Margaret Conlon (Cavan-Monaghan, Fianna Fail)

I welcome the opportunity to contribute to the debate on the Nurses and Midwives Bill. I acknowledge that Irish nurses and midwives are renowned all over the world. As Deputy Ó Caoláin stated, all of us have had experience at first-hand of their professional and caring nature. I wish to put on record my appreciation of the great work they do. As was noted, they do not always get the recognition they deserve in media commentary and mention.

Nurses and midwives have been to the forefront in the health care profession in progressing and changing their roles to meet the needs of their patients, always with a patient-centred focus. They perform critical functions. Nurses and midwives are often the first contact person people will meet in the health service. There is a very special relationship between the nurse or midwife and the expectant mother. I commend them for their professionalism and caring nature. They take their responsibilities very seriously. They carry out their daily functions to an extremely high standard and deliver a service to thousands on a daily basis, often in a quiet manner. They do so to enhance our health service.

It is heartening to see that nursing and midwifery are still popular choices among our young students. Leaving certificate students remain very interested in the profession. They see it as a caring profession, one where their individual characters, personalities and skills could, and in the future will be used to provide a vital service to patients.

Since the Nurses Act was introduced in 1985 we have witnessed major changes in our health services. These are reflected in the way services are delivered to the public. In more recent times we have seen a greater concentration in the delivery of services in the community with the setting up of the primary care teams and centres where services are delivered to patients in a much more community-based focus.

The public is looking for improvements in patient safety and this,in itself, would help to build patient confidence. I welcome the fact that more than 200 individuals, organisations and representative groups engaged in the consultation process. They saw it as important, felt they had something they wished to contribute and wanted their views to be taken into consideration. Those people have the benefit of the working experience and of dealing with patients. The Minister for Health and Children, Deputy Mary Harney, reflected carefully on these submissions in the preparation of this Bill to ensure the balance was right, that the public was protected and that nurses and midwives were benefiting by the putting in place of a proper framework. That will ensure they are dealt with in a manner comparable to other health care professionals.

I welcome that the word "midwives" is used in the Title. It is very important that they are recognised as being separate and distinct from nurses because, since the 1950s, midwives have been classed under the banner of nursing. I welcome that the group will be seen as distinct and the name of the body will reflect that in the nursing and midwifery board of Ireland.

The board's objective will be to protect the public in its dealings with nurses and midwives and the integrity of the practising of nursing and midwifery through the promotion of higher standards of professional education, training, practice and professional conduct among nurses and midwives. I welcome that the Minister has broadened the membership of the board to include the many different stakeholders in the health service, the public and the education sector. It is a good and balanced mix.

Nurses and midwives will have the opportunity to elect eight representatives to the board and at least three of the members must be engaged in clinical practice, which is very important. These people have valuable expertise and information to share from daily contact with patients and the public.

I welcome the new register for advanced nurse practitioners and advanced midwife practitioners. These roles are clearly defined and these nurses and midwives work at an advanced level. In order to have public protection, it is necessary for structures and governance procedures to be in place. There is a demand for a comprehensive fitness to practise structure, which can act in a speedy and appropriate manner when individuals make a complaint. One would hope that would be the exception rather than the norm.

Complaints will be assessed by the preliminary proceedings committee before the board makes a decision on the necessity to hold a full fitness to practise inquiry. Investigators will be appointed if necessary to facilitate investigations, which is very important for both patient and public confidence. A mediation process will deal with less serious complaints. There are nine grounds on which people can complain, including professional misconduct, poor professional performance and inappropriate behaviour. To have those listed in a clear manner will be of great assistance to the public.

In this country our nurses and midwives have a very high standard of education and training which is recognised the world over. The new degree programme has contributed in a positive way but nurses and midwives, like all other professionals, require ongoing professional development. Gone are the days when a person could qualify and just get a degree; there is a great need for ongoing professional development and support for all professionals, and specifically nurses and midwives. This development contributes to the maintenance of a very high level of competence, which ensures that patient safety is rightly at the heart of everything.

That issue is the focus of this Bill and it will ensure greater public confidence in the services provided while supporting and enhancing the high standards in education, training and competence in nurses and midwives. Like the Minister, I look forward to its early enactment following careful consideration on Committee Stage.

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