Problem
According to HSE annual report figures for 2016, nursing staffing levels have fallen by more than 3,000 since 2007 and the HSE has committed to increasing the nursing and midwifery workforce to deliver 1,208 additional permanent posts this year. Overseas and EU/EEA qualified nurses need to achieve an Individual score of 7/9 in Academic International Language Testing system(IELTS) to gain registration with The Nursing and Midwifery Board of Ireland (NMBI) is responsible for evaluating overseas applications from nurses and midwives who want to work in Ireland. International nurses started migrating into the Ireland when no language requirements were in place. At a later stage, the NMBI implemented the academic IELTS requirements. The requirements are based on 4 modules: Listening, Reading, Writing and Speaking. Individual scores of 7 needs to be achieved in each module (with no category being under 6.5) in a single or double sitting. This is considered really difficult to achieve and unnecessary for the needs of the profession.
As from April 2018, EU and EEA nurses, as non-EU (overseas) nurses, also need to go through the same IELTS scoring criteria. Coincidentally, during this time, the number of EU/EEA staff registering to the NMBI has gone down. We believe, and from feedback on the ground from nurses who want to work in Ireland, or are already practising in Ireland - the language requirement remains a significant barrier to registering with the NMBI.
Sir Bruce Keogh’s report identified that the shortage of nurses and understaffing levels were the reason for high death rates in 14 NHS hospitals. Also, the Royal College of Nursing (RCN) report says the NHS faces a shortage of 20000, nurses leaving patients to suffer (this original figure has now been superseded and is now 24000, as quoted by the RCN and predicted to reach up to 42000, within 6 years). The Health Foundation report published in May 2017 highlights the combined issues of the current problems: recruitment, retention and morale which the issue of IELTS is aggravating and could lead to unsafe staffing levels. That was happening on UK until last month Nursing and Midwifery council UK (NMC) received and accepted the suggestion made in a petition just like this one and it will reduce the score over there. It is very easy to understand that with the shortage of nurses that Ireland has, our country has also crossing the same problems as UK
A recent consultation conducted by the NMC stated that the majority of the public believed the IELTS score threshold for registration with the NMC should be reduced and this to still be satisfying patient safety. Also, the report says the IELTS does not reflect mastery of language and other approaches should be considered. 'Academic IELTS' requirement is not a good reflection of the English needed to practise as a nurse. A high level of Oxford grammar is not necessarily what will best equip nurses working with elderly residents in a private nursing home in rural Northern Ireland or Scotland. Accents, colloquialisms, phone situations will be more relevant than a university lecturer’s standard of English. Steve Brent, CEO of International House and IELTS expert, who facilitated 46,000 tests last year, says that General Training would be ‘a better fit for recruiting nurses than the Academic Module’.
After this renowned organ (NMC) has accepted the circumstances involved in this English test and how much it is in most of the times failure it is also time to NMBI reconsider here in Ireland their patterns for registration of EU and overseas to work here.
Overseas qualified nurses of which a majority have gained bachelor or masters degree and are competent working in the healthcare sector, are being downgraded to healthcare assistants and support workers for a decreased wage. This opens up worker's right issues. A similar scenario occurs for EU/EEA citizens, overseas nurses of which qualifications and nursing/midwifery competencies are recognised are also being downgraded to a lesser grade due to the failing of the IETLS exam.
Furthermore, it is also worthwhile emphasising that the cost of the exam is €230.00 a time. Anecdotal evidence shows some nurses takes the exams more than 9 times or over (cost not including potential extra costs if attending language courses.).It is also evidenced that many native English speakers will struggle to score 7/9 in the IELTS. The concern is that the test is becoming a money making exercise.



Solution
In light of these facts, we hereby petition for consideration of the following suggestions;
1. Reducing the academic IELTS score for NMBI registration (ideally to 6.5 with no categories under 6.0)
2. Provision of exclusion for nurses who have completed a degree or masters from Ireland Universities.
3. Reduce the IELTS requirements for overseas and EU/EEA nurses who have 3 or more years of work experience in the healthcare sector in Ireland
4. Change the Academic IELTS to General IELTS for NMBI Registration.



Personal story
I am nurse, graduated since 2012 in Brazil. Having 6 years of experience in E.R. and nurse coordinator also a Master's degree in Primary Health Care. Tried the test twice achieving the score 7 overall however failing in writing task with score 6. Working as a carer in a nursing home and living in Ireland since February 2018.