimination’.
A spokeswoman said: ‘The HSE takes seriously its responsibilities under the Public Sector Duty to eliminate discrimination, promote equality, and protect the human rights of staff and service users.’
The spokeswoman insisted that the HSE is ‘working to improve the recruitment, support, and retention of employees across all diversity grounds’. The statement cited the
HSE’s Diversity, Equality and Inclusion Strategy, which it said contains ‘advice and guidance to staff and managers on any issue relating to diversity, equality and inclusion such as discrimination’.
Measures relating to race equality are also specifically included in workplace policies such as those relating to Dignity at Work.
Among its training schemes is ‘a specific course for leaders of multicultural teams, and an Intercultural Awareness eLearning programme which supports staff to be aware and respectful of ethnic, cultural and religious diversity of people who use our services’.