Charlie O'Connor (Dublin South West, Fianna Fail)
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Question 205: To ask the Tánaiste and Minister for Health and Children the progress made to date in implementing the recommendations of the Commission on Nursing; the funding necessary to effect all the recommendations; and if she will make a statement on the matter. [22147/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Government investment and support has ensured rapid progress in implementing the recommendations of the report of the Commission on Nursing. This commitment by Government has transformed nursing in Ireland over the last decade. The commission examined and made recommendations on areas such as the evolving role of nurses and midwives, promotional opportunities and the training and educational requirements of nurses.

The change in pre-registration nurse education has been the most significant development on foot of the recommendations of the Commission on Nursing. Nurse training has moved from a three year diploma to a four year degree programme and there is now an annual intake of 1,640 students, an increase of 70% on the 1998 numbers. The Government has provided capital funding of €240 million for 13 new schools of nursing in the universities and institutes of technology. The annual revenue cost of the degree programme is in excess of €90 million. The first group of students on this programme will graduate in autumn 2006.

A major recommendation of the commission was that a clinical career pathway be developed in addition to the managerial and educational pathways already open to nurses. It also recommended that an independent statutory agency be established with responsibility for post-registration professional development of nursing and midwifery. The National Council for the Professional Development of Nursing and Midwifery was established in 1999. The council has responsibility for setting criteria and approving posts at clinical nurse specialist, CNS, and advanced nurse practitioner, ANP level. My Department is providing funding of €4.22 million to the council this year. To date the council has approved 1,674 CNS posts and 24 ANP posts.

The Commission on Nursing made a number of important recommendations in relation to the role of nurses and midwives in the management of services. These recommendations have been implemented. Developments in this area include the development of the post of chief nursing officer in the Department of Health and Children; the establishment of eight nursing and midwifery planning and development units; and the introduction of new nurse management structures. The number of management positions in nursing has significantly increased since the publication of the report of the Commission on Nursing. The number of assistant directors of nursing, for example, has increased by 140% between 1997 and 2004.

The Commission on Nursing 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". On foot of these recommendations it has been agreed 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. In 2003, 513 health care assistants undertook the healthcare support certificate. During 2004/2005, 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. Healthcare organisations are increasingly recognising the potential of health care assistants and have requested further development of their role.

In the area of nursing in the community, the commission recommended that midwifery should no longer be a mandatory requirement for public health nurses. An Bord Altranais approved this rule change in November 2004 and I gave my approval as required under Section 26 of the Nurses Act 1985 in December 2004. Work is continuing in my Department of a strategy for nursing and midwifery in the community, or NAMIC.

The Commission on Nursing recommended a number of amendments to the Nurses Act 1985. My Department is currently involved in drafting new legislation which will amend that Act. The new legislation will modernise the regulatory framework operated by An Bord Altranais for nurses and midwives. Work on the draft heads of the Bill is at an advanced stage and all stakeholders will have an opportunity to comment on the draft legislation.

The commission made over 100 main recommendations. Work is ongoing on some of these recommendations including the preparation of the new Nurses Bill and NAMIC. The commission also made a recommendation in relation to care of the older person. This is clearly an issue related to service provision rather than nursing per se. Care of the older person is a key service area and one about which I have particular concerns. I will be deciding how best to proceed on this front shortly.