Could the Minister explain subsection (4) which gives him an inordinate amount of power? What is his interpretation of that subsection?
Nurses Bill, 1984: Committee Stage (Resumed).
Question again proposed: "That section 16 stand part of the Bill."
The Minister as a member of the Government must ensure that the rate of pay of chief executive officers——
It was subsection (4) I queried.
I wish to make the point that the Minister has certain functions in relation to the pay of chief executive officers and must ensure in respect of a body under his aegis that the CEO is paid only what he is entitled to.
I asked the Minister about subsection (4). He has given an explanation in regard to subsection (3) on a number of occasions. Subsection (4) is very important and we should have some idea of what the Minister intends. Subsection (4) states:
The Minister may, whenever and so often as he thinks fit, declare that any power conferred on the Board by this section shall be exercisable only with the consent of the Minister and whenever any such declaration is in force, the said power may be exercisable only with such consent.
It appears that the board can do absolutely nothing without the consent of the Minister. What is the Minister's interpretation of that subsection?
I will give an interpretation which the Deputy will probably understand a lot better than my personal interpretation. I would refer to the Medical Practitioners Act, 1978. The then Minister was Deputy Haughey. Section 16 (4) of that Act states:
The Minister may, whenever and so often as he thinks fit, declare that any power conferred on the Council by this section shall be exercisable only with the consent of the Minister and whenever any such declaration is in force, the said power may be exercisable only with such consent.
After this morning's debate I thought we would get away from saying that because a provision appeared in previous legislation it was therefore all right. We are trying to bring in a Nurses Bill that will do justice to the general public and the nurses and will be a credit to the legislators. I have read the Medical Practitioners Bill and I appreciate that it contains that subsection. I have stated a number of times that there is an inordinate amount of ministerial control throughout the Bill which does not appear in the Medical Practitioners Act. If the Minister of State looks at section 16 (1) of that Act he will see that the Medical Council have the power to appoint a registrar and do not need the consent of the Minister. Under section 16 of this Bill the Nursing Board must have the consent of the Minister. That is an example of a change from the time when the leader of our party was Minister. I understand that the Minister's name appears 46 times in this Bill with special powers for himself. There is nothing like that in the Medical Practitioners Act. I am asking what the subsection means in terms of ministerial power.
It gives the Minister power to make the terms and conditions of service of the CEO subject to his consent if he considers such a step necessary at any time. The Minister considers that the subsection is necessary.
Does he have to have the approval of Finance for that?
No.
Question put and agreed to.
SECTION 17.
I move amendment No. 12:
In page 12, lines 14 to 20, to delete subsection (5).
Again, this subsection deals with ministerial powers. I am seeking to delete subsection (5) which states:
(5) In determining the number of persons to be appointed or in making any appointment pursuant to this section, the Board, or the Chief Executive Officer, as the case may be, shall act in accordance with any directions given by the Minister and in making any determination under subsections (1), (2) or (3) of this section, the Board or the Chief Executive Officer, as the case may be, shall act in accordance with any directions given by the Minister.
Effectively, this appears to indicate that the Minister has total control over the personnel the board appoint. That is extraordinary for a board that will not be funded by the Exchequer but by nurses. The nurses will elect 17 members to the board, a majority, and the Minister will appoint a further 12 members. The 29 members of the board will be subject to the control of the Minister as to the people they employ and the conditions of service for employees. I do not understand the need for that subsection. We have spent a long time debating the composition of the board and, hopefully, as a result when the Bill is passed we will have good legislation but if we do not have confidence in the board to do their job effectively we should not be debating this legislation. In view of the fact that the board will not be funded by the Exchequer it should be given the authority to employ people and lay down their conditions of service as they see fit.
I have re-examined the contents of the section, particularly subsections (4) and (5). I sought to provide in the section a clear distinction between the overall administrative personnel function of the board and the purely executive function of the chief executive officer in the manner of recruiting staff and determining their terms, conditions and duties. To this end I am following a precedent set by the Health Act, 1970, which contains similar provisions in relation to functions of health boards' chief executive officers. Further I am seeking to tie up all loose ends. I may be duplicating the provisions for ministerial powers in subsections (4) and (5) and it is proposed to delete subsection (5).
The Minister is accepting our amendment?
Yes.
Amendment agreed to.
Question proposed: "That section 17, as amended, stand part of the Bill".
Subsection (3) states:
(3) There shall be paid by the Board to its officers and servants other than the Chief Executive Officer out of funds at its disposal such remuneration and allowances as the Chief Executive Officer, with the consent of the Minister, from time to time determines.
Is that an executive function or is there a case to be made to permit the board to decide that issue?
It provides that officers and servants will be paid by the board such remuneration and allowances as the CEO, with the consent of the Minister, may determine.
I should like to draw attention again to the fact that the Minister's consent is necessary. The Minister mentioned the Medical Practitioners Act but subsection (5) which has been withdrawn did not appear in that Act.
Question put and agreed to.
Section 18 agreed to.
SECTION 19.
Question proposed: "That section 19 stand part of the Bill".
The section deals with superannuation and I should like to know if the term "officers and servants" is appropriate in view of the changes made in recent years in regard to superannuation for officers working for the board.
This term has to be used because it is the term used in the Local Government (Superannuation) Act.
I understand that there was a change in recent years and that the terminology is not appropriate.
Question put and agreed to.
SECTION 20.
I am advised that the Minister will not be moving amendments Nos. 13 and 14. Is that the position?
Yes.
Amendments Nos. 13 and 14 not moved.
Question proposed: "That section 20 stand part of the Bill".
Is it in order to ask the reason why the Minister is not moving his amendments?
The amendments were intended to meet the needs to protect the employment of an officer or servant of the board who is nominated as a candidate for election to Seanad Éireann as opposed to a Taoiseach's nominee. The amendment sought to provide that such a person would not be seconded from employment with the board until he is actually elected and then only from the date of his election. Senators have often pointed out the anomaly that a person can be nominated for election to the Seanad without his prior consent and cannot then withdraw his candidacy. I understand that the Minister for the Environment is examining this matter with a view to making the necessary amendments to the Seanad electoral legislation. Clearly a global amendment to Seanad electoral legislation would be a more efficient means of achieving this protection of employment of staff of statutory bodies.
Will the amendment to the Seanad electoral legislation have the same effect?
I think so.
Question put and agreed to.
SECTION 21.
Question proposed: "That section 21 stand part of the Bill".
Subsection (2) states:
(2) The accounts of the Board shall be audited at least once in every year by an auditor appointed for that purpose by the Minister and the fees of such auditor and the expenses generally of such audit shall be paid by the Board as soon as may be after each such audit.
Why is it that the Minister should have the power to appoint the auditor especially in view of the fact that he will not be making a contribution to the board out of Exchequer funds.
It is normal procedure.
I accept that but I would hate to think that all the provisions of the Bill are in it because "it is normal procedure". I would like to think that between the Minister of State, and myself, in the absence of the Minister for Health, we will make a good job of the legislation and not insert provisions because they represent normal procedure.
I aim to be very cautious.
Will the Minister look at this to see if there is a need for the Minister to have the power to appoint the auditor? The Minister might appoint auditors who would be expensive, and the board, by choosing their auditor, might get a contract on favourable terms. The Minister might decide on somebody who would cost thousands of pounds which the board would have to fund out of their own resources because it would not come from the Exchequer. If the Minister were prepared to pay the auditor, I would be happy to leave it as it stands.
Basically it is to ensure objectivity.
That is not the purpose——
We think it is.
How will it ensure objectivity in a way that could not be ensured if they appointed their own auditors?
It is normal procedure that the Minister appoint an auditor. Deputies may question this if they wish and if they want further clarification we will give it.
It may be normal in some cases but in this case the fees to be paid to the accountants would come from the contributions paid by the nursing staff. From discussions I had with nurses on this Bill it seems that the will of the Minister is pervasive in every line. It is too much that he will now appoint the accountant to sort out the nurses' money.
I will quote from the Medical Practitioners Act, 1978, at which time the Minister for Health was Deputy Charles J. Haughey. Section 21 (2) reads:
The accounts of the Council shall be audited at least once in every year by an auditor appointed for that purpose by the Minister and the fees of such auditor and the expenses generally of such audit shall be paid by the council as soon as may be after each such audit.
This is the Nurses Bill and if something is right it is right, and if it is not right, it is not. Some people might make the accusation that the medical profession were in a position to pay the auditor, irrespective of who appointed him or what his fees were — I do not agree with that — but nurses will not want to pay an increased fee if the Minister appoints an auditor whom they will not be in a position to pay. If we have any confidence in the board they should be allowed appoint their own auditor.
The expenses and the remuneration of the auditor will be no different from that charged by any other type of auditor. Does the Deputy think that if the board were allowed to appoint their own auditor they might get a better price?
Different auditors charge different fees. I notice that while in practically every section of the Bill the consent of the Minister is necessary, it is not necessary for the auditor's fee.
Question put and agreed to.
SECTION 22.
Section proposed: "That section 22 stand part of the Bill."
Is there indemnity for members of the board following borrowing by the board.
Yes.
May I have that clarified?
This section empowers the board to borrow, subject to any conditions or directions imposed by the Minister.
If the board borrow, is there indemnity for members of the board?
I cannot give a direct answer but in all probability they are not liable.
I consider it important that members of the board know that.
I consider it important too.
This is the Committee Stage and it is important to clarify this legislation. In my view it is important to know if members are indemnified following borrowing by the board or are they liable?
The board borrow, not inividual members.
Is not the board made up of members?
The board is a corporate entity.
Are members indemnified following borrowing by the board?
Yes.
Question put and agreed to.
Section 23 agreed to.
SECTION 24.
Question proposed: "That section 24 stand part of the Bill."
Subsection (2) reads:
Any expenses incurred by the Minister in the administration of this Act shall, to such extent as may be approved by the Minister for Finance, be paid out of moneys provided by the Oireachtas.
Would the Minister give examples of how that would arise? For what moneys will the Minister for Health, subject to the approval of the Minister for Finance, be liable? In the event of the board not being able to meet their commitments because the retention fee is too large, will he subvent the board? Would he consider paying out of public funds the auditor he appoints. In what type of situation would the Minister envisage that expenses would be paid out of the public Exchequer?
The Minister will pay the expenses of the first election and thereafter the board are responsible for their own finances.
Does that mean that the only expenses for which the Minister will be responsible is the organising of the initial election?
Yes.
Why is this subsection here? Is it necessary to have this stated in the Bill if only one election is involved and there will be no more money from the public Exchequer after that? The Minister gives an undertaking that an election will be held as quickly as possible so that before the middle of next year that subsection will be obsolete.
The Minister needs the power to set up the board. As I said, he will pay for the expenses of the first election and any incidental expenses incurred in relation to it. Thereafter the board are responsible for their own finances.
But they cannot appoint their own accountant.
So be it.
The Minister is saying that only the expenses incurred in the holding of the first election will be paid for by the Minister. Is that so?
Yes.
After that it is up to the board to make their own financial arrangements?
Yes. It is up to the board to finance themselves thereafter.
But they may not employ their own accountant.
We have already dealt with that.
It would be much better if this subsection were worded so as not to mislead the members of the board who may feel that the Exchequer will meet any deficit in their running expenses during the year and that the Exchequer will pay other expenses for them. That subsection should be re-worded to spell out the explanation which the Minister has given here, that it refers specifically to the first election of the board and that the Exchequer will have no further responsibility in that regard. It would be fairer to everybody if the section was re-worded in that way. At present it gives the impression that from time to time the Exchequer would be allocating money for various purposes to the board.
These are standard provisions.
The Minister has resorted to this phrase time and time again. I support Deputy O'Hanlon in this major issue. The Minister appears to show goodwill and to accept our points but, when pressed further, he refuses to go the whole hog——
I have a great deal of goodwill towards the Deputies' point of view.
In that case, perhaps the Minister would implement it.
Subsection (1) says that all expenses incurred by the board shall be defrayed out of funds at the disposal of the board. The Minister qualified that by saying that the Exchequer will defray expenses but only those of the first election. If the Minister is going to do that it will have to be specifically included because what is here is carte blanche to do anything.
The section dealing with auditors adopts the correct approach and is in the interests of the taxpayers. However, I should like the Minister to clarify whether we are talking about consultancy fees or legal advice subsequent to the first election as it is understandable that there will be expenses in that connection?
Subsection (1) says that all expenses incurred by the board shall be defrayed by the board out of funds at the disposal of the board. I am not trying to be cantankerous but the Minister has said that those expenses mean expenses in regard to the first election. What is the point of not putting that into the Bill?
Subsection (2) says that any expenses incurred by the Minister in the administration of this Act shall, to such extent as may be approved by the Minister for Finance, be paid out of moneys provided by the Oireachtas. Many people will see that as a responsibility on the Exchequer to contribute from time to time to the Nursing Board for various responsibilities of the Minister. The Minister of State said that the Minister will have discharged that responsibility as soon as the first board is set up. Assuming that the Bill is passed, within six months the subsection will be obsolete. For the sake of good legislation, the subsection should be worded in accordance with the very clear explanation which the Minister of State gave this afternoon.
I have already said in relation to the first election that the Minister is prepared to foot the bill. If there are administrative costs later on this will enable the Minister to meet them.
I am not very happy about this section.
It is important to clarify this because many other people outside the House will be reading this Bill and I am sure that the nurses and the Nursing Board will be very interested in it. They should know exactly what responsibility the Minister has in terms of Exchequer funding of the Nursing Board. Am I to understand that, apart from the first election, this subsection will not be obsolete but that there may be times when the Minister will be obliged to pay out of the Exchequer?
It is not possible to envisage that at present.
Could the Minister give an example?
From time to time the Minister may be prepared to fund other activities of the board.
Question put and agreed to.
SECTION 25.
I move amendment No. 15:
In page 14, line 8, to delete "giving" and insert "re-issuing".
This amendment refers specifically to the giving of a certificate. The question is to whom will these certificates of registration be given because I understand that a person will first apply to the registrar to have his or her name placed on the register and will be obliged to pay a fee. Presumably, the cost of an annual, two or three year certificate will be included in the cost. Therefore, I cannot understand why there is a subsection to provide for a fee for the giving of a certificate of registration. In other words, they will be charged twice, when they apply to have their name placed on the register and when they pay the annual retention fee. I would have thought that a receipt would be in the nature of a medical certificate similar to other bodies but, according to this, the board may charge them for giving a certificate. I want the word "giving" taken out because if somebody loses their certificate and applies to have it reissued, it is reasonable to expect them to pay a small fee for that service because there would be a certain amount of work involved but I cannot see why there would be a charge for giving a certificate of registration to a person who has already paid a fee when applying to have their name placed or retained on the register. Under no circumstances would a certificate of registration be given to anybody other than the nurse whose name would be going on the register, so there is no question of giving a certificate to a third party. Obviously a certificate of registration will only go to the nurse whose name is on the register. That is why I put down this amendment and perhaps the Minister has some explanation as to why it is worded in this way.
I was going to make a point later on but it arises now because Deputy O'Hanlon has mentioned the question of what he calls an annual retention process of the names of nurses on the register. Is it intended that the register should be updated annually? There is general agreement in the nursing profession, so far as the advice I have from it goes, that there should be a live register and that there should not be people on it who are no longer bona fide practising the profession. The question of whether the retention of people on the register should be determined annually does not seem to arise on this section. The section does not say at what intervals the register is to be updated. The advice I have been given from the nursing profession is that, while there is agreement with the principle of keeping the register a live register, perhaps one year is too short an interval at which to update it. This is because nurses, particularly in the early years of their service, are often out of the country for periods longer than a year. Depending on where they were situated that would not altogether exclude their applying even from a foreign address for retention of their registration but it might impede it if they were in a distant part of the world. I should like the Minister to indicate the attitude of the Department with regard to this. The matter arises here only because Deputy O'Hanlon seems to take it for granted that the register should be updated annually——
No, I said perhaps at intervals of three years or five years.
Acting Chairman
This discussion seems more appropriate to section 27.
No, it arises under section 25(b) to which Deputy O'Hanlon has adverted a few times, quite rightly because it is relevant to his amendment.
I do not think there should be a retention fee every year. I hope the Minister will take into consideration the views of all the people who have made representations that there should not be a registration fee every year. There are no such fees in many other areas in the public service. It should be a once-off payment. The updating of the register of all the nurses should not have to take place each year. There should be only the addition of the new members.
I support the amendment of Deputy O'Hanlon: It appears to us that nurses in addition to paying a registration fee will be subject also to a certification fee. When a student pays a fee for the leaving certificate examination he or she gets the certificate without any further payment. The point put forward by Deputy O'Hanlon is quite clear. He wished to find out if in addition to payment of the registration fee a nurse will also have to pay a certification fee. If that is the case we will be opposing it.
I should like to clarify one aspect that is likely to be misinterpreted. I refer to paragraphs (a) and (d) of subsection 25. The board is empowered to charge fees for registration of the person on the register and the giving to the person of a certificate of registration and this is a matter for the board. For registration of a newly qualified nurse there is only one fee which is £40 at present. This covers the nurse's registration and the supplying of a certificate of registration. This is how the present board work and there is no reason why there should be any change under the new board.
With regard to the Deputy's amendment, I must assume he envisages a double fee, a fee for actual registration and a fee for the supply of a certificate. If I may speculate about the Deputy's wishes, I do not think he is in favour of having two fees paid by a newly qualified nurse. He wishes to ensure that the fee in respect of paragraph (d) shall apply only to the re-issuing of a certificate. However, I must point out that the certificate of registration at paragraph (d) covers not only the re-issuing of an original certificate but also a certificate for a second or subsequent division of the register. As the Deputy is aware, a nurse who is registered in one division of the register may, through further study, acquire further qualifications that may be registered. I cannot accept this amendment which does not provide for the full implications of the section as drafted.
In relation to the point made by Deputy Kelly regarding the updating of the register on an annual basis, there is no guarantee but in all probability it will be updated on an annual basis. However, it is a matter for the board. The receipt of payment will act as proof of registration.
Will the Minister of State be willing to suggest to the new board that if they opt for an annual updating of the register they will make some special provision to facilitate nurses who are abroad, perhaps in some place that is difficult of access, so that a nurse who may have difficulties regarding communications will not find herself deregistered without her knowledge? I will not press the Minister to give details of what solution he might find but I think the matter should be brought to the attention of the board. I hope the Department will take on board what I am saying which I think is the view of the nursing profession in general.
I have listened carefully to the Minister's reply. He agrees entirely with us that a newly qualified nurse should not have to pay a second fee for certification or the retention of a nurse on the register. My concern is that there is nothing in this section that makes clear what the Minister has just said to us that a nurse will not have to pay a fee for a certificate having already paid for registration or for retention on the register. I am sure if the Minister were in charge of the board he would ensure this would not happen, but it will be the board who will decide on the fees and the persons who will be obliged to pay. I ask the Minister to look at the section. Perhaps if he were to insert a provision regarding the registration of a person in the register and the giving of a registration certificate that would suffice to ensure that the giving of a certificate was included in the two paragraphs. In this way a newly qualified nurse who applied to have her name on the register would not have to pay another fee for a certificate. I am not so sure that it would be justifiable to charge a fee for a certificate on some sub-group of nurses. It is possible in those circumstances that a sub-register might be set up with a charge for placing names on that register.
I am not so sure that nurses will not end up paying two or three different fees. With regard to Deputy Kelly's point concerning the updating of the register every year, I am not sure of the Minister's intention in that regard. Does he intend to have an annual retention fee? If that is the case we will be opposed to it. I will give a small example of how costs can spiral out of all proportion. When I qualified in medicine I paid a subscription of £15 but last month I wrote a cheque for £324. That is an indication of how costs can spiral.
I suggest that the Deputy's representatives on the board are not doing their job.
We look to the Minister to correct that. We are totally opposed to having an annual retention fee and would be advocating something along the lines of retention fees applying for the duration of the board, or some similar suggestion.
We all agree that there is necessity for a register which it is hoped will be effective in getting employment for nurses. If it is a register which is kept up to date there will be no need to find out who on the register is available for work. How often one would have to update it and pay a registration fee plays a part here. This raises certain problems, particularly to do with the careers of women. It is hoped that there would be a 50-50 registration of male and female nurses in the future who would be sharing responsibility in their homes and that there would not be the same demands on women as there are now.
I take the example of a qualified nurse who for reasons of child rearing and domestic responsibilities might wish to remain on the register but might not be able to continue to pay a high annual or regular fee. Could that type of circumstance be taken into consideration by the Minister and perhaps a nominal or sliding or holding fee obtain? The fee might fit the circumstances of a woman taking five or ten years off nursing and then wishing to return and not lose her place on the register. I hope in the future that we would be talking as seriously about male nurses and their domestic responsibilities and their taking time off also. However, at the moment the female nurses are my first consideration.
For information, regarding certification, in the case of a nurse on the register getting extra qualifications is it only in those cases where that extra qualification or expertise is granted and the nurse wishes that information be registered that the extra fee takes place? Economically, it might then make sense.
On the amendment before the House I want to make one observation. Amendment No. 2 is not acceptable, for the fairly obvious reason that an interpretation of it would be that if the board decided to increase the registration fee in any year they would be obliged, it seems to me, mandatorily to increase the registration fee by an amount equivalent to the increase in nurses' salaries for that year. I know that that is not the intention, but that is one reading or interpretation of it.
We are not on that amendment.
Acting Chairman
We are now discussing amendment No. 15.
May I make a point with regard to the section? Am I in order in doing so?
Acting Chairman
We are not on the section yet. We are on section 25, amendment 15.
I want to express basic concern about the effect of this section. It introduces a State control with regard to the right of people to work. For the first time people who are privately employed in the area of health care would be obliged to pay a fee for the right or privilege to take up work or to continue to work. It would be a fee dictated by the Minister of the day — by the board initially but, as we know from other sections, if the board do not satisfy the requirements of the Minister, the Minister may intervene. Indeed, in any matter in this Bill the Minister has the last say.
Allowing for the fact that there is possibly a benevolent attitude prevailing on the part of the current Minister, and indeed the current Opposition if they were in power, the reality is that we are entrusting to a Government, in effect, the right of disbarring people from work. That is something we should not rush into very easily. I am not convinced that there should be a need at all for an on-going fee. I understand that on a cost-effective basis arguably there may be need for the cost of the board to be recouped, the cost of initial registration. Of course, if the State managed their affairs effectively that cost would be very little. What it boils down to, I assume, is the issuing of some type of form, its completion and return to the board and an assessment of that form by some competent representative of the board to make sure that it is in order and its being incorporated into a ledger or whatever.
In fact, the section and amendment 15 are about something which goes far beyond that. They talk about re-issuing it. Is there a need to pay a fee to have a name of a person retained on a register? What is the cost associated with that? I accept that some official has to open the book once a year to find out if the name is there and so on, but the onus should be on the State before they introduce what is potentially a very serious managerial control to prove that it is necessary. The effect of it would be that thousands of people at present working in the nursing profession will now for the first time ever pay to have access to that right to work. It is no less than that that we are talking about.
It is all very fine to say that it is a matter of tidying up the books and keeping things in order, but interpreted in a malign or vindictive way — and it is quite possible that that could happen in the order of things — then a woman who might have very strong personal views as to how things should be run in a hospital might find herself discouraged in a variety of ways from practising her profession. I could also see a woman not being able to afford a fee and I wonder what the attitude of the board would be then. I should like to think that they would take a sympathetic attitude. It would be very sad if there were even one case where a nurse could not afford the fee of the day. It sounds like a small amount now, but the section clearly allows the fee to rise and the amendment to which we will be coming later on would also facilitate a regular increase.
I am concerned about the need for this registration process. It essentially means that nurses would have to register annually and pay for the right to work and, if they do not, they simply will not be able to work. That is very serious. I accept that I did not have the benefit of hearing the Minister's comments on this earlier on and perhaps he may have answered some of these queries. However, I do not know why we should have to go that far.
The controls essential in an area like this should be the minimal necessary to do whatever the objective of this Bill is, which I presume is to bring improved standards of excellence, if that be possible, and standards of order into this area. It should not go beyond that and this Bill goes far beyond that. Grave difficulties could be caused to persons who are practising nursing to a very high standard of excellence right now, who would be suddenly encumbered by a whole barrage of regulations and controls, particularly payment of a fee on an annual basis — an unspecified fee to work. I want to put that on the record. I am deeply unhappy about that basic innovation. Would the Minister be good enough to comment on the necessity for payment of a fee at all, particularly for retaining a name on a register and the issuing of a licence?
I will make an attempt to answer all the points made.
The Minister of State is honest anyway.
When we consider that we are talking about a 29-member board made up of people working in the profession naturally they will take all these points into consideration. We are setting up a system whereby the profession will be allowed to operate the board subject to certain controls by the Minister. It is up to them to operate it in whatever way they see fit but if they do not operate it as the Minister thinks it should be operated he will be able to step in and say something about it from time to time.
The registration fee will include the issue of a certificate. It is a matter for the board to decide if they want to charge a retention fee or an annual fee for registration. I am sure that in doing so they will take into consideration people who are unemployed. If there is a charge for registration it helps to ensure that there is a correct register. If there was no charge it is possible that after the initial registration the register could go out of date. Someone mentioned the cost of registering an extra qualification. They asked if it was in addition to the registration fee. The practice has been that there is an additional registration fee for an additional qualification. We are setting up the board and it is up to the profession to run the board as they see fit.
I come back to amendment No. 15. I do not want to become involved in the debate on the section generally. My concern is that a person who has already paid a fee to register on the nurses register and have their name retained on it should not be obliged to pay another fee for a certificate. I want to ensure that if a person pays for registration or retention on the register they will not have to pay another fee for a certificate. The certificate should be part of the original fee. I should like to see that written into the section. There are eight subsections already and it should be possible to insert that into one of them.
My amendment on the re-issuing of a certificate to any person under (d) would fit the bill. I understand what the Minister said that the board might set up sub-registers and that they might give a certificate if a person was a member of, for example, a midwife sub-register. I would be totally opposed to charging someone who had already paid their annual retention fee another fee for a certificate if they registered for a particular group: for example, if a midwife registered on a midwife sub-register or a psychiatric nurse registered on a psychiatric sub-register. Not alone would they have to pay a retention fee but we are now being told they will have to pay another fee to have their name placed on a sub-register. No matter whether it is a main register or a sub-register, the one registration fee should cover certification. The only charge for giving a person a certificate would be in the case of re-issuing a certificate to someone who lost it and wanted a second one. Otherwise it should be included as part of the registration fee.
I take the point made by the Minister of State that fees will be determined by the board. As of now the majority of this profession are women and traditionally women have a more broken career than men. Would it be possible for us, before the Bill goes through the House, to have written in as part of the section the fact that the board would take that into consideration and also take into consideration nurses who leave the profession for domestic or other reasons and who may wish to remain on the register? Perhaps they might have a sliding fee or nominal fee which would enable them to remain on the register.
I thought we normally dealt with amendments first and then went on to the section.
Acting Chairman
That is correct.
There is some confusion because everyone is talking about the section rather than the amendment.
Acting Chairman
We are on section 25, amendment No. 15, and we must confine ourselves to that.
When Deputy O'Hanlon was speaking he made a point about nurses being registered a second time. There is a separate section in connection with two or three divisions. Have we talked our way into section 28 on this issue? Section 28 states that nurses can be registered in more than one division. We are talking here about payment of fees for each division.
Acting Chairman
I will read the amendment.
I know it.
Acting Chairman
We are on section 25, amendment No. 15: "In page 14, line 8 to delete `giving' and insert `re-issuing"'. It is as simple as that. If we confine ourselves to that we will not be getting into difficulty.
There should not be a registration fee each year for all nurses.
Acting Chairman
That does not arise on the amendment.
Are we only dealing with the amendment?
Acting Chairman
Yes.
The point Deputy O'Hanlon makes is sensible. He is trying to eliminate the possibility of a situation arising where the widest interpretation of the section could give rise to someone being asked to pay the same fee twice, or to pay two separate fees when the intention of the Minister is that there would be one fee.
The preamble to section 25 reads:
The Board may charge such fees as may, from time to time, be determined by the Board with the consent of the Minister, for——
and then——
(d) the giving to any person of a certificate of registration.
It can be argued that it also allows the board to charge a fee for the registration of a person in the first instance and secondly for the retention. It could be argued that those are separate charges.
That is right.
Therefore the words "the giving to any person" must be interpreted as being the issuing of the certificate. Presumably that is what the Minister is trying to achieve. If that is the case, the word "giving" is too loose. Under this section as proposed the amendment obviously is trying to ensure that the person who is paying the registration fee is not asked two months later for a fee for the giving of the certificate. It is simply a question of what I might call English usage, unless the intention is to charge two fees. I do not think that is so, unless I am misinterpretating what Deputy O'Hanlon is saying. The wording should be considered again, otherwise, depending upon what the board and the Minister would say, it can be argued that the person would pay a fee on registration and then pay a fee three months later when the certificate was being issued. I presume that is not the intention of the Bill.
I support the amendment. Deputy Keating has made most of the points. The only one I would like to add is that which Deputy O'Hanlon made initially and which we are forgetting about at this stage. I presume it is not the intention in paragraph (d) —"the giving to any person"— that I could go and get a certificate of registration for you as a nurse. I presume the Minister means that "any person" is not a third party, that it must be the nurse who is concerned.
A qualified person.
It is important when somebody pays a registration fee that included in that should be the certificate. The only instance when a nurse would have to pay for a certificate of registration would be if that nurse lost the initial certificate of registration.
I rise in support of our spokesperson, Deputy O'Hanlon, in relation to this paragraph and the overall section.
Acting Chairman
Stick to this paragraph.
I will deal with the paragraph about the issuing of a certificate. Deputy Keating has outlined the difficulties that arise in that regard. Nurses generally have little confidence in the Minister in this regard. The Minister may use this paragraph or any other section of the Bill as a form of taxation on nurses.
We are well outside the paragraph.
Nurses should have registration for life unless they are struck off the register. It is unconstitutional and unacceptable that nurses who are unemployed at present should pay a fee for retention as qualified nurses. It is another form of taxation added to the excessive taxation imposed on every member of the community, particularly nurses who pay all the levies, PRSI and PAYE, and who as a group are also paying into their union fund. This is another form of taxation which the Minister is bringing about through this Bill. I support our spokesperson in opposing this type of imposition.
Acting Chairman
Is the amendment being pressed?
When I was speaking the Minister was nodding so I presume he was approving.
I think the Minister missed the first part of the debate, but there is nothing sinister in the proposal in the amendment. It is merely to ensure that the board will not have a whole range of fees for any nurse who registers for either annual retention or for the first time, that there will be one comprehensive fee which will include the giving of a certificate. If there is a sub-register for the various specialities within nursing, that will be included in the one fee and the nurse will not pay her annual retention fee or her fee to register and then find that she will have to pay another fee for the issue of a certificate later. Deputy Geoghegan-Quinn made the point, and I agree, that a certificate can be issued only to the person whose name is placed in the register. It cannot be issued to a third party. That is not clear from paragraph (d). Naturally, a certificate can be given only to the person whose name is in the register; therefore that person would have to pay the fee. I am suggesting in the amendment that for the re-issuing of a certificate it would be in order for the board to charge a small fee. If somebody receives a certificate, loses it and wants another, then I would deem it appropriate that that person pays a small fee.
Could we have clarification on paragraph (h)?
Acting Chairman
We are not on that. We are on section 25, amendment No. 15, dealing with paragraph (d).
A Deputy
The Minister has the floor.
I have the floor but we must appreciate that the floor belongs in many respects to the board. In the legislation we are trying to devolve responsibility as broadly as possible on An Bord Altranais and to determine charges from time to time. Deputies come into the House and demand virtually that two-thirds of the representation of the board should be for the nursing profession and they are absolutely preoccupied with the role of the nurses on the board. This enabling provision is to enable self-regulation by the profession, by nurses, for themselves in terms of running their own board. The admittedly comprehensive series of measures was drawn up to ensure that An Bord Altranais would not be inhibited in any way, by virtue of their own internal decisions, in deciding how they should raise revenue and charge members of the profession for the work they perform on behalf of the profession, and in not being a grant-aided body dependent solely on their day to day income from this measure and from whatever other assets they may have. I was extremely anxious not to spancel the board in any way in that regard. I tell Deputy O'Hanlon that I am easy about the question of giving or re-issuing. My initial reaction in not favouring the amendment was largely that I wanted to tease out the arguments here as to why it should be within another framework. I will look at that between now and Report Stage, and also at the point made appropriately enough by Deputy Geoghegan-Quinn. There is a difficulty. If we are to put every contingency into this Bill in relation to the activities of An Bord Altranais we would finish up with a Bill of a couple of hundred sections. It can do no more than lay down the general principles.
I find it repugnant to accept Deputy Leyden's arguments that this is another form of taxation on nurses. It is not. If you want An Bord Altranais to discharge the professional functions they should discharge, and in the future will discharge as far as I am concerned, then they must have cash resources. They must be able to employ staff. They must be able to employ a comprehensive professional staff and, above all else, they must have a live register. I speak as a member of a trade union and of some professional bodies. As a member of, for example, The Institute of Industrial Engineers I pay an annual fee to my institute for keeping myself on a live register in order to perform whatever I might perform if I am kicked out of this House—and that would be a difficult performance.
The Minister should have remained on that register.
A retention fee would be necessary. It is ludicrous to suggest that there should be a straight payment for life in respect of registration. We are not talking about life membership of the GAA. We are talking about a professional body. The current register is a nonsense. It contains the names of many who are abroad or who have long since died. I will examine the issue raised by Deputy O'Hanlon and I assure Deputy Geoghegan-Quinn that I am sympathetic in regard to the points she raised. I will examine that point between now and Report Stage.
I welcome the Minister's statement that he is prepared to consider the matter and to consider the problems we foresee. I would not wish to hold up the Bill but we are anxious to ensure that nurses will not be confronted with the payment of two or three fees for various essential services either at the time of their first registration or subsequently in respect of retention on the register. Perhaps between now and Report Stage the Minister will find a better way of dealing with the problem than the way proposed in my amendment. On that basis I am prepared to withdraw the amendment.
Amendment, by leave, withdrawn.
I move amendment No. 16:
In page 14, between lines 14 and 15, to insert the following subsection:
"(2) Any fee which may be charged by the Board pursuant to paragraph (b) shall increase by a percentage of not more than the percentage increase in nurses' salaries during the preceding year."
None of us is anxious that a fee be imposed on any person in respect of enabling him to work, especially on persons who may have registered some years ago and who were of the opinion that that was the last time they would be asked to pay a fee for registration. However, if the fee is to be introduced there must be some control in regard to its being increased, whether the increases occur annually, at three-year intervals or at five-year intervals. The amendment would have the effect of keeping some control on the level of the increase in the fee.
In respect of the medical profession the fee was introduced in 1981 at £15. Now it is £38. That was a very rapid escalation. We would not wish that sort of development to follow in the case of nurses. The amendment would go a long way to assuaging the fears of nurses that if even a modest retention fee is accepted, it may escalate in the second year to perhaps 10, 20 or 100 per cent greater. We should introduce some system whereby the level of increase would be controlled.
Acceptance of the amendment is the least we could expect of the Minister in this matter. Those nurses who are already registered have been of the opinion that they were registered for life. The Minister reminds us that we are not talking of life membership of the GAA. Up to now nurses registered on the completion of their training and no further fee was involved in that respect. Therefore, it is understandable that they are perturbed that in this Bill the Minister is providing that they must register each year. The Minister has expressed the hope that the provision would not be regarded as a tax-gathering device but that is how it is being regarded by a considerable number of the nurses concerned. They would like to know what advantages will accrue to them on foot of this annual registration fee. When a nurse completes her training she is deemed to be qualified and that remains the position regardless of whether she pays a fee. If this Bill goes through in its present form many nurses will regard the fee as something they must pay in order to be permitted to work.
The Minister referred to the register but I do not know what value the register is so far as individual nurses are concerned. It is useful to the Department and perhaps because of that they might consider paying for its compilation.
I wish to raise also a couple of practical points. What is to be the position of those nurses who are working on a temporary basis and in some cases, for only a couple of weeks in the year? Also, a very considerable number of qualified nurses are unemployed. Are all of these to pay the full registration fee? In many cases the nurses concerned would be on the lowest point of the scale. In these circumstances I have considerable reservations about the imposition of a fee. At the very least, the Minister should accept the amendment.
I, too, support the amendment. We should not leave the question of the fee open-ended because to do so would result in the fee increasing by leaps and bounds each year. Deputy Faulkner raised the valid point about the large numbers of nurses who are out of work and also those who work on a temporary basis, perhaps only for a month each year. It would be very unfair to nurses in that situation if they were expected to pay a fee that increases annually.
I agree also that we should not leave this question open-ended. We have the experience of the Medical Council who were set up not so long ago. Already the doctors are complaining about the escalation in their fees in that regard. We do not hear of large numbers of doctors being unemployed but there are 2,000 nurses unemployed. In those circumstances nurses should be given some measure of assurance that the fee will not escalate to such an extent that they would be precluded from participating. I support the amendment.
Few would quibble with the spirit of what the amendment seeks to achieve but there are practical problems. First, the purpose of the fee clearly is to offset the cost of the administration of the register. It is regrettable but inevitable that there has to be any charge but the fee will not relate automatically to increases in nurses' salaries throughout the year. Over a ten-year period there could be either an inadequate or an excessive increase in registration fees. It may not be the right approach to put down a guideline for the Nursing Board. There is no point in having a dog and barking yourself. If the board is to have any function it would have to be responsive to the Minister particularly when the Minister may overrule the board in many respects to take cognisance of real income increases in the nursing profession. I agree with Members who have expressed disquiet about the analogies in other professional areas where the inevitable growth of empires which occurs on these boards means that the costs increase proportionately at a greater rate than one might reasonably expect. I am also concerned that the amendment as proposed might put an automatic obligation on the board to increase the registration fee. A court might interpret that section which says:
Any fee which may be charged by the Board pursuant to paragraph (b) shall increase by a percentage of not more than the percentage increase
as being an implicit order to increase the fees in line with inflation and I have no doubt that that is not what is intended here. Most of us would like any increases being pegged in some realistic ratio to the increase in the salaries of nurses. I am not convinced that this formula is the proper one. Also, there would not be automatic agreement about the percentage increases in nurses' salaries during the preceding year. There are many categories of nurses and many categories of increases.
I recall Members on the other side of the House arguing vehemently for index linking of fines in the criminal justice area and that sort of reply was advanced, that there are always conflicts about the economic indicators. If a general directive is given to the board which takes into account the perceived percentage increase in nurses' salaries and if the Minister watches that carefully and takes action when appropriate that might meet the need rather than the insertion of an amendment which might not meet what it is designed to do and which might be interpreted in a malevolent way to do something else.
I agree with Deputy Keating. I would be worried in case the insertion of this amendment would hint to the board that they should increase the fees annually. We cannot dictate to the board but we should try to get across to them that they should find a way to register nurses who wish to work and find a way of ensuring that people who are not working when they register but wish to keep themselves available for work do not have to keep paying for registration. This amendment if put in would encourage the board to increase the fees annually. Deputy O'Hanlon may be able to get rid of my fears about this but what he should say to the board is that they should find a way to have a register with a sliding scale for people who are not actually working but who wish to retain their names on the register. I can see great justification in the complaints of nurses that people who are not working will have to continue to pay the registration fee each year. I cannot suggest a way to ensure that the board do not keep increasing the fees but this amendment will not do what Deputy O'Hanlon would like it to do.
I am intrigued with Deputy Owen's performance. Is she seriously suggesting that this side of the House should do her job for her? On two occasions she has made reference to what Deputy O'Hanlon should do in relation to the board. In view of what the Deputy has said I suggest that she should transfer to this side of the House.
The Deputy has not convinced me that this amendment will do what he says.
The Deputy should try to convince the Minister of her view and not expect us to do it for her.
(Interruptions.)
I, like other speakers, would express my reservations——
(Interruptions.)
Deputy Ormonde, without interruption, please.
You say one thing, and vote the other way on a number of Bills. There is hypocrisy there.
(Interruptions.)
I, like many speakers am apprehensive about the open-ended situation of a retention fee. Nobody would deny that there should be a retention fee. If we want to make the board masters of their own destiny we must put them in a situation to finance themselves. What I am afraid of and what most speakers are afraid of is that this thing will take off. Deputy Alice Glenn made a reference earlier to the Medical Council, about which I know something as I have to pay the fee. In 1981 the retention fee on the Medical Council was £15 and in 1984 it is £38. If there is not some control on the annual retention fee it can shoot up out of all proportion. When I qualified, I paid a fee of £15 per year and I wrote a cheque for £342 last month in relation to that fee.
I would urge the Minister to take our views into consideration and to consider Deputy O'Hanlon's amendment or some recommendation to hold the fees at a reasonable level. Perhaps the fee should apply for the duration of the board to be increased by a percentage thereafter in relation to the percentage increase of nurses' salaries. There should be some provision to prevent the spiralling that will otherwise take place.
In relation to what Deputy Faulkner said about those in temporary and part time employment, we must make some provision for them and for the people who are unemployed. Unfortunately due to the lack of funding from the Department of Health to the various hospitals and the major shortfalls we will see in 1985, there will be major cutbacks in employment. We must take the unemployed nurses into account. They should not be expected to pay a retention fee similar to that paid by working nurses. Might I make one last plea to the Minister as somebody who suffered in relation to the retention fee to be paid to the Medical Council. I would urge that plenty of notice be given to those on the register. As in the case of the Medical Council, non-payment of the registration fee to An Bord Altranais means that one will find oneself omitted from the register. Unfortunately I discovered that the hard way last year when I omitted to pay my fee.
It is difficult to describe the kinds of expectations we have of An Bord Altranais. In some respects we, the legislators, suffer from a kind of Walter Mitty or perhaps a split personality complex when it comes to expectations of the board. On the one hand we want to have a board performing the job we all want to see undertaken— and we all have a very good idea of what we want them to do — while, on the other hand, we are not going to trust them to do the job. In terms of the retention fee, what it boils down to is: do we trust An Bord Altranais to establish reasonable fees for the variety of purposes for which they determine professional standards? Do we or do we not? We have got to make up our minds. That is the basic issue. I shall have every confidence in An Bord Altranais, in their composition, to act in a reasonable manner. We have taken legislative powers to so ensure. In respect of the initial fee, as is stated here, the consent of the Minister for Health of the day is required.
That does not show much confidence in the board.
It is a basic safeguard which is there and which I am sure Deputies would not want to hand over; in other words, for the initial registration fee the consent of the Minister will be required. Bearing in mind the exotic sensitivities of people about paying money in this country for professional purposes, I am sure the Minister for Health of the day will act with great sensitivity and compassion in that regard in terms of whatever proposals are put before him, even in respect of Medical Council fees of £320 per annum. For God's sake, a good radiologist would earn that amount for one hour's work.
Not if one is on unpaid leave of absence.
Let us be quite clear about it. When it comes to the nursing profession, needless to remark they are paid as much as radiologists. At present, for example, they must pay £45 in order to take the preliminary State examination, £55 for the final State examination; the registration fee, following their final examination, including their certificate amounts to £40; registration in second and subsequent divisions of the register costs £40. Registration for persons from outside Ireland is £45. The fee to sit for post-graduate examinations, for example midwifery or second registration for dual qualified nurses, is £55. Registration in the student index is——
What scale of fees are those?
They are the current scale of fees of An Bord Altranais. As I was saying, registration in the student index is £10 which would not break any farmer's daughter. The registration fee of verification for Irish nurses going abroad amounts to £30. It should be remembered that one must pay £5 to leave Ireland at Dublin Airport. Registration following removal from the register has not arisen.
I might also point out here that when An Bord Altranais submits applications for increases in their fees to the Minister for Health of the day; the Minister, in accordance with the prices legislation, must go to the Minister for Industry, Trade, Commerce and Tourism and to the National Prices Commission seeking their approval for such increase. This country being the incestuous administrative bureaucracy it is, nobody does anything without half a dozen other people formally agreeing to it. Therefore, I will have to go to my colleague, the Minister for Industry, Trade, Commerce and Tourism and to the National Prices Commission to seek approval for any such increase in fee by An Bord Altranais, by which time An Bord Altranais have gone bankrupt because it will take about three months to effect all of that. It is necessary. That is the procedure. There is nothing particularly obsessional about it. When it comes to An Bord Altranais, of course, they will have to take cognisance of the fact that a nurse may be unemployed and, as an unemployed nurse — and there are not 2,000 of them around because, if one puts an advertisement in the newspapers, one finds to the contrary. I was talking to the matron of a Dublin hospital the other day who had a vacancy for a theatre sister. She had 100 applicants, 94 of whom were working in other hospitals. This hysteria about 2,500 nurses being unemployed and so on is totally exaggerated. Incidentally not a shred of a nurse has lost a job since I assumed office in the past two years. I should like the Deputy opposite, the Southern Health Board and everybody else, to give me the names of the first ten nurses who lost their jobs in Ireland when, frankly — although within the privilege of this House — I would be tempted to pay them £10——
Is the Minister honestly suggesting that there are no unemployed nurses at present?
I will revert to the issue. We should stop nurse shroud waving. Certainly I would hope there would be a differentiation in fee payment for unemployed nurses as there should be for part-time nurses, nurses abroad and those who have retired who want to retain their status. I would even encourage such differentiation to be operative in the case of nurses on a career break and I know of nurses at present on a career break. I would contend that they should pay a lesser fee and that could be done.
Therefore, it is not a question of empire building in An Bord Altranais. At present An Bord Altranais is in a situation of being an emperor without financial clothes, collecting these fairly modest fees. It should be remembered that there are young nurses who would go on a Continental holiday, spending £300, at the end of a year's work and it would not cost them an awful lot of thought. Yet there are people screaming at me because they are asked to pay £20 to become a registered, professional nurse. It is a load of special pleading. I shall be keeping a very close watch, on behalf of the profession and of the Department, on An Bord Altranais who will look for the money. If they want to put up exorbitant propositions to the Department they will have to justify them line by line.
I might even contend that I could not accept at all the suggestion made by Deputy O'Hanlon that the fees should be related to the nurses' salaries. Why nurses salaries? Why not the consumer price index? Why not something else? The reason for any prospective increase in fees is that the board will need the money, justifying to themselves the need for such money. It should be remembered also that there will be on that board 90 nurses from all over the country, all fairly tough individuals in their own right. To get elected to An Bord Altranais one needs to be tough and remain tough to convince sufficient people to vote for one. One would need to be a fairly articulate, competent person to get elected in the first place; I have no doubt about that. Such members will not willingly face reelection five years later, having crucified the profession by massive increases in fees over the years, and have themselves put before the annual conference of the Irish Nurses Organisation. I have come before the Irish Nurses Conference, admittedly on a social occasion, and it is a fearful experience. But to be a delegate attending that conference endeavouring to justify massive increases in fees to one's peers would mean that one would get fairly short shrift. Therefore, An Bord Altranais must approach us, producing their financial projections for two to three years ahead. They have an excellent chief executive officer at present. He is not likely to go around stealing cheque books belonging to nurses or endeavouring to put student nurses into personal impoverishment, facing their mothers and fathers, while they endeavour to scrounge together enough money to pay their fees. That is not the intention. We should calm down and appreciate that we should not relate fees to nurses' salaries. I would be very much opposed to that proposition because, in any one year, they might not want to increase the fee at all; in fact they might even reduce the fee. It is not unknown for fees to be reduced in some instances, and increased in others.
It is a long time since anything was reduced around here.
Therefore I am glad Deputy O'Hanlon tabled his amendment but there is no great need for it. Its outstanding merit is that it has given us an opportunity of discussing the question of fees here. The subject has become quite a vexed one. The special pleading which has gone on on this issue is no more special than that which took place in relation to the fees of the Medical Council and other professional bodies. I can assure Deputy O'Hanlon that I do not think we shall ever reach the stage of sanctioning fees of, say, £320 per annum. That is not the intention.
Our concern is that nurses will not find themselves in a situation where their retention fee will go up by perhaps 100 per cent. It is important that we as legislators should try to ensure some control on the fees. The Minister said he would have to give his consent to any increase in fees, following approval by the National Prices Commission and the Minister for Industry, Trade, Commerce and Tourism. It is specified in section 24 that the Minister shall pay out funds with the approval of the Minister for Finance. There is no such provision in section 25. If the Minister were to write into the Bill what he has just told us it would go a long way towards alleviating the fears of the nurses and of this side of the House.
If the board decided they would not increase the fee there is nothing in the amendment that would oblige them to increase it. It merely provides that the fee should not be increased by more than the percentage increase in the salaries of nurses in the previous year. It would seem appropriate if there were to be an increase in fee that it should be an increase they could tolerate in keeping with the percentage increase they received in the previous year. I take Deputy Keating's point that different grades of nurses might receive different percentage increases but that is unlikely since most increases are negotiated nationally and most nurses are employed in the public service. There has been a tendency for similar percentage increases for nurses. It would be reasonable to take the average percentage increase. It is important to lay down some structure whereby nurses would not find themselves having to pay an increase of 50 per cent or 100 per cent.
In the final analysis the imposition of fees must have the consent of the Minister. He mentioned a number of categories such as part time workers, people taking career breaks and retired nurses and he agreed that there should be some kind of sliding scale. Can he give an assurance that if some kind of sliding scale is not included in any proposal which comes before him he will take into consideration the sentiments of this House and ask for that kind of scale to be brought in?
My fear would be that in the setting up of the board the initial thrust would be to get in as much money as possible so that the board could get off to a good start with adequate funding behind them. I do not think that is a good enough reason to start off on a wrong footing. I hope the Minister will not approve a scheme of fees which does not have special provision for people who are not working full time. My concern would be about women working in the home who might want to stay on the register.
The Minister said that the consent of the Minister was required. I know what he had in mind. He would have the responsibility for controlling any increase in the fee suggested by the board. What would the situation be if An Bord Altranais decided to charge an initial fee which the Minister did not consider to be high enough? Would he refuse to give his consent unless they charged more?
In relation to the point I raised about unemployed nurses or nurses who have only short periods of work, the Minister said that this would be taken into consideration in respect of the fee charged. The section states that the board may charge such fees as may, from time to time, be determined by the board, with the consent of the Minister, for the registration of a person in the register. If a fee is fixed for the registration of a nurse, how does the Minister suggest that the board will be entitled to charge a lesser fee to somebody who is in part time employment? It is not his interpretation or what he might desire that will come from this legislation, but rather the manner in which it will be interpreted by the courts if that is felt necessary. There is no suggestion anywhere in section 25 that a lesser fee can be charged to nurses on temporary duty.
It appears that the House is generally favourable to the spirit of Deputy O'Hanlon's amendment. Deputy Owen and Deputy Keating said they were perturbed about the wording. None of us is an expert parliamentary draftsman and if it was found that the drafting of the amendment was not perfect I am sure Deputy O'Hanlon would be satisfied with a guarantee from the Minister that the spirit of the amendment would be accepted and that he would come forward with a properly drafted amendment to the same effect as Deputy O'Hanlon's amendment.
I do not think it is fair that the House should allow the record to contain the Minister's expressed opinion in relation to the numbers of fully qualified nurses who cannot obtain employment at home. I was astonished to hear the reference the Minister was making to unemployed nurses. I would refer the House to a statement issued only a few weeks ago by the general secretary of the Irish Nurses Organisation which clearly indicates that there are 2,500 registered nurses unemployed. I do not know whether the Minister read this statement.
The Minister made a passing reference to unemployment among nurses in speaking on the amendment relating to fees. I presume that Deputy Flanagan will make a similar passing reference.
Mine is a passing reference to correct the statement made by the Minister. If the Minister is right, then the general secretary of the INO is wrong. I wholeheartedly accept the statement of the trade union representing nurses that there are 2,500 unemployed nurses.
Progress reported; Committee to sit again.