Colm Burke (Fine Gael) | Oireachtas source

I wish to raise the issue of how in real terms, very little reform has occurred in the health service. One subject I raised during a Commencement matter this week was the issue of nurse prescribing, particularly in nursing homes. There still is a huge problem, in that nurses have the qualification and are competent to take on many of the roles on which the sign-off of a doctor previously was required. However, there appears to be an extremely slow process in dealing with this matter. In the reply I was given, I found that only somewhat more than 1,000 nurses had been trained up in nurse prescribing. Members need to have a debate on the reform of the entire health service. In addition, while I welcome the recruitment to the Health Service Executive, HSE, one major problem it now is causing is the executive is recruiting nurses from private nursing homes. This is now causing its own problems within the private nursing home sector. Service providers in that sector wish to bring in people from abroad but cannot because there is not adequate training here for those who come in from abroad. They must go through an educational process, and rightly so, but not enough courses are available to fill the vacuum that has occurred within the private nursing home sector. One should remember that more than 22,000 people are participating in the fair deal scheme in private nursing homes, with another 7,000 or 8,000 people in community hospitals. There is an urgent need to examine this issue, as the numbers requiring nursing home care will continue to increase each year for the next 20 years. As it has been predicted that an additional 4,000 nursing home beds will be needed by 2021, this is a matter that cannot be pushed down the road and left to move along at its own pace. Members must dictate the pace and in particular, they must dictate the pace of reform as not enough reform is taking place in this area. Although a large percentage of nurses now have academic qualifications, their role has not been upgraded. I refer to where they are extremely competent and well able to manage patients in roles in which they must rely on junior doctors to make decisions. Members must have a major debate on that issue, as well as on the broader issue of reform in the health service.