Finian McGrath (Dublin North Central, Independent)

I welcome the opportunity to speak on the Medical Practitioners Bill 2007 because it is an important element of the wide-ranging debate on health. This area has been a major issue over several years and one of grave concern to many of our citizens. It is something about which we all care passionately. However, if we confine ourselves just to this section of the debate we will not get anywhere, particularly if we fail to examine the broader issues also. I emphasise that in order to resolve the current crisis in the health service we need reform, investment and extra beds. Anyone who says the opposite has his or her head stuck in the sand. That is the way forward and it is very important.

The significant personnel in the context of the health service are patients, doctors, nurses and ancillary staff. These are the key people and if we do not take their views on board and work with them, we will not resolve the issues. We must have professional standards and we must do something about the MRSA crisis. People have to take responsibility for their professionalism and levels of hygiene and cleanliness. However, we also have a responsibility to ensure everyone does so.

What happened at Beaumont Hospital in my constituency during the week was unacceptable. I do not accept, as the Taoiseach said, that it was a bad day. I strongly challenge the Taoiseach's flippant remark about people chasing ambulances, and this was reported to me this morning when I was out and about in the constituency. Many people on the northside of Dublin were hopping mad in the past three or four days about the Taoiseach's remarks in this regard. There was a major crisis the other day in Beaumont and the reality is that we need extra beds and extra facilities for the elderly. To say anything otherwise is to mislead the public. The public is extremely annoyed about those remarks and I point this out to the Minister for Health and Children as she is in the Chamber.

When we talk about the so-called row with the consultants, it should be borne in mind that they are major stakeholders in the health service. It might surprise people to hear me defending their interests. I strongly support the policy of consultants working in the public sector and it must be emphasised that they have made a major contribution to the development of the health services. Some of the best consultants in the world work in our hospitals and are saving lives every day. I do not believe having macho rows a few weeks before a general election will resolve the issue. I advise the Minister to sit down and talk to them, get on with the job and work with them on this issue. This is crucial because the consultants have played a valuable role, as have many GPs, in the health service and have made a massive contribution to this country and to saving lives. I will stand by those people, particularly those who have done a very professional job. Admittedly, we have had a few bad examples, but the vast majority work long hours, giving dedicated service to patients and saving lives. That is something we should appreciate.

The other major stakeholders, the nurses and midwives, are on a countdown to a work to rule in regional hospitals around the country in the coming weeks. It takes a good deal to force nurses and midwives to take such action. Even at this stage, their willingness to engage in negotiations to avoid this path is open. However, it appears the political system is not amenable to their legitimate concerns for equality and fairness. Theirs is the only administrative and technical grade in the public service working 39 hours a week. This is on foot of a 1980 Labour Court recommendation that nurses should be the first to benefit from a reduction in the working week, due to their difficult working environments. Benchmarking is not the only show in town. They have clearly been shown that this is not the case. Nurses are fully aware that many deals have been brokered while they have been left out in the cold.

In New Zealand, for example, 40% of nurses abandon the profession within three years. In Ireland, if the trend continues, some 70% of newly qualified nurses will leave within 18 months. America requires 1 million nurses by 2012 while Canada needs 331,000 by 2016. In the light of the global, urgent and increasing need for nurses and midwives, people should value, respect and reward them in Ireland. Shortages are particularly evident in the Dublin teaching hospitals, where the number of nurses and midwives is critical. International nurses must be constantly recruited and replaced in Ireland. Nurses do not have to be paid to decentralise. They simply cannot afford to live in Dublin.

The lack of nurses and midwives impacts on patients and the health care systems as well as on economic and social development. The challenge for the Government is to focus on the retention issues and related cost-effectiveness. Some 15,000 nurses and midwives are registered with An Bord Altranais, but often do not practise. This is absolutely appalling. Surveys confirm that improvements in salaries and working conditions would attract nurses and midwives back into active service. I urge the Minister and the Government to think outside the box. If there are 15,000 people available, let us do something to facilitate those who are not practising and get them back into the service again.

Some 42,000 INO and PNA members are on their way to a dispute. The majority of these general and psychiatric nurses want to have the issue resolved. They want a 39-hour week, a proper week's wages and appropriate working conditions, so let them get on with it.

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