James Reilly (Dublin North, Fine Gael)
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Question 410: To ask the Minister for Health and Children the progress made on the programme for Government commitment to see the further development of the nursing profession; and if she will make a statement on the matter. [30047/09]

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.

The HSE has recognised the status of the nursing profession and has established the office of the Nursing Services Director at national level. This is a dedicated office which has a priority to provide leadership, support excellence and build capacity in nursing and midwifery in order to enhance patient care and service delivery.

At the end of May 2009 there were 38,450 whole time equivalent nurses and midwives employed, which is an increase of 366 (or just under 1%) on the December 2008 figure of 38,084.

There are currently 120 approved Advanced Nurse Practitioner posts and 2,069 approved Clinical Nurse Specialist posts. These posts are created to meet specific service needs, are spread across the country and across the nursing and midwifery disciplines, and these type of posts are continuously being developed.

Nursing and midwifery led services are provided across a number of areas. For example, Accident and Emergency, Diabetes, Respiratory, Care of the Older Person, Midwifery, and Mental Health.

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. The new legislation will enhance the protection of the public in its dealings with the professions and ensure the integrity of nursing and midwifery through the continued promotion of high standards of professional education, training and practice and professional conduct. The legislation is consistent with the Government's commitment to strengthen and expand the provisions of the statutory regulation of health professionals and is aligned with the provisions of the Medical Practitioners Act 2007.

My Department undertook an extensive public consultation on the proposed legislation and received 213 written submissions from individuals, groups and organisations as part of this process. Following consideration of the submissions and meeting with key stakeholders, the draft Heads of Bill were revised. The Government approved the revised draft Heads of Bill in March 2009 and the Attorney General has assigned a Parliamentary Counsel to draft the Bill. I plan to introduce the Bill into the Houses of the Oireachtas later this year.

Management and unions have been working to introduce a 371⁄2 hour week for nurses on a cost neutral basis and without diminution of services to patients as provided in the recommendation of a National Implementation Body (NIB) statement in May 2007. 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 over 31,000 nurses and midwives (approximately 81% of the total).

The Commission on Nursing Hours was established as a result of a recommendation of the NIB to produce an independent assessment of how a further reduction to a 35 hour week for nurses and midwives can be achieved. As part of its work the Commission undertook an extensive national consultation process with nurses, midwives, staff groups and other stakeholders. It also made a public call for submissions and commissioned research which included a review of international best practice with regard to the deployment of the nursing resource. The Commission completed its deliberations earlier this year and subsequently presented its Report to me. I am examining the Commission's findings with a view to bringing its Report to Government for its consideration.

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

A number of initiatives have been introduced in recent years which facilitate nurses and midwives expanding their roles and improving the services provided to patients and clients. I have amended the relevant legislation and introduced new regulations to allow for the introduction of nurse prescribing. Currently 295 nurses and midwives have commenced or completed the education programme for nurse/midwife prescribing. These programmes are conducted in University College Cork and the Royal College of Surgeons in Ireland. There are currently 84 registered Nurse Prescribers from a diversity of health service providers and clinical areas throughout the Health Service Executive with the authority to prescribe medicinal products.

I have introduced the necessary regulation to authorise nurses to refer an individual for medical ionising radiation (X-Ray). Currently the first post-registration nurse education programme for nurses to undertake this expanded practice has commenced. Thirty nurses from a range of hospitals around the country are taking part in this programme. The introduction of this expanded practice for nurses is a significant initiative in the Irish health service and will have implications for service users in terms of convenience, cost-effectiveness, improved access to radiology services and simplification of the patient journey.

A good example of the development of nursing services is in the sensitive area of providing a service to victims of sexual assault. Nurses are well placed to conduct forensic examinations on victims of sexual assault and following a review of the Sexual Assault Treatment Services in Ireland a number of nurses have undertaken forensic training to provide this service. The Higher Diploma in Nursing (Sexual Assault Forensic Examination) programme was established to support the role out and development of the Sexual Assault Treatment Units (SATUs) nationally. Eight students were sponsored by the HSE to undertake the Higher Diploma in Nursing (Sexual Assault Forensic Examination) in the RCSI.

All eight nurses have successfully completed the Higher Diploma in Nursing - Sexual Assault Forensic Examination programme. These nurses are now available to their sponsoring SATU areas and are equipped to provide appropriate care to victims, while contributing to and participating in an integrated team approach to service delivery.

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 in late 2008 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. The HSE has established an Interim Education Advisory Committee to implement the recommendations of the Review.

A pilot Post Registration Psychiatric nursing programme for registered nurses wishing to become psychiatric nurses commenced in February 2008. A total of 46 students undertook this one-year post registration psychiatric programme in Dublin City University, which finished in February 2009, 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. A Report on the evaluation of this programme is currently in course of preparation.

While the above provides clear examples of this Government's commitment to the further development of the nursing and midwifery professions I believe that there is significant potential for the continued development of these professions and the more efficient use of the nursing and midwifery resources.

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. Towards this end my Department has recently established a Steering Group to provide policy direction and develop further areas of practice for the expanded role of nurses and midwives in a rapidly developing health and social care environment.