Áine Brady (Kildare North, Fianna Fail)

I indicated on Committee Stage that I would consider Senator Mullen's amendment, the effect of which is to acknowledge that assessments will be carried out by multiple persons. Accordingly, I propose amendment No. 6 which is effectively identical to amendment No. 7 and which I ask Senators to accept in place of the amendment tabled by Senator Mullen and Senator Quinn. I also carefully considered the proposal to include a definition of "multidisciplinary team" in amendment No. 2. The reason I am not proposing the inclusion of a definition of multidisciplinary team is that such an action would be very likely to have unintended consequences.

Everyone knows how complex and difficult it has been to draft this legislation. The need to consider carefully all possible consequences when amending a Bill is something to be taken seriously. Indeed, Senator Norris very astutely highlighted an unintended consequence that arose as a result of amending the Bill to reflect a proposal by Deputy Reilly in the Dáil. I thank the Senator for highlighting this issue and it is now addressed by way of a subsequent amendment tabled for consideration today.

Senator Fitzgerald and Senator McFadden's proposed definition is based on the HSE's code of practice for integrated discharge planning. With respect to the definition provided by the HSE in its document, it is clearly not intended as a legal definition. Indeed, at one point within the document it notes that the person, his or her carer and his or her family also constitute part of the multidisciplinary team. Furthermore, because it is intended as guidance rather than as a legal definition, the definition is inconsistent in the terminology used. For example, some of the terms such as "dietician" are defined in regulatory legislation, while others such as "discharge coordinator" or "spiritual adviser" are not. Furthermore, some professions are covered by generic terms which are not defined in legislation. For example, medical practitioners seem to be covered by the generic term "medical staff", while nurses are covered by the term "nursing team". This use of undefined terms, especially when mixed with terms defined in primary legislation to refer to specific regulated professions, is inconsistent and legally ambiguous.

The use of undefined terms also presents another problem. The historic structure of the health sector as eight distinct health boards, coupled with the undefined nature of the terms, has resulted in different terms being used in different parts of the country to refer to a professional undertaking a particular role.

The approach adopted in the definition recognises some specialties while ignoring others. For example, nurses specialising in public health nursing appear to be identified while nursing and medical personnel specialising in psychiatry of old age are not mentioned.