James Reilly (Dublin North, Fine Gael)
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Question 286: To ask the Minister for Health and Children the progress made in relation to the Programme for Government commitment to further development of the nursing profession; and if she will make a statement on the matter. [26804/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The further development of the nursing profession has been progressed in several different ways under this Government.

The 2007-2012 Programme for Government's commitment to further the development of the nursing profession sought to increase both the status of nurses and midwives and the number of nursing and midwifery posts. It also gave a commitment to keeping the Benchmarking process open to nurses.

At the end of 2006 there were 36,737 whole time equivalent nurses/midwives employed and this increased to 37,850 by March of this year. In addition to increasing the overall number of nurses it must also be acknowledged that nurses are beginning to work at a high level of specialist practice e.g. in Intensive Care, Cardiac and Bone Marrow Transplants units.

There are 113 Advanced Nurse Practitioners and 1,979 Clinical Nurse Specialists currently in place. These posts are created to meet specific service needs, are spread across the country and across the nursing disciplines and these type of posts are continuously being developed.

The development and modernisation of the nursing profession requires a new legislative framework for nurses and midwives from that set out in the Nurses Act 1985. My Department is currently preparing new legislation in this regard. This proposed legislation will provide a modern framework for the regulation of the professions and the practices of nursing and midwifery and for greater protection of the public. An extensive public consultation process on Heads of Proposed Nurses and Midwives Bill has recently been completed. The development of this new legislation is well advanced and it is planned that it will be in place next year.

In line with last year's recommendations of the National Implementation Body (NIB) I have established a Commission to produce an independent assessment of how a 35 hour week for nurses and midwives can be achieved having regard to the issues set out in Labour Court Recommendation No. 18763. It began its work in March 2008 and it plans to submit its report at the end of the year.

The Commission is examining the international experience of best practice in the activities and deployment of nurses and midwives, and the type of flexibilities and change which would be necessary to achieve a 35 hour week. The Commission will take account of the submissions from the HSE management, based on the analysis it is initiating, and the nursing unions who should elaborate to the Commission on the changes they believe would facilitate the 35 hour week.

In addition to the above, management and unions are working to introduce a 37.5 hour week for nurses on a cost neutral basis and without diminution of services to patients as also provided in the NIB statement last year. This entails a more efficient use of the nursing resource and it is being introduced on a site by site basis. To date the reduced working week has been introduced in sites covering 14,275 nurses and midwives (approximately 38% of the total).

The commitment to keeping the Benchmarking process open to nurses was honoured. Nursing issues were considered and addressed by the Benchmarking Body last year and included in its report dated December 2007.

I have amended the relevant legislation and introduced new regulations to allow for the introduction of nurse prescribing. By the end of 2008 there will be approximately 150 nurses and midwives who will have completed the nurse prescribing education programme and will be available to prescribe medications in areas such as Accident and Emergency Departments, cardiology, maternity services and other specialist care areas such as diabetes, respiratory and sexual health to name a few. These programmes are conducted in University College Cork and the Royal College of Surgeons of Ireland and commenced in April 2007.

There are currently 13 nurses in the service who are prescribing medications. I have always believed that the expansion of nursing practice into prescribing could benefit the full spectrum of health services. The extension of prescriptive authority to nurses and midwives can improve quality of life for patients, especially in areas such as care of the older person, chronic disease, palliative care, maternity services and many more. Health service delays will be reduced for patients and nurses and midwives will be able to use their time more effectively to give the right care at the right time in the right setting.

Last year I also introduced the necessary regulation to enable nurses who meet the standards and requirements set down by An Bord Altranais to refer patients for x-rays. The introduction of nurse x-ray prescribing will give authority to enable nurses and midwives to refer patients for an agreed range of x-rays which will be undertaken within their scope of practice. This will enable nurses to develop and use their education, skills and knowledge to maximise their contribution to patient care and at the same time achieve the highest levels of professional judgement.

The Requirements and Standards for Education Programmes to enable Nurses prescribe x-rays have been approved by An Bord Altranais. I understand that the HSE has commenced the process of implementation for nurses to undertake this expanded practice starting with establishing the required educational programmes.

A good example of the development of nursing services is in the sensitive area of providing a service to the victims of sexual assault. Nurses are well placed to conduct forensic examinations on victims of assault and following a recent review of the Sexual Assault Treatment Services in Ireland nurses are currently undertaking forensic training to provide this service. Eight nurses commenced an education programme in January 2008 to enable them to carry out this service.

In 2002 the first phase of the 4 year nursing degree was introduced and this was finalised by the introduction of midwifery and integrated children's/general nursing degree programme in 2006. There is now an annual intake of 1,880 student nurses and midwives into this programme.

The establishment of management and clinical career pathways for nurses and midwives has heralded the development of post-registration nursing and midwifery education programmes throughout the country. There exists a comprehensive programme of post-registration education which is widely availed of. A total of 286 nursing and midwifery specific post-registration courses were offered by 14 higher education institutes in the Autumn of 2006 and Spring 2007. The HSE has recently completed a review of all nursing and midwifery post-registration education programmes. The recommendations of this review will provide a comprehensive strategic framework for the future development and delivery of nursing and midwifery post-registration education in Ireland.

A pilot Post Registration Psychiatric nursing programme for registered nurses wishing to become psychiatric nurses commenced in February of this year. Interest for places on this programme was high. A total of 46 students are currently engaged in this one-year post registration psychiatric programme in Dublin City University and have signed service commitments to work in their sponsoring mental health services including the Voluntary Services in Counties Dublin, Kildare and Wicklow for a further two year period following successful completion of the programme.

The Deputy should note that the Government has provided significant funding in recent years for the education and development of the nursing profession and funding has also been provided for the up-skilling of support staff who work with nurses and midwives. I believe that there is significant potential for the continued development of the nursing profession and the more efficient use of the nursing resource.

My Department and the HSE are committed to the expansion of the role of nurses and midwives so as to empower them to work in new ways, make better use of their skills and knowledge so as to provide an enhanced service for patients and clients.