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Seanad: Maternity Protection, Employment Equality and Preservation of Certain Records Bill 2024: [Seanad Bill amended by the Dáil] Report and Final Stages (24 Oct 2024)

Lynn Ruane: I wish to mark the legislation coming back into the Chamber today. The Minister said at the committee that he would move heaven and earth and I was still looking at him sceptically. I wish to now take that back.

Seanad: Maternity Protection, Employment Equality and Preservation of Certain Records Bill 2024: [Seanad Bill amended by the Dáil] Report and Final Stages (24 Oct 2024)

Lynn Ruane: As he can understand, when things are out of your power, when you have spent so long working on something and then hand it over and when you have to give over and suspend all power over or hand in what happens next, it is difficult. As it is such groundbreaking legislation, there was always a concern there would be enough pushback on it for it not to happen. I wish to acknowledge the...

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: We have apologies from Deputy Stanton and Senators O'Hara and Seery Kearney. Deputy Quinlivan is substituting for Deputy Gould. Members will come in and out given they are needed at other meetings. Parliamentary privilege is considered to apply to the utterances of members participating online in a committee meeting where their participation is from within the parliamentary precincts....

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: I thank Dr. Kelly. I now invite Mr. Barry McBrien to give his opening statement.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: The Deputy can have another ten minutes. The clock was not working.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: Next up, we have Senator Mary Fitzpatrick.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: I apologise but we have a second session in the afternoon so I have to move people along. I appreciate that our witnesses are being extremely diplomatic regarding the whys in this regard. Perhaps I will get time to dig into that at the end. One of the whys - financial incentives - was touched on and I am sure there are more. I call Deputy Shanahan, who is joining us online.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: If any of the witnesses wish, they may take that up.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: I thank Professor Comiskey and Deputy Shanahan. I am going to move on now to Deputy Quinlivan.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: This has been a great conversation so far. We need to extend prescription power to nurses. If we do not, it is a clear indication of a further stigmatisation. There is a kind of paternalistic idea that a nurse cannot determine a safe amount to prescribe. It means that where the healthcare service is working with an individual who needs methadone, there is suspicion off the bat. We are...

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: That is what I thought. Perhaps there is a difference between a hospital setting and a primary care setting. Within the GP contract, a GP may be reimbursed. Do we know how much per annum per person a methadone patient would cost within a GP contract?

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: That should be transparent. We do not want a situation whereby methadone patients do not receive the care they should be receiving while also being seen as an additional resource to a GP. That could inhibit the other professionals, such as nurses, stepping into that space and prescribing. I am interested in the rights-based approach. This is a bit of a side note, but I am thinking of...

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: The rights-based stuff has already been established.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: It is about ensuring it is implemented across the professions and in the different sectors. I will go back for a moment to differentiating between methadone and morphine. Is there a stigmatisation of methadone? If methadone changed its name and was just called an opioid, would things be different? Methadone has become synonymous with a particular group. Can the witnesses explain the...

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: I refer to the monopolisation, in one sense, of prescribing and the gatekeeping and the potential personalities driving that gatekeeping. Going back very briefly to the point about methadone and morphine, the methadone is slow release and longer acting. It is ticking along, whereas morphine can have much more of a flow in terms of its highs and lows. They are both of a similar nature and...

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: I was trying to explain that in the context of a nurse prescribing morphine or methadone the precautions and assessments needed during their prescription. There would not be an increased risk in the assessment in the prescribing of methadone versus morphine.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: That is a mapping and follow-up issue with the person, rather than a clinical decision regarding the millilitres required or the safe dosage to give somebody in a particular setting or whatever.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: It is an economic decision as well, if the State wants to look at it as such. Does anyone have any final comments? As there will be a second session, I do not know if we have time for a full second round of questions, but any member who has outstanding questions may ask them.

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: Does anyone want to make any final comments on any matters they were hoping we would cover?

Committee on Drugs Use: A Health-Led Approach: Discussion (Resumed) (17 Oct 2024)

Lynn Ruane: If this committee comes out with anything that is not progressive, it will be against the evidence. That is how I will reframe that contribution.

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