427. Deputy Noel McCarthy asked the Minister for Health the current situation with respect to the ongoing pay review process of advanced nurse practitioners here; when it is envisaged that a pay link between the grades of advanced nurse practitioners and assistant director of nursing will be established; the reason a pay link has not been established to date; the time period being considered for the restoration of back pay as part of any payment link; and if she will make a statement on the matter. [48455/26]

As the Deputy will be aware, the matter referenced relates to the Expert Review Body on Nursing and Midwifery, published in 2022. There is currently an ongoing process surrounding two specific recommendations of the Review:

Recommendation 42, which states that

“Align the salary of a single Director of Nursing in each of the nine Model 4 hospitals to that of the Area Director of Nursing for Mental Health.”

and Recommendation 43 which states that

“The Hospital Banding System currently in place to be discontinued. A revised approach for determining Director of Nursing/Midwifery and Assistant Director of Nursing/Midwifery grading across the system to be implemented. This should take into account the revised roles, scope, and responsibilities in the context of Sláintecare and the reforms required to provide integrated and universal healthcare. The number of grades to be rationalised to eight salary scales, the details to be determined between the relevant parties in the context of the next public service pay agreement.”

These recommendations are relevant only to Director and Assistant Director Nursing and Midwifery grades. The Review explicitly notes that there are “14 DON/M and ADON/M” in need of reform. No other grades are mentioned.

A process of engagement in relation to recommendations 42 and 43 began in 2023 and engagement is continuing. The Department is working hard to reach a resolution on this process and has been actively engaging with nursing unions to do so.

While the process has taken some time, it must be acknowledged that an offer was made in respect of this process to the unions last year, which would have provided for a 6% average increase to those affected. This offer was not accepted and discussions continue.

The inclusion of further grades in this process would amount to a cost increasing claim and, as such, is prohibited under the terms of the Public Sector Agreement 2024-2026 – outside of the Local Bargaining process.

The Local Bargaining process, which provides an allocation of €38 million for nursing-related claims, represents the only appropriate mechanism through which matters relating to grades outside the scope of Recommendations 42 and 43 may be progressed.