Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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381. To ask the Minister for Health if he will provide the details of oversight and governance of the Nursing and Maternity Board of Ireland; if in view of the spending of State funds and unilateral increases in registration fees, the NMBI should be open to scrutiny to ensure financial appropriateness; and if he will make a statement on the matter. [3688/15]

Leo Varadkar (Dublin West, Fine Gael)
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The Board is governed by the Nurses and Midwives Act 2011 and is a legal entity in its own right. Its accountability to the Minister for Health is set out in statute and in this regard the Minister may for example direct the Board to amend a statement of strategy submitted to him under section 18. Having regard to the relevant sections of the Act, there is a certain amount of accountability to the Houses for example the Act requires the Minister to lay a copy of the statement of strategy before each House of the Oireachtas. The Minister can also lay the business plan submitted to him before the Oireachtas and the annual reports are also laid before each House of the Oireachtas by the Board. Further all rules made under section 13 and approved by the Minister must be laid and annulled. It should be noted that the Board’s accounts are also examined by the Comptroller and Auditors General’s Office. In this regard the accounts for 2012 and 2013 were recently published and arrangements will be made to lay them before the Houses of the Oireachtas.

The Board is an independent body, with the responsibility to ensure that it has the financial capacity to undertake all its legal obligations. The cost of enacting the additional requirements under the Nurses and Midwives Act 2011 was set out in the Regulatory Impact Analysis that was carried out prior to the enactment of the legislation.

It was also made clear at the time of the legislation that the Board would continue to be self-funding and needed to plan and cost how it would fulfil its legal obligations. Following detailed negotiations with the Executive and Board members in 2013 it was agreed in October 2013 that an initial once-off sum of €1.6m would be granted by the Department to the Board to cover 2013/2014 costs, but that the Board would have to increase its income in 2015 to undertake its commitments in the legislation. The Board of the NMBI made the decision to increase the annual registration fee at its meeting on 17th September, 2014.

I am concerned regarding the implications for the health service and patient safety should the current impasse over the annual retention fee increase continue. I have therefore written last week to the President of the Board of NMBI asking that options be explored to bring a resolution to issues surrounding the annual retention fee. I recognise that the Board must meet its obligations within the financial resources available. This also demands that obligations are met on the most economic basis possible and all planned expenditure can be demonstrated as necessary. I requested that the Board of NMBI re-engage in discussions with the staff associations, as a matter of urgency. I have offered that both my officials and I are available to engage with the Board should that be of assistance.

An outcome must be found which secures the Board’s minimum financial operating requirements but avoids a scenario where nurses and midwives are removed from the Register for non-payment of fees with potential consequences for service availability. I will continue to monitor the situation closely in the interests of patient safety and continuity of care.