Liam Twomey (Wexford, Fine Gael)

I thank Government and Opposition Deputies who contributed to the debate and even though they did not restrict themselves to the motion, they gave interesting insights on the issue. The Government amendment makes little reference to the recommendations of the national task force on alcohol. That is possibly because it is embarrassed by the fact that it has done so little on the recommendations of the national task force on alcohol and the abuse of alcohol. The Government should circulate it to its members to see if we can achieve some progress on it.

It was insinuated during the course of this debate, and it is insulting to the professionalism of the doctors and nurses who work in our accident and emergency departments, that they would treat anybody as being just another drunk. I worked in accident and emergency departments. I recognise when a person is drunk and I do not need to breathalyse them. Neither do doctors and nurses in accident and emergency departments. I know when a person is aggressive or is abusing staff and I do not need any breathalyser to make that judgment. Some Members have said the doctors and nurses in the accident and emergency departments cannot tell the difference between a person who is irresponsible and a person who has a significant illness. Every doctor and nurse can tell whether a person has a head injury which may have internal bleeding and may have alcohol on board. We can tell if a diabetic has alcohol on board or if a person has epilepsy and a range of illnesses. To insinuate that because a person has alcohol on board he or she will be treated in a negative manner is a disgraceful remark to make in this House.

When discussing this issue, Deputy Fiona O'Malley did not appear to understand the proposal. She certainly does not appear to have been following the debate during the past two weeks. If so, she would have understood the most rudimentary aspects of what we are talking about. There are no beds in the "wet rooms". They are plastic mattresses on the floor to ensure people do not roll out of bed and hurt themselves.

Deputy Fiona O'Malley referred to dragging gardaí off the street and into accident and emergency departments. Patients who are sick in accident and emergency departments are as entitled to the same protection from the law enforcement agency as those walking the streets. The reason we cannot have gardaí in accident and emergency departments is that the Government made a promise to put 2,000 extra gardaí on the street and has not bothered to do so during the past three years. We should also examine how the Garda is rostered and, if there is a difficulty, it should be examined. The Minister referred to changes to the Criminal Justice Bill to enable a person to be prosecuted for assaulting emergency workers. Emergency workers are ambulance personnel, fire fighters, doctors and nurses. I suggest these changes be made.

Some Members have a difficulty in understanding what I mean by hangers-on. I am talking about an elderly person, a responsible friend or a relative. Any Deputy who does not understand what is a hanger-on should take a trip to an accident and emergency department on a weekend night when they have nothing better to do and they will soon know what is meant by the term. In and around the accident and emergency department is the hospital environment. This problem exists not only in the accident and emergency department waiting room or even in the treatment room but in the public areas of hospitals, in wards and in and around hospitals. For those Members who question what the term "in and around accident and emergency departments" means, we will get them a map and show it to them. Also, hospital visitors have their cars broken into when visiting sick relatives. A substantial number of incidents occur around hospitals and glib remarks from members of the Government show their lack of interest in this issue and their arrogance.

A report on aggression and violence in accident and emergency departments will be published in the Journal of Nursing Management. Perhaps we will send a copy to some of the Members in question. The authors of this report, Ryan and Maguire, point out that this is a growing problem internationally. The UK is pursuing a policy of zero tolerance towards this problem. Zero tolerance is a phrase we have not heard from the Government for some time. It has given up on it. Complacency and arrogance mean it does not have to care any more. It does not matter if there is indiscriminate violence on our streets, if teachers are being assaulted in classrooms or if doctors and nurses are exposed to intimidation while trying to do their work.

In her contribution, the Tánaiste and Minister for Health and Children said that tackling alcohol will not improve rostering to ensure patients are seen. For the Tánaiste's benefit, international research shows that fear for personal safety emerges as the key influencing factor when individuals decide on a nursing career. Therefore, violence contributes to the recruitment of people to train as nurses and their retention in a nursing career. Nurses leave the profession because they are exposed to violence and harassment in the workplace. More than 80% of staff in accident and emergency departments have suffered verbal aggression. At the same time, less than one third of staff are trained to deal with this type of violence and aggression that they face on a regular basis. Some 20% of nurses experience harassment of a sexual nature, much of which is related to alcohol, while trying to do their work and it appears the Government has little or no interest in it. Some 50% of nurses and care assistants were exposed to either physical or verbal violence in the course of this study. Much of it goes unreported because it is reaching a level of acceptance instead of management tackling the issue before there is a greater problem in retaining staff.

There is a major maternity hospital in the country which has pregnant women and new-born babies with significant illness, yet it is has no dedicated security staff after 10 p.m. That is one hospital I have been informed about during the course of this debate. If we probe more, since we cannot get this information from the Health Service Executive or the Government, we will discover there is much more of this type of behaviour.

This is what our Private Members' motion is about. It is not that we should broaden the debate. I would like to broaden the debate and would come in to the House every night for the next month and do so but I know what would happen. The Government will take no notice of what we are saying and is deaf to the concerns of the people it represents. That is what is happening here today. If the Minister for Justice, Equality and Law Reform were serious about this issue, he would bring this Bill forward sooner and make it stand-alone legislation to protect doctors, nurses and teachers who have been left out of the debate. It applies to everybody who makes a major contribution to society on our behalf. We do not respect them or look after them in the way we should.

There was a reference in the Tánaiste's ten-point plan to the effect that the director of the national hospitals office is finalising arrangements for the establishment of a national audit and inspection process to measure cleanliness in all acute hospitals. What was different 20 years ago when hospitals were clean that an audit is now required? Rather than an audit, what is required is someone to take responsibility. This is the problem with the health services and with the Government which has a fierce problem finding out who is responsible. There is a difficulty in finding out the Government responsibility in the matter of the €1 billion in nursing home charges. There is no need for an audit nor for more reports on the cleanliness of acute hospitals. Who is in charge of the hospitals? The Government should inform the House. This is the issue which the Government should deal with, not this nonsense about audits and more investigations and reports.

The Minister of State, Deputy Tim O'Malley, stated last night in the House: "To ask Dáil Éireann to approve a motion calling for "hangers on" to be "rounded up" shows no real appreciation of the legal, medical or civil rights requirements." What are the requirements? Perhaps I am stupid. Will the Government tell me the requirements? Why can this Government not take action on anything to do with the health services? Why can it not take action against the abuse of alcohol which is out of control in accident and emergency departments? What are these civil rights and medical and legal requirements which tie the hands of the Government? One side of the House tells me the Government is taking action and then we are given this nonsense. The problem is the Government refuses to do anything.

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