Peter Kelly (Longford-Westmeath, Fianna Fail)

I wish to share time with Deputy Aylward.

The Bill will result in the formation of a new nursing and midwifery board. The legislation recognises the role of nurses and midwives in the health care system and one of its important functions is to recognise the role of midwives and to classify them as a separate and distinct profession. It is only right that midwives be recognised in such a way. Their role in caring for women before, during and after child birth is distinct from other medical professionals. My own regional hospital in Mullingar is a fine institution in which there were more than 3,000 births last year. The midwives, nurses and doctors provide an excellent service in Mullingar and I pay tribute to them and to their dedication.

I am encouraged that the Irish Nurses and Midwives Organisation has warmly welcomed the publication of this Bill. The Bill incorporates recommendations on nursing made by the organisation to the commission and its officials feel it reflects the changing environment in which nurses and midwives practise. The organisation will examine the legislation and we will all welcome its feedback.

The most important element of this Bill is that it not only regulates and protects nurses and midwives but also expectant mothers and families. It will provide a new regulatory framework, through the nursing and midwifery board, which can give everyone confidence in the system and the service that is provided and received. Nurses and midwives will have full confidence that their expertise, qualifications and experience are recognised. The legislation prioritises confidence in the profession. It will give the public protection and serve to increase the integrity of the profession, which it rightly deserves.

The new board will register nurses and midwives, regulate nursing and midwifery education, recognise qualifications, set standards of practice, give ethical guidance, maintain professional competence and handle complaints. I am pleased membership of the board will include many nurses and mid-wives. Of its 23 members, 11 will be nurses or midwives with eight being elected. I am also happy there will be a broad representation of competencies with nurses drawn from the disciplines of psychiatry, intellectual disability, public health and geriatric care. I am hopeful nurses and midwives will be confident that their views and concerns will be adequately represented on the board, which will regulate the profession.

The goal of the board is "protection of the public in its dealings with nurses and midwives and the integrity of the practice of nursing and midwifery through the promotion of high standards of professional education, training and practice and professional conduct among nurses and midwives". It is essential that midwives have the appropriate qualifications and competencies to practise and the new board will provide the guarantees that everyone involved in the profession needs. It does not serve midwifery as a profession well if people who are unregulated or unqualified set themselves up as midwives. It is a recipe for disaster, not only for the pregnant woman, but also for the profession as a whole, which could be damaged by unregulated, unqualified people not performing as a midwife should. I am happy that the Bill allows for strict penalties for those who practice unregistered. I am confident large fines and the threat of imprisonment will prove to be an adequate deterrent.

The Bill will allow for the establishment of three registers. The nurses and midwives register will include the names and qualifications of registered nurses and midwives and will include divisions on nurses, midwives, advanced nurse practitioners and advanced midwife practitioners. A candidate register will include the names and details of all candidates who are in education and training that will lead to first-time registration with the nursing and midwifery board. The third register will be the advanced midwife practitioner-advanced nurse practitioner register. The Bill will allow for the setting up of other registers if needed by the board. I welcome this flexibility. Those registers will ensure that both health professionals and the public have guarantees of transparency on the nursing and midwifery professions and everyone can be assured of the relevant qualifications and experience. The registers will be published but personal information will be protected from disclosure.

Extra protection will be provided for expectant mothers and their families. The prohibition on unregistered nurses and midwives practising will be complemented by an improved investigation mechanism for complaints. A preliminary proceeding committee will be established as part of the Nursing and Midwifery Board of Ireland to give initial consideration to complaints against nurses and midwives. At least one third of the committee will not be nurses or midwives. Grounds for complaint will include professional misconduct, poor professional performance, inappropriate behaviour or the failure to comply with an undertaking or to take any action specified in a consent given in a response to a request.

The board can appoint persons including members of staff to assist with investigations undertaken by the preliminary proceeding committee. It can also suspend the registration of a nurse or midwife where it is considered necessary to protect the public. The Bill ensures that all parties involved in a complaint will be kept fully informed of the progress of any complaints. The board can impose measures against the nurse or midwife including advice or admonishment, a fine, conditions to registration, suspension or cancellation of registration or the prohibition on applying for the restoration of registration for a specified time. All of these measures can serve to increase public confidence in nursing and midwifery. No one likes to consider the worst happening at such a joyful time as the birth of a child, but having a transparent method of dealing with complaints can only improve public confidence in the profession. I also welcome the fact that all parties will be kept informed during the process. That is important as any cause for complaint would be a source of considerable stress and distress not only for the patient, but also for the practitioner.

The Bill also ensures that midwives will have adequate indemnity insurance as it is considered vital that mothers and children are protected in the event of a negligence case. Those midwives who are employed will be able to avail of their employers insurance but those who are self-employed will have to sign up to the State's clinical indemnity scheme. It is important that the role of midwives is recognised and that they are supported in their work. Part of that support is education and training and I am pleased that the Bill has a strong focus on this area. As per the Bill, the HSE will facilitate, in so far as it is possible, the education and training of midwifery candidates. The HSE will also promote and co-ordinate the development in co-operation with the new board of nursing and midwifery training bodies. The HSE will also undertake planning to meet the needs of nursing and midwifery for the public health service and will advise the Minister for Health and Children on the need to develop specialist nursing and midwifery education and training. That is vital if practising professionals are to keep up to date with the latest research and international practice.

I am hopeful that nurses and midwives will look at this Bill and consider the implications. I am confident that it will serve to improve the profession giving protections to both the practising professionals and their clients. Childbirth is a wonderful time for any family and nurses and midwives play a huge role. It is only right that their role and professionalism should be clearly recognised and that they should be supported in their work. The formation of the Nursing and Midwifery Board of Ireland is an excellent development and I am confident that it will be a great success.

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