Lack of Nursing Leadership Visibility Across Ireland: A Call for Change

In a recent article in the Mail on Sunday, we read about the absence of Public Health leadership in the Department of Health, yet once again, nursing and midwifery are overlooked. This oversight is not an isolated case, but rather a reflection of the broader issue in the Irish healthcare system: the glaring lack of visible nursing leadership.

While the HSE is quick to highlight the work of many medical professionals, nursing and midwifery leadership remains underrepresented at senior levels. Excluding the Office of the National Director for Midwifery and Nursing (ONMSD), and the National Doctors Training and Planning (NDTP) units, which focuses largely on postgraduate education for nurses, midwives and doctors, there is no dedicated nursing leadership visible within the HSE.

In sophisticated healthcare systems worldwide, a strong triumvirate of leadership exists: the CEO, the Medical Director, and the Director of Nursing and Midwifery. Yet, in Ireland, all leadership within the HSE often funnels through many layers of management, ultimately controlled by a medical doctor. It’s time to ask ourselves: how much longer will we allow this archaic structure to dictate the future of nursing and midwifery? The days of medical doctors overseeing the work and impact of nurses and midwives need to be over. It is a disservice to both the professions and the healthcare system.

What is even more contradictory is that nurses and midwives have been appointed to some of the highest positions, and yet, their voices remain largely unheard. They should be the strongest advocates for their professions, yet their presence and influence appear minimal.

During the pandemic, nurses and midwives were on the frontlines, playing a crucial role in patient care. And yet, there was little to no visibility of their leadership then—and the same erasure continues today, as seen in the Mail on Sunday article. This is a travesty.

Across Ireland, there are many exceptional nursing and midwifery leaders who are tirelessly working within their own organisations. Yet, many of these leaders are left to focus solely on operational matters. While their expertise could be used to develop the professions at large, they are often left without the security of visible leadership roles that would allow them to have a broader impact. The contradiction is that they have been appointed to the highest positions and therefore should be more vocal about the professions that it appears.

Currently, the only public representation of our professions comes from the unions— organisations focused primarily on industrial relations, not on advancing the nursing and midwifery professions. This leaves us with no true voice or visibility in the development of our fields. Media outlets, including radio, television, newspapers, and social media, continue to follow the government's medical-led narrative, neglecting the critical role of nursing and midwifery in shaping the healthcare landscape.

We must advocate for a future where every nurse and midwife has a leadership voice at the table. It’s time for change. Let’s recognise and amplify the invaluable contributions of nurses and midwives, not just those in advanced roles, but those working daily at the frontlines of care such as general medical and surgical nurses and midwives, developing solutions daily, and impacting lives every single day.

At ArrowHealth, we believe that nursing and midwifery leadership should not only be heard but actively shape the future of healthcare in Ireland. Whether you're a patient in need of clinical care at home or a nurse who believes in a more visible, empowered profession — we’d love to connect.

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