Northern Ireland Assembly
Tuesday 16 January 2001 (continued)
There is a danger of the motion's falling between two stools. I have particular remarks to make about the NHS, and I hope that the Minister of Health, Social Services and Public Safety will hear them. There is clearly a shortage of staff in the NHS. Medical staff are leaving, and there are chronic shortages in some disciplines. That leads to overwork and disillusionment for those remaining, and so the cycle begins again. There is uncertainty about the future of primary care and acute hospitals - both these issues are currently the subjects of studies - which has led to a loss of confidence. We need to sort out the NHS now. The system needs to be reorganised and settled down.
There is a shortage of nurses. Some are leaving, but, perhaps more seriously, fewer are joining. I was speaking recently to a former very senior nurse. She is retired, but she visits schools. She recently visited a sixth form to talk about nursing. Out of that entire sixth form only two students were interested, and she believes that only one of the two will actually go on to nurse. That is worrying. There seems to be a culture in Northern Ireland that regards nursing as no longer an attractive profession. Perhaps that is not surprising given the view that nurses are not paid enough.
The recent short-term solutions have been to import nurses from Australia and the Philippines and to encourage nurses back into the profession. I recently met a lady who trained in the Royal Victoria Hospital but spent her entire nursing life in America. She returned here to retire but was persuaded back into nursing. She is having an absolute ball, back at the Royal, having completed her retraining course. That solution can only be short-term.
I am concerned too that the Department may not know how many trained nurses there are here. Lots of ladies train but leave to have families. I wonder whether a record is kept of all trained nurses and doctors so that they can be contacted, given the shortage, to see if they are interested in returning.
I am also worried that the Department may not have a proper human resources department with the necessary expertise. Some of the shortages may be attributed to slightly daft reasons. Dr Hendron touched on the subject of occupational therapists. That is an interesting area. Some elderly people, or those who live on their own or in Housing Executive property, need handles to help them get up in the toilet or bathroom or move outside, and the only people qualified to decide where these handles should go are occupational therapists. The skilled tradesmen who fit these handles and rails - presumably they do such jobs and know where to put them - are not allowed to do this work for health and safety reasons. If someone fell, the tradesmen would end up in court. That is daft. Hundreds of people need such measures fitted, but there are insufficient occupational therapists to make the necessary visits. That leads to the perception of a chronic shortage of occupational therapists.
If someone were to come up with a design based, for example, on the height of the patient, that could determine the point above a bath at which a handle should be placed, thus enabling tradesmen to fit them, would there be this perception of an enormous shortage of occupational therapists? It seems crazy that no one can be bothered to find a solution to that. We prefer to disappoint and inconvenience hundreds of elderly people rather than try to find a practical solution to the problem. The Department needs a proper personnel branch to develop solutions for recruiting, training and retaining staff.
Finally, I will move to the general skills shortage. Businessmen tell of the abilities of potential staff and their enormous skills shortage - some cannot add and others cannot write for toffee. Universities say that they have to run courses for their first year students - to retrain them. Shorts has set up a department to deal with that. Clearly there is a problem with providing these necessary skills.
I ask the Minister to get together with his Colleagues in the Departments of Education and Enterprise, Trade and Investment to produce a common training system or curriculum that will give employers staff with the right skills to the right standard. Until we do that, we will have a skills shortage.
I support the motion.
Mrs I Robinson:
The motion speaks of the skill shortage in the Health Service and calls on the Minister of Higher and Further Education, Training and Employment to take steps to address the problem. However, the skill shortage is due to other factors in the Health Service. I agree with Dr Birnie that the motion could have been broadened to include action that the Minister of Health needs to take urgently.
First, there is the contributing factor of getting enrolled nurses to become registered nurses. There are over 400 enrolled nurses here. If the majority were to become registered, it would make a big impact on the skills shortage. We need to find out why they do not want to do that and with what emoluments they can be encouraged. Is it the lack of reward, the undervaluing of the service or the cost of conversion courses? We must find out why we have so many enrolled nurses who remain so.
Secondly, there is another hidden factor - staff bullying by seniors. The money paid out to those who have taken claims against trusts is an indication of the number of skilled staff, including nurses, leaving the service. A recent meeting in Lisburn for staff being bullied in the Health Service attracted over 200 people. The situation is so bad that a support group has been set up. While we do not know the exact numbers that have left because of bullying, we will get a better indication when we know what money is being paid out- a factor that I am currently pursuing with the Minister of Health.
Thirdly, some 1,500 staff took early retirement in the last three years. Technically, each year 500 skilled staff take early retirement and are lost to the service. To cover for that loss and to make up the shortfall we would have to recruit twice that number. Failure to do so has worsened the situation. Perhaps the Health Service should operate the same policy as applies in education, where school governors only look at an application for early retirement if it will have no impact on the service given to pupils and if a suitable replacement can be found. Can this not be done in the Health Service?
A written answer on 7 December 2000 showed that more than 8,000 staff are on long-term sick leave. How many of these account for the skills shortage? I doubt if anyone knows. However, if that matter were tackled, it would reduce the numbers of skilled staff needed.
Finally, there is the bad decision making that demoralises staff, causing them to leave and go elsewhere. Take the decision to close the Jubilee and transfer maternity services to the Royal.
Mr J Kelly:
On a point of order, a LeasCheann Comhairle. Is the closing of the Jubilee and the transfer to the Royal really relevant to this debate?
Mrs I Robinson:
With the greatest of respect, it is. To date, some 40 staff have quit, which is very relevant, and time after time, services have had to close. Senior staff have even gone to other countries, taking a pay cut at the same time, because they have been so demoralised by the bad decisions continually being made.
That serious issue must be addressed if we are to retain the skilled staff that are so essential. It is evident to all that there are a number of problems in the Health Service, which, if tackled, would reduce the skill shortage and, thereby, the need for overseas recruitment.
I support the motion.
Mr Deputy Speaker:
There are four more Members who have indicated a wish to speak. If those Members could limit themselves to five minutes each, we should be able to get through everyone.
Mr M Murphy:
Go raibh maith agat, a LeasCheann Comhairle. I support the motion. It would be remiss of me not to say that it is unfortunate that the debate should be used to attack the Minister of Health, Social Services and Public Safety. That is what seems to be happening. Constant negative reporting, fuelled by many in the House, does not help to make the Health Service attractive to work in, yet it only functions because of the staff's hard-working commitment. The truth is that chronic under-funding, a lack of planning and successive British absentee Ministers have had a detrimental effect on it.
I want to broaden the debate and concentrate on employment and skilled workers generally. I would like the Minister to ensure that business competition is not hobbled by a lack of people with the right skills. We have to reach out to the disaffected and socially disadvantaged and persuade them that learning is not a burden, and they must have the means to learn. We must build on what has succeeded in post-16 education and training and create a scheme that is even better. We must set up a learning and skills council as a non- departmental public body that will work with employers of all sizes to assess their current and future skills needs and fund effective training that is open to as many as possible. Small businesses especially need help with training. Many firms require a skilled workforce to enable them to move into new product areas and provide new opportunities.
The learning and skills council should seek to break down the barriers that have stopped people undertaking training that would put them on the right path to a job. Barriers exist for all kinds of reasons, including religious discrimination, age, disability and gender. The learning and skills council must ensure that it funds training to suit people's needs. Colleges and training providers should find innovative ways of getting training to those who want it. Making a decision to update skills or change career should not mean that people have to disrupt the rest of their lives to get the right training.
The learning and skills council should take over from the training and enterprise councils and organise training locally. Council members should be drawn from local areas, and a percentage should be employers who are best placed to know what skills are and will be needed locally.
Councils should have about £100 million to spend on training, much of which would lead to qualifications, though some would not. Some training might help people keep up to date with changes in technology, while other training might assist those who missed out on formal education earlier in life and improve their chances in the job market. Other training would help people to make more of themselves and realise their potential as individuals.
The aim of the council should be to bring thousands of people back to learning. It should work over a large area by identifying colleges or training providers and encouraging them to work together instead of competing. That would make the most of public money and ensure that no effort was wasted.
Planning co-ordination should reduce the limited training provision caused by rapid technological change. It is unrealistic to continue investing in specialist equipment, such as printing, when an employer's premises could be used as a centre of excellence to train trainers in the latest technologies. Councils can recognise local needs and provide specialist courses through in-house training.
The point of the learning and skills council is to bring more people into learning for longer and to raise standards. It would bring a new and sharper focus to the way training is funded, help build strong businesses and communities and assist individuals to play an active part in securing economic success.
Go raibh míle maith agat.
I am pleased that Mr O'Connor has raised this important matter. I wish to concentrate on the shortages in the health and social services sector as they relate to experiences in my constituency.
First, there have been unduly long waiting lists for occupational therapy services. Assessments for some of my constituents have taken 12 to 18 months. I acknowledge that there has been some additional investment in occupational therapy, but there has also been additional responsibility - for example, for wheelchair assessment and allocation - which is absorbing some of that investment.
Occupational therapy assessment can affect the quality of life of the infirm, elderly and disabled. Many home improvements await assessments - whether it be for handrails, showers or heating upgrades. Those adaptations enable constituents to live longer in their homes and, thus, reduce the cost to the community care budget that would be incurred if they were to go into residential care.
My constituents have also made me aware of the pressures on specialist speech and language therapy in schools and the patchy provision of speech therapy for those seeking treatment. One constituent had his speech therapy interrupted for eight months because his therapist was ill and there was difficulty with recruiting a replacement. I quote from a letter that I received from a health trust:
"Our experience over the past year is that we have had to advertise posts a number of times before filling them and that the number of applicants applying for posts is very small. In some instances there are no applicants for posts."
I have raised that with the Minister responsible and understand that a review group was to report at the end of last year. I do not know whether the Professions Allied to Medicine (PAMs) group has yet met.
Finally, I turn to the shortages in the nursing profession - a number of Members have mentioned this - which are limiting the quality of health care that can be provided. In the early 1990s, we exported nurses. We trained many able students; we did not have sufficient vacancies; and nurses were forced to leave.
Nursing training was reduced from over 800 to about 400 - a huge drop. It was crazy to reduce the training so dramatically, and now we have shortages. During that period there have been technological changes that require more intensive nursing. Also, demographic changes have resulted in a more elderly population that requires additional community care services.
There seems to be a variety of estimates of the current number of nursing vacancies. In answer to a question that I asked last year, the Minister estimated 141 vacancies. The Assembly's research department estimates that the trusts and boards have some 300 to 400 vacancies. In the independent sector there are a further 300 to 400 vacancies. There is a big question mark about the quality of information in the Department. I welcome the fact that 100 additional nurses are now to be trained each year, but there is considerable doubt about whether that will be enough.
I have one constituent who sought from an early age to become a nurse. Her qualifications would meet the requirements of the nursing boards in Scotland, but she was not successful in Northern Ireland. Higher qualifications are required here. We are now exporting students for training in other parts of the United Kingdom, when the demand is here. There is mismanagement in the Department.
In addition, in answer to a question the Minister said that 107 work permits have been issued here for nurses from outside the European Union. That mismanagement is a result of the existing structure. There is a central Department, but I do not know what it does. It does not deliver services. We need one authority to be responsible for training nurses with flexibility in its budget to enable it to deliver what is needed. Linking the delivery of services to a central health authority is part of the solution.
I congratulate Mr O'Connor on tabling the motion. As the Chairperson of the Higher and Further Education, Training and Employment Committee said, an inquiry into skills training and needs in the public and private sector industries is ongoing. Ninety organisations have indicated that they want to make submissions. Sadly, however, only one private sector employer has agreed to submit material to the inquiry. The remainder are in the public sector. That is an indication of our enterprise deficit. However, the Committee is trying to get more private sector employers to give it their opinions.
The motion refers to the skills shortages in Northern Ireland in general and in the Health Service in particular. It is a result of the mismatch between supply and demand in the labour market, and that is a challenge for us all.There is a particular challenge with the long-term unemployed, central to whom are the 20% of people who lack basic numeracy and literacy skills. That must be tackled, and I hope that the Minister will be able to do something about it over the next two to three years.
People who live in large urban housing estates and have endured long-term unemployment do not have any hope. We must give them hope with skills training that will enable them to compete.
There is also the shortage of skilled personnel in the Health Service. I agree with Dr Hendron that, in the past, seven hospitals provided nursing training. I am not sure about the merits of centralising all such training in universities. I lectured in further education and saw many aspiring nurses do a pre-nursing course before their hospital training. University training may be desirable, though, for higher skills.
Mr McFarland said that a survey of sixth formers at a secondary school showed that only two people were interested in nursing. I agree. It is no longer the attractive option it once was, and it is more difficult to get into. Nowadays, one has to be a high-flying academic to get into nursing. However, nursing is mainly about caring. Very often people who study nursing do not need such high-level academic entry qualifications. Many students go on to do the Advanced GVNQ in health and social care, which is not the proper route for people who want to be nurses.
Mr J Kelly:
I am sure the Member is not suggesting that nurses have lower academic qualifications than other professionals. Nursing is a critical area that touches on life or death.
Mr Deputy Speaker:
May I remind Mr Byrne that if he gives way his time will be limited.
Yes, but I was being sensitive to the Member's interests. I do not think that my comments indicate that I am in favour of lesser qualifications for nurses. In the past when nurses were trained in hospitals more people wanted to enter the profession. Fewer people are now entering it, and there is a shortage of 800 nurses here. As Mr Beggs said, we are importing trained nurses, while in the past we exported them.
Also, when we had matrons, there was a leadership role for nurses. Nurses feel demoralised. Ward managers are largely in charge of their responsibilities, and many of them find that difficult to cope with. That can be tackled if there is co-ordination between the Department of Health and the Department of Higher and Further Education, Training and Employment, and I hope that that will happen.
Lastly, when the Committee concludes its inquiry we will have a clearer picture of the skills gap in general and, I hope, in the Health Service in particular.
Mr R Hutchinson:
I support the motion, but it is rather unfortunate that its wording seems to point the finger at the Minister of Higher and Further Education, Training and Employment. I am sure that was not intentional. Lest Dr Farren think I have made a new year resolution to give him an easy ride, he need not panic. He will not get an easy ride. Both Dr Farren and the Committee have taken this seriously and are doing an excellent job trying to rectify the imbalances in this area.
In spite of the disturbing fact that little research evidence supports the apparent shortage of staff and expertise in some hospital trusts, significant recent examples confirm that the standard of service being offered by the trusts is considerably burdened. We read horrific stories in newspapers, and constituents tell us about the difficulties that they encounter. It appears that meeting current needs from the indigenous market is no longer an option. Instead of recruiting from inside Northern Ireland, which has an unacceptable level of unemployment - trusts, as Dr Hendron said, have had to travel.
I felt as if I was back in church on Sunday morning, because every time my clergyman says "And finally," I know that he will go on for another 45 minutes. Dr Hendron said that a few times this morning, and I was panicking lest none of us would get a chance to speak.
However, I agree with what he said about bringing nurses from the Philippines and Australia to remedy our shortages. Although there is no research to prove it, evidence suggests that there are not even enough agency nurses. Can the Minister of Health explain why research into skills shortages here is so inadequate? Establishing the extent of her Department's need would be a useful first step towards dealing with the dire situation. How does she intend to address the surprising lack of research?
The problem is not restricted to nursing. Leading practitioners and medical laboratory staff are also in the spotlight over their frustration with a system that has consistently underfunded acute medical needs. Members will recall our debate a few months ago on laboratory technicians. They feel under pressure, and their needs are not being adequately met. Indeed, the difficulty is less the responsibility of Dr Farren than of the Minister of Health, Social Services and Public Safety, who seems to be less than eager to put it right. There is a logjam, and the Health Minister needs to acknowledge her responsibility to sort the situation out. Can she assure the House that she has done more than simply adopt the policies of her predecessors? What significant steps has she taken to answer the complaints of patients, practitioners and nursing and technical medical staff about the chronic underfunding?
Mr J Kelly:
On a point of order, a LeasCheann Comhairle. The Minister of Health, Social Services and Public Safety is not here, because the debate is a matter for the Minister of Higher and Further Education, Training and Employment. Should the Member be able to attack the Health Minister so vociferously? She is not present to defend herself in a debate, which, ostensibly, does not concern her Department.
Mr Deputy Speaker:
Order. I accept Mr J Kelly's point. Several Members have strayed from the subject of the debate, and it is inappropriate to direct questions to a Minister who is not in the Chamber.
On a point of order, Mr Deputy Speaker. The motion specifically mentions health and social services.
Mr Deputy Speaker:
I take the Member's point, but given the time limits, we should allow Mr R Hutchinson to continue.
Mr R Hutchinson:
I am delighted to have stirred up such debate. We have a sophisticated society, but how confident can patients be in a Health Service that is struggling to meet its needs, particularly its staffing needs? One is often left feeling that Minister de Brún's Health Service is in urgent need of a radical cure.
The Minister of Higher and Further Education, Training and Employment (Dr Farren):
I welcome the debate, and I have listened to all the contributions with considerable interest. It is important that Members reflect concern about matters such as the skills needs of our economy.
Most Members who dealt with the part of the motion that refers to the Health Service accept that those matters do not lie within my sphere of responsibility. I am sure that my Colleague the Minister of Health, Social Services and Public Safety will take note of the comments made in respect of her responsibilities and respond to Members accordingly.
There is, of course, a degree of overlap on a small number of Health Service related issues. In our universities and, to some extent, in our colleges of further and higher education provision is made for the professional needs of the Health Service. Members need to appreciate that the provision of places on such courses is, by and large, a matter for negotiation between the institutions concerned, the Department of Health, Social Services and Public Safety, the trusts and the health boards.
Therefore it is only in a limited way that I have even indirect responsibility. It is up to the universities and the colleges, in the context of those negotiations, to determine the level of provision that is made for places on their degree and other courses. I respond to the debate from the more general perspective that is suggested in the opening part of the motion.
I was particularly pleased to note the comments of the Chairperson of the Committee who reminded Members that the Committee is now engaged in an extensive study of the skills needs of our economy. Obviously, from the range of responses received and from some of the submissions already made, there is great interest in the Committee's work. I look forward to its report.
I want to make some general points which are pertinent to addressing the skills needs of our economy. My first point, to which some Members have referred, is that we are operating in a labour market that is much more positive and challenging than it was a decade ago, or perhaps even five years ago. With unemployment at the low level of approximately 6%, and employment at a record high, we have a tighter labour market. Certain skills are in high demand, and pressures, of a kind not previously experienced, are being felt across a number of sectors.
Members will appreciate - and this has also been referred to - that people who were trained here in various occupations have left Northern Ireland. That has had consequences for the Health Service, and we are attempting to attract specialists from overseas, from very distant lands, to make up the deficits.
Our labour market is not isolated, and our situation is very open. There is considerable mobility in the Health Service and the construction industry, with whose representatives I have been in regular contact over recent months. They point to the highly attractive rates of remuneration and job opportunities available south of the border, factors that are drawing many away who have skills that are needed by the construction industry. We are working hard to make up the deficits thereby created.
We also see these problems in the information and communications technology area and others. These pressures are not simply a result of our economic successes in recent years. Pressures are also from without - whether south of the border, across the Irish Sea, or globally. Members will appreciate that the information and communications technology sector is operating in a labour market which, globally, is experiencing considerable skills shortages. We therefore need to undertake more detailed planning to enable us meet the skills needs of our economy and ensure that all its sectors are provided with sufficient workers with the highest possible level of technical and professional skills.
Some Members suggested that there is an absence of strategic planning. That is far from the truth. A considerable degree of strategic planning is constantly under way in my Department, and that is reflected in the Programme for Government, as those who have read and studied it know.
We have a well-endowed education and training infrastructure to meet the challenges, which many Members frequently acknowledge. A report published last month by the Northern Ireland Economic Council, written by Prof Michael Best, a world-renowned researcher and commentator on economic planning from the University of Massachusetts, states
"Northern Ireland's educational system offers a basis for competitive advantage with considerable potential. Few regions in the world of the size of Northern Ireland have the range of university level disciplines in engineering and science-related areas, particularly in information technology."
Elsewhere in his report, Prof Best refers to the size of the information technology programmes at the University of Ulster and Queen's University as being "particularly impressive". He describes them as
"a magnet for information technology companies given the global shortage of skills in this area. The opportunities for industrial policy are considerable."
Later in his report, Prof Best points to the considerable potential of our further education colleges to help to meet the skills needs of our economy.
Members will appreciate that the professor's report is not simply a list of compliments. He makes criticisms but also recommends plans to meet our skills needs. I agree with some of his criticisms, some of which have been voiced here this morning. However, action is being taken in response to almost all of the points, and I remind Members of some of the initiatives that are underway.
We are not yet achieving 100% success, but any objective assessment would conclude that we are making considerable headway in the drive to meet our skill needs. The major focus of my Department, since its establishment, has been on avoiding skills shortages. I have taken steps to ensure that the vocational education and training system is focussed on and addresses industry's needs.
These measures include placing greater emphasis on researching the labour market. One Member said that there is no evidence of any such research, but a considerable amount has been completed, and reported on, in recent years. I invite Members who may not be familiar with my Department's annual bulletin to examine its wide- ranging set of research reports on many aspects of our labour market. That negatives any suggestion that there is an absence of detailed research into the labour market here.
I have increased the number of places in higher and further education, particularly in vocational areas of employment growth. The number of modern apprenticeships, for example, now stands at more than 3,000, and it is increasing. Many of these include apprenticeships for the construction industry. The areas in the higher and further education sectors, such as information and communications technologies, electronic and software engineering, manufacturing engineering, tourism and catering are all receiving particular attention to the extent that the number of places available to students has increased significantly. In my recent proposals for new forms of financial support for students, I have identified key areas requiring special attention. My objective is to give those from low income and disadvantaged backgrounds access to further and higher education.
Increasing access to education and training for all through New Deal programmes, the bridge-to- employment initiatives, the promotion of individual learning accounts and the opening of a considerable number of "learndirect" centres across Northern Ireland is further evidence that the strategy to meet skills needs is being implemented. Indeed, most Members are now familiar with the phrase "life-long learning", which encapsulates many of those initiatives. Only yesterday, I attended an event organised by the Educational Guidance Service for Adults to publicise adult learners' week, which, although not its only initiative, will devote particular attention to the basic skills needs of many adults.
I sympathise with the remarks made about that problem by many Members. It causes me a great deal of concern. The programme will receive all the resources that we can make available. The Chairperson of the Higher and Further Education, Training and Employment Committee and other Members reflected a degree of concern over the budgetary allocations required to deal with that. I am working hard to ensure that additional allocations will be made available from the Executive programme funds.
The strategic report detailing how we should address the need for basic skills, literacy and numeracy was published shortly before Christmas by the basic skills unit. It is a detailed report, and I trust that the resources needed to implement its recommendations will be made available. Members may recall that the "Back to Your Future" campaign was launched recently in conjunction with the Minister of Enterprise, Trade and Investment to attract highly skilled and experienced people back to Northern Ireland. Companies have been pleased with the numbers who have logged on to the web site.
Members might be interested to know that there have been over 2,000 hits on the web site. Sixteen companies advertised job vacancies, and in a short time 150 applications were attracted. A considerable degree of satisfaction is being expressed. It is a small initiative, designed to attract people from Northern Ireland currently working abroad to return and make their future here.
Other initiatives either directly or indirectly involving my Department address skills needs. One of those is the interdepartmental working group on employability. A Member referred to the needs of those who leave school with minimal qualifications, who are at the margins, as it were, of society and at risk from whatever appeal there is in crime, drugs and so on. Reports on their condition and circumstances are among the reasons for that committee's establishment. In that context, we will address the barriers experienced to becoming employed and engaging in training programmes. We hope, as a result, to be much more effective in directing our training resources.
I wish to draw Members' attention to another initiative that is more directly the responsibility of the Minister of Education, though my Department is represented. A committee, chaired by Prof Sean Fulton, has been set up to look at careers guidance. Mr O'Connor and others referred to the urgent need for effective careers information and guidance in schools and further education establishments to give young people the best possible information, guidance and direction on the opportunities available.
Specific points were raised that I want to address. Reference was made to the report from the Federation of Small Businesses, which has just come to my desk. That identified a number of skills needs and deficits. The small business sector is probably under a lot of pressure as a result of expansion in some of our major enterprises, and its needs should be addressed in particular. I draw Members' attention to the fact that, with the University for Industry's support for adult training, small business and its training needs are receiving help from the courses being set up by the learn direct centres across Northern Ireland. Members can play an important role by encouraging more adults to take out individual learning accounts, which will enable them to avail of the training and education opportunities.
Mr Deputy Speaker:
Minister, I remind you of the time constraint.
I am about to draw my remarks to a close.
I could refer to other initiatives, but those that I have mentioned should show Members that there is a multifaceted strategy because the issues to be addressed are wide-ranging and multifaceted. There is no single answer to the skills needs of our economy. A range of initiatives is being taken, many in a way that indicates the growing partnership between employers, trade unions and the training and educational institutions. We should pay tribute to all those involved in the Departments, the agencies and the institutions. We may not have got it all right, but we are clearly determined that we will get it right.
I accept that the wording of my motion means that it may fall between two stools. I had no intention of criticising Dr Farren or Ms de Brún. I merely wanted to open up debate on the subject as a result of needs identified by Mr R Hutchinson and Mr Beggs, who have received the same types of complaint as I have about one-year-long waiting lists for occupational therapy and children waiting 18 months for treatment for dyspraxia, which is not considered a priority. We talk about adult learning, but we cannot address the basic learning needs of young people because of the lack of facilities.
The motion might have been worded more clearly, but it was worded in response to constituency needs. I had spoken to various health trusts and was advised that while funds were available, trained people were not. I tabled the motion as a result of that information.
A much wider picture has emerged, however, given that various Members, starting with Dr Birnie, have referred to adult education. Mr Carrick elaborated on the point, stating that 20% of people starting on Jobskills, about 1,800 people, lack basic numeracy and literacy skills. We must address that. We have a multifaceted approach, strategic thinking and planning, but we still have unemployed people. We are bringing in people to do jobs that unemployed people here have not been trained to do. That may be an oversimplification of the problem because we do accept movement in the labour market. As Dr Hendron said, nurses come here from the Philippines while, as Mr Beggs said, people leave our shores to go to Scotland to nurse.
A hard core of unemployed people must be affected by our actions if we are to target social need. As the Minister acknowledged, young people are those most likely to be influenced by crime or drugs, and I am glad that he is aware of that.
Mr Carrick also touched on the export of skills. We do not want to create a brain drain; we want people to stay and help us become more prosperous. We do not want our best people to go somewhere else. That is why it is important to focus on training for the jobs that are here and need to be safeguarded. In an ideal world, everybody would like everyone to be working and earning £1,000 a week, but then we would have to bring in people from other countries to do some of the more labour-intensive tasks.
Ms Morrice mentioned a lack of vision, saying that in the past there was job creation without thought of sustainability. There were quick fixes by previous Ministers who threw a few jobs at a sector, thinking that if it were to collapse in a couple of years, no real harm would be done because a new Government would be in place and it would be somebody else's problem. We want to create a sustainable economy here that can develop and make people much more prosperous.
Mr John Kelly said that 55% of small businesses are unhappy with the availability of skilled labour, such as bricklayers, joiners, carpenters, plumbers and so on. These people are important. If we are going to have a factory that employs 200 people in the IT industry, we need people to build the factory in the first place. People seem to be obsessed with IT, thinking that everything is going to be about computers, but factories and houses will always have to be built.
People can earn big money by going to Dublin or elsewhere, so we have to ensure that we create the type of economy in which they can earn that sort of money here.
Mr McFarland mentioned alternative solutions. He suggested that time could be managed better by the simple implementation of certain aides-mémoires to people carrying out occupational therapy work. The purpose of the debate was to try to throw out a lot of new ideas and to ensure that people could listen to what others were saying and get some degree of focus on what is needed.
Mrs Robinson spoke about staff bullying. It is horrific that so many people attended a meeting on that. I have heard of people being bullied at work, but I did not realise that it was happening on such a horrendous scale. If we have 500 early retirements in addition to normal age retirements each year, there is clearly a great need to recruit, not just to tread water but to remedy the deficits that Mr J Kelly and Mr M Murphy mentioned and which we saw so much of in the past.
Mr Murphy also made an important point about identifying and targeting local training needs. The training for people in Fermanagh might be geared towards hospitality, whereas in east or north Antrim it might be geared towards hospitality and tourism, and in other areas to construction or IT.
That is an important point. We want to achieve local input, and local democracy is supposed to do that, yet Mr Beggs highlighted the 107 work permits that were granted to nurses from countries outside the EU, including the Philippines.
According to weekend television reports, hospital trusts in the United Kingdom have been bringing in nurses from Africa who carry the HIV virus. There are potential dangers in bringing in staff from Third-World countries. I do not wish to appear xenophobic, but we need to examine how our staff are trained.