Rose Conway-Walsh (Mayo, Sinn Fein) | Oireachtas source

Amending the regulation of health and social care professionals by the Medical Council and CORU is the subject of the measures in the Bill. The amendments to the Health and Social Care Professionals Act 2005, Medical Practitioners Act 2007 and Regulated Professions (Health and Social Care) (Amendment) Act 2020 are very welcome.

The Bill will restore the ability of holders of British medical degrees to take up intern training posts in this State. This is essential for attracting sorely needed internationally-trained doctors into the HSE and protecting all-Ireland movement of students and professionals, especially in the health and social care sectors. A report published by the education committee on third-level student cross-Border enrolment in Ireland exposed the low levels that exist. It showed how partition continues to have a huge effect on where students go. Brexit posed, and continues to pose, a threat to the low level of students we see going North or coming South to study.

During my research for that report, the RCSI and others raised the issue of the effect Brexit had had on the mutual recognition of qualifications on this island and between Ireland and Britain. Prospective students must have full confidence that their qualifications will be recognised in the other jurisdictions. It is also essential for the functioning of a variety of sectors. It is incumbent on all stakeholders to work together to minimise the Border’s ability to separate us and limit the education options for students and employment opportunities for graduates. This Bill is a step towards addressing those concerns but more needs to be done. Guarding against any hardening of the Border centred on maintaining an absence of physical infrastructure and frictionless trade and this justifiably became an important political issue at national and international level. However, the public discourse did not always show the degree to which the Border is present and exists as a very real barrier in many aspects of people’s lives in its current form.

I echo the comments made by my colleague, Deputy Cullinane, on the regulation of home care workers. Home care workers continue to operate in an unregulated manner. Workers in the sector know that this has a negative effect on employment standards and pay. People in receipt of home care hours and their families also deserve to know that the sector is properly regulated. Many of these people are vulnerable and should have these standard safeguards. HIQA has repeatedly made these calls but they seem to be falling on deaf ears. The absence of formal recognition for home care is directly connected to the shortage of home care workers. I am constantly dealing with difficult cases where people are awarded home care hours but are forced to survive without the service because the workers simply are not there. The Minister of State is well aware of that as many of those cases land on her desk. The Government’s hands-off approach and the HSE's outsourcing of home care to private providers has failed. Do Deputies recall when we had a good home help and home care service across communities? Everybody was happy and people got an hour and knew they were worth an hour. Then the HSE started chopping it down to half an hour and less than that. It has been an absolute failure. Proper regulation as well as secure, well-paid employment conditions are long overdue.

Many Deputies, including the Cathaoirleach Gníomhach, have talked about the difficulties relating to the GP shortage but that has not happened by accident. We have not had proper workforce planning or the number of places we need in the third-level sector to make it easier for people. I meet people all the time who desperately wanted to do medicine but could not. I meet nurses all the time who did a post-leaving certificate course but only 3% of them go on to do nursing because we do not have the places for them. Joined-up thinking is needed in this regard. Our not doing that is putting people in jeopardy and is a terrible indictment of us.

On a related matter, I raise with the Minister of State the care students from the Dublin Business School, DBS, who were left in abeyance because they could not get the CORU approval earlier this year. Many of those students are still in limbo. I have written to the Minister to ask him what the options are for them. I am aware there are options for a limited number of them but approximately 80 are impacted. They are all social care workers who need to be in the system. This block should not be put in their way. Schools such as DBS need to step up to the mark to ensure these courses are accredited before they sell them to students. After all, the schools make a lot of money from them. I would appreciate it if the Minister of State could give us an update on that as well. I thank her for the Bill and welcome it.

See this speech in context