Mr. Edward Mathews:

On the question about the new responsibilities and duties that nurses and midwives have assumed in many locations and the necessity for greater progression, the blockages are twofold. One is a systemic unwillingness to recognise the full contribution that nurses and midwives can make in specialist and advanced practice roles. The international research is clear regarding the ability of nurses and midwives in specialist and advanced practice roles to manage both complicated and uncomplicated care in a variety of settings, be it primary care, acute care, elderly care or mental health, and the ability to do that, which in turn increases the positivity of patient experience, has been shown to reduce hospital admissions and increase the integrated nature of the care. That is the big block within the silo system we have at present, which ultimately is leading to people not getting the care required and is leading, in turn, to the incredible pressure in the secondary and tertiary systems.