Frances Fitzgerald (Fine Gael)

I thank the Minister of State for a detailed reply which I do not find convincing. It will be to the detriment of those who will go into nursing homes that she will not accept this range of amendments and in their interests for her to accept them. Even if the Minister of State does not accept the amendments, she should have tabled amendments outlining a response to key concerns raised by Senators in this House about the potentially narrow and ultimately detrimental nature of the assessment that would be made. The Government should have provided a definition of "multidisciplinary team". The Minister of State has outlined a series of concerns about the definition of the term and these could have been dealt with in legislation. She has some concerns about dealing with this in primary legislation. If it had been dealt with by the Minister of State, she could have produced a definition of "multidisciplinary team", which would mean that the assessment would be better for the individual. The Minister of State does not want to accept the definition suggested by this amendment, even though it comes from the code of practice of the HSE. I welcome the fact that regulations will be developed. I reiterate how important this is and that assessment should be multidisciplinary in many cases to deal with the complex needs of the high dependency individuals being assessed.

Senator McFadden referred to mental health. It is important that this is written into the regulation because it is not clear at present. The definitions in this legislation are very focused on the physical aspect and are very narrow. The four professions referred to in the legislation are very narrow. The regulations must address the fact that what we want to see in most cases is a multidisciplinary team assessment, if necessary beyond the four practitioners mentioned in the amendments. I am very concerned that this will not be done if it is not included in primary legislation. There will be fewer good quality care assessments. If the quality of the assessment is not good enough, the quality of care will be compromised. I am very concerned about this. I regret that the Minister of State has found fault with these amendments. She should have tabled amendments that dealt with the issues outlined and should have taken into account the arguments made while dealing with the underlying issue, that being the need for a multidisciplinary team assessment.