Michael Kitt (Galway East, Fianna Fail)

I am glad that when she was there - as Deputy Connaughton was too - she confirmed that the two consultant appointments to the region would be based on 27 hours in Ballinasloe and ten hours in Galway. That is welcome. I thank Mr. John Hennessy, who came to talk to us about developments at the hospital.

Ballinasloe town has a psychiatric hospital, and many of the nurses there are members of unions such as PNA and SIPTU. They are keen to link the work they are doing with the general hospital in Ballinasloe. There have been moves in recent years to build a more definite link between psychiatric medicine and acute hospitals.

We often discuss the need for flexibility in the nursing profession. Psychiatric nurses have shown they can achieve that flexibility. There were a huge number of patients in St. Brigid's Hospital years ago, but there are now only a few. It is a tribute to the nursing profession that they have left their place of work to go out and work in the community, with house parents, in many of the houses that were rented by the old Health Board and are now rented by HSE in towns throughout County Galway. It is a huge change for those psychiatric nurses to go from hospital to community surroundings.

Dental nursing is an area that has not received much attention. IMPACT has been involved in promoting the cause of dental nurses, who do excellent work and have to deal with anaesthetics. The public health nurses are working on the ground, and we must pay tribute to them. They deal with the elderly in particular, and with others who live in isolated areas.

If we are serious about keeping such people in their homes - as the Minister, and no doubt every Deputy in the House, wants to do - we need to recognise the importance of the people who work in public health. They provide a good and regular service to the elderly.

Nurses are held in high regard, particularly the public health nurses, who have to cover very big areas in some cases. They were there in the bad times when there was very little money in the Health Board. There are difficult times now, economically and financially, and they are still doing great work.

A lot of nurses now work in palliative care. Given the incidence of cancer - we have seen recent reports on the incidence of skin cancer, for example - there is a great need to develop services in that area. I remember, as I am sure Deputy Connaughton does, our battle to get funding for the Galway Hospice in Renmore, which went on for years. Those services have since been extended and developed in the community. There are nurses who visit people with cancer, and the hospice movement has strengthened. Those nurses are working in a difficult area, on which I commend them.

Deputy Jan O'Sullivan made a very interesting point about the training of nurses. She is right in suggesting many health professionals must leave the country after having been trained in order to find employment. This is not just true of nurses, but also of young doctors and other health professionals. Perhaps many young people feel they would gain experience working abroad. Many of them go to the more well-off countries but many others go to developing countries, particularly those in Africa, to do nursing.

We should spare a thought for those who are returning to Ireland to pursue nursing. Some have great difficulty not so much in finding jobs, but in trying to get their documentation together when they return. They are obviously put through a very thorough examination by An Bord Altranais, which is only right. However, even with modern technology, nurses find it hard to obtain documentation and references from the foreign hospitals in which they worked. They should ensure they have their work history and all their documents and references when they return to work in Ireland.

I am a little surprised that education and training are in Part 10 of the Bill because they are very important. There has been a considerable debate on the training of nurses. When a degree course became compulsory for nursing there were many objections because it was felt it would take longer to educate and train nurses. People felt nurses needed to be trained more quickly. The same argument was made in regard to teachers. The year after the teacher training course was extended from two years to three years, no teachers emerged from the teacher training colleges.

It is very important that nurses have a degree and extra training. One must remember that many young nurses wish to work outside the country and they need a degree to do so in European countries and internationally. It is only right that they have a degree. It is now accepted, despite the debates we had in the past, that nurses should have degrees and diplomas.

Let me refer to the membership of the board. The board, comprising 23 members, is quite big and represents nurses and midwives. Also represented are the educational bodies and stakeholders. As many Deputies suggested, there have been some questions asked about the representation of midwives on the board. Perhaps the Minister will re-examine this issue. The board will have the power to create committees to fulfil some of its functions. There is a reference to the preliminary proceedings committee, the fitness to practice committee, the midwives committee, the education and training committee and the health committee. I welcome the fact that the board is large and very representative. I also welcome the provision for sub-committees. This is not unusual as it occurred under the health board and in respect of An Bord Altranais.

I welcome the Bill, which has been very much welcomed by the nursing profession. There has been strong emphasis on midwifery, which is welcome, but we should not forget other types of nursing. Traditionally, we considered nursing a female professional but that is far from the case today. It is very welcome that so many young men are now entering the profession. I hope the Bill has a speedy passage through the House and that it will address the issues that arise regarding the registration of nurses and maintain the integrity of nursing and midwifery.

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