Jan O'Sullivan (Limerick East, Labour)

-----while others are extremely overworked. Rather than putting the onus of extra costs on the nurses and midwives who are paying the fees, the Minister might review whether there are surplus staff within her Department. The Minister has successfully negotiated with the representatives of health service staff a level of flexibility that may not have existed previously. As such, there may be the possibility of transferring staff from her own Department.

I broadly welcome the Bill but there are genuine concerns on issues such as the size of the boards and that so many of the board members, including the president, are nominated by the Minister. There is also the issue of the muzzling of chief executive officers, as referred to by Deputy Reilly. This is an issue the Labour Party has raised in the context of many of the Bills that have come before us recently. There is no reason that the chief executive officer should not be allowed to express genuine concerns. The retirement yesterday of Mr. John Lonergan as governor of Mountjoy Prison reminded us of his considerable achievements. He pointed out inadequacies in the prison system many times over the years and was a powerful advocate for prisoners. As a result of his advocacy, some, though not all, of the changes he proposed were implemented. The chief executive officer of the nurses and midwives board and others should be able to express genuine concerns without that necessarily being seen as an undermining of the Minister for Health and Children, the Health Service Executive or anybody else. People are entitled to express their views.

The Bill increases to nine the definitions in respect of fitness to practise. Nurses' representatives have expressed concerns to me about the vagueness of the reference to "inappropriate behaviour". Could a nurse or midwife be hauled up for wearing a short skirt, for example? If fitness to practise hearings are held in public, a person brought up for "inappropriate behaviour", even if not found guilty, will receive considerable publicity. There must be clarity in regard to this definition.

There are issues regarding advanced nurse practitioners and student nurses, such as whether student nurses can be held responsible for mistakes and what fees they are expected to pay. Finally, there is the question of the Board's power to bring issues of concern to the attention of the HSE and other health service providers.

I have concerns in those areas. However, I welcome the fact that we are finally debating the legislation, and that it recognises the professions of nursing and midwivery. I hope the Minister will respond to the concerns expressed by Members of the Opposition when she replies to the debate.

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