Paul Connaughton Snr (Galway East, Fine Gael)

I welcome the Bill. If I were a midwife or nurse, which I am not, I would welcome it also. It puts midwives and nurses on a more professional footing. Deputy Michael Kitt mentioned the time it became obligatory for nurses to have a degree. I always supported that move. There was a great debate about it at the time not so much about the fact that there would not be as many nurses available in a given year, but about whether the bedside manner of a nurse would be more positive or negative on foot of her having a degree. This has nothing at all to do with bedside manner. The Bill puts the professions of nurse and midwife on a standing comparable to all the other professions. This point has been proven since the degree became obligatory.

I have not had an opportunity for many years to state how much I admire what nurses and midwives do. At the risk of turning back the wheel a little, it is no harm to remember that one of the remarkable features of Irish life, both urban and rural, was the presence of the midwife. The midwife represented one of the greatest connections between whatever health service existed and the birth of babies at home in very difficult circumstances. The Minister of State, Deputy Áine Brady, will certainly have heard of the late Nurse Kilcommons of Mountbellew, who delivered more babies than any maternity wing in any hospital.

We all owe a great debt of gratitude to such people. They were very poorly paid and worked in atrocious conditions but saved a lot of lives. This is one reason there is a great degree of affection for all nurses and midwives. It is an interpersonal phenomenon for most people.

The sophistication of modern maternity hospitals is something to behold. I acknowledge mistakes are made, and that we all make them, but statistics prove the life expectancy of babies has improved dramatically in recent years. While I do not want to make personal remarks on this matter, this was brought home to a member of my family last year. I happen to have a one year old granddaughter who is able to walk around although she started life not much more than a pound in weight. In the past, neither she nor her mother would have been likely to live. This is the only opportunity I will get in the House to state that the professionalism of the staff in the Coombe hospital and the hospital in Ballinasloe has caused great happiness in a particular house.

I can well imagine the reasons for this Bill. I wish to speak about some incidental aspects of it, as well as its major features. As it is a good Bill that appears to be accepted by all the stakeholders, one wonders why it should be spoiled to some degree by the insistence that the president of the council be nominated by the Minister. There will be 23 members on the board, 15 of whom will be appointed by the Minister and eight of whom will be elected by the professionals. I see nothing wrong with that. The idea is that the eight professional members of the new board are supposed to represent each discipline. I have spent a lifetime dealing with all sorts of boards. One can make all sorts of arguments about who is most entitled to be on a board. It seems at first glance that it could be argued that the midwives are not getting a great deal on this. Leaving all that aside, why is it necessary for the Minister to appoint the president of the council? I do not know the reason for that. It appears to me that this kind of thing should be autonomous. I do not know whether it will work out in that exact way. That is the perception around the country.

I want to refer to a number of other issues. It is natural that there is no place in this Bill for much of the day-to-day work of nurses or midwives. I do not hear or see anything in the Bill about a system to facilitate whistleblowers. When nurses, midwives and others in the health care profession see something going wrong, they may genuinely believe in their heart of hearts that something has to be done about it. I know efforts are being made to protect whistleblowers and thereby make whistleblowing more attractive. The Acting Chairman, Deputy O'Connor, knows as well as I do that the whole lot of it is a dangerous business. It is important to build mechanisms into every system - inside or outside nursing - so that action can be taken when a member of staff sees something going wrong. If something happens that is highly injurious to patients or the public, a mechanism must be available to allow the whistle to be blown without it rebounding on the whistleblower. It is a very lonely place to be. I have met a few highly principled people who believed they were doing right, but came out worse from the row. They might not have lost their jobs, but they were demoted and treated as pariahs in the workplace. The cases in question had nothing to do with nursing. It is against that background that one would hope that a whistleblowing mechanism can be worked into this Bill, or some other Bill.

Nurses and midwives have a huge degree of interaction with patients. I agree entirely with Deputy O'Sullivan's suggestion that most patients - I refer specifically to male patients - are more likely to reveal their innermost secrets to a nurse than to anyone else. I imagine that it is easier to talk to most nurses than to consultants. A consultant who is in a hurry in the morning might be good for one's health, but he might not be great for one's ego. We owe a great debt of gratitude to nurses and midwives of every discipline in our hospitals and elsewhere. I am familiar with the remarkable input of nursing staff and others in old people's homes, which is a major area at the moment. Such work calls for great compassion, expertise and professionalism. I am glad to see a great deal of that, for the most part, in nursing homes throughout the country. It is another feather in the cap of the nursing profession.

I am sure the new board will spend some time looking at the whole question of flexibility. This is one of the prime reasons this legislation will be seen in years to come as the bedrock or foundation of the nursing and midwifery profession. It will demonstrate that nobody, least of all those who work in this area, is an island. In the health sector, regardless of who one is or what one does, one depends on many other disciplines. There has traditionally been a fair amount of demarcation of what people should and should not do. I suggest that a more integrated approach is needed.

Deputy Michael Kitt spoke earlier about psychiatric nurses. They have surely shown a great ability to go with the flow. Many years ago, one would not see a psychiatric nurse outside the big walls of the mental institutions. Their work was not done anywhere else. They are now distributed throughout the country, including rural areas. I appreciate that this has nothing to do with the Bill before the House. I have to say the psychiatric nurses have covered themselves in glory in this regard. I refer to how well they have dovetailed with the social changes in this area. We now know that people with mental handicaps should never have been inside the big walls of the mental institutions at all.

The Minister of State, Deputy Áine Brady, is familiar with my home village of Mountbellew. In this small village, there are four or five houses with five or six residents under the guidance of house parents. Every time I go there, I see the residents out and about. I have to say they are extremely well dressed and presented. They walk around the town and do their little bits of shopping. It must be heaven on earth, compared to the big institutions from which they came. I appreciate that they were looked after as well as possible in those times. It is a different thing altogether now.

One of the great pluses for society is that such developments have been welcomed by local communities with open arms. There was a time years ago when that would not have been the case. Local people were afraid that people with mental handicap might present some form of danger, but that has turned out to be absolutely false. The authorities that drove this change over the years were entirely right. It must be wonderful for the people in question to live as ordinary members of ordinary communities. Regardless of how bad the economy goes, I hope we will not have to stop this line of business. I hope the Minister of State agrees that this should not happen. How many minutes have I left, a Cheann Comhairle?

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