John Perry (Sligo-Leitrim, Fine Gael)
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Question 94: To ask the Tánaiste and Minister for Health and Children if the INO and the HSE management have reached an agreement on the introduction of a new nursing grade; and if she will make a statement on the matter. [15409/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I presume the Deputy is referring to the health care assistant grade which supports the work of nurses-midwives and acts under their supervision. This is not a nursing grade, however. Health care assistants are part of the nursing team and make a valuable contribution to the care of patients. Health care assistants and similar grades such as nurse's aide and ward attendant have been a feature of the Irish health service for some time. In recent years there has been investment in the upskilling of these grades so that they can play a greater role in the delivery of care and allow nurses to concentrate on more high level work appropriate to their education and training.

Section 23 of Sustaining Progress includes a commitment to the implementation of improved skill mix in the health service. There is a recognition of the need to mainstream existing developments including greater use of health care assistants. The Report of the Commission on Nursing, 1998, made recommendations in paragraphs 4.55 and 7.63 regarding the scope for increased use of care assistants and other non-nursing personnel in the performance of non-nursing tasks. Specifically, paragraph 7.63 recommended that a group be established to "examine opportunities for the increased use of Care Assistants and other non-nursing personnel in the performance of other non-nursing tasks".

This group was established to examine the effective utilisation of professional skills of nurses and midwives. It issued its report in May 2001. The group recommended that the grade of health care assistant-maternity health care assistant be introduced as a member of the health care team to assist and support the nursing and midwifery function. It also made recommendations related to the education and training of health care assistants including that the healthcare support certificate, FETAC, NCVA, Level 2, qualification be the preparation required for employment as a health care assistant.

Health care assistants are now integrated into many health care teams. During 2004-05, over 900 health care assistants undertook the healthcare support certificate. In addition, health care assistants have been introduced in eight pilot sites in the mental health services and they are undertaking the healthcare support certificate. The pilot programme in mental health services is currently being evaluated.

This vocational education programme has enhanced the skills and competency levels of health care assistants. As a result, health care organisations are increasingly recognising the potential of health care assistants and have requested further development of their role.

The Irish Nurses Organisation does not represent health care assistants, however, because they work under the supervision of nurses-midwives. The INO and other nursing unions have been involved in discussions on the mainstreaming of this grade across the health service. The INO is currently in dispute with the Health Service Executive in relation to the content of one training module in the healthcare support certificate programme. I hope that the matters in dispute will be resolved in the near future in the interests of improved patient services.