As amendments Nos. 1, 2, 3 and 4 are related they may be taken together.
Nurses Bill, 1984: Report and Final Stages.
I move amendment No. 1:
In page 8, line 5, to delete "27" and substitute "29".
It is disgraceful that on a very important Bill such as this, the Government Deputies have left the Chamber.
This is not a point of order.
Perhaps we could at least have a House.
Notice taken that 20 Members were not present; House counted and 20 Members being present,
Deputies will recall that on Committee Stage I indicated that I would be prepared to increase the representation of the clinical panel from one to two for general nursing and psychiatric nursing but that I could not go beyond that increase from 27 to 29 because to do so would unduly enlarge the board. The amendments make the necessary provision to increase the overall membership of the board from 27 to 29 and to increase the clinical panel from five to seven.
I should like to make a couple of points in relation to the section as it will be following acceptance of the amendments and relative to matters raised specifically on Committee Stage. At that time Deputy Kelly queried a number of issues and asked for elaboration as to the rules for election. He asked, for example, who would be entitled to vote for the elections. He asked if the rules would specify the minimum experience required for election to the clinical panel. In general it is intended that nurses from particular disciplines — for example, general nursing, psychiatric nursing and mental handicap — will be eligible to vote for the candidates representing those disciplines in the three panels. Where nurses have multiple qualifications — for example, where they are qualified for general nursing or midwifery or for general nursing and psychiatric nursing — they would be given the option as to which discipline they wished to vote for. The intention is to ensure that a nurse will be able to vote for candidates representing the disciplines in which he or she is practising whether in the teaching, administrative or clinical areas.
The prescribed qualifications and the minimum period of experience both for eligibility for election and for entitlement to nominate will be specified in the rules. The present board's rules specify prescribed qualifications with a minimum of three calendar months experience for entitlement to nominate and two years experience for eligibility for election.
Deputy O'Hanlon asked me to look on Report Stage at the possibility of providing in the Bill that the Department's nursing adviser would be officially a member of the board. The Deputy will recall that he related my comments to the embargo problem. While I have every intention of appointing the Department's nursing adviser to the first board, I am reluctant to nominate one of the Department's appointees as a nursing adviser in the Bill because there may not always be a nursing adviser in that post at the time of nomination. A vacancy might occur and the competition might not produce a suitable candidate for some time or there could be considerable delay between a vacancy arising and a person being appointed. I thought I would deal with all these points at this stage because we are restricted in our interventions on Report Stage.
I welcome these amendments, but they do not go far enough. The Minister is increasing the number of nurses engaged in clinical practice and general nursing and is increasing the representation of nurses in clinical and psychiatric nursing by one. We welcome this. It is important that nurses in clinical practice should be properly represented on the new council. There are approximately 25,000 nurses who are so engaged representing the largest section of the nursing profession. I should like the Minister to tell us what category of nurses will be included in the nurses engaged in administration and in training. As it is important to ensure that there is broad representation on the nursing council, these categories should be wide. For example, would a sister in charge of a ward be considered to be involved in teaching or administration? If the Minister took a liberal interpretation of teaching and administration this would go some way towards having a better representation of all the nurses involved in clinical nursing practice.
It is disappointing that the Minister has not acceeded to our request to change the composition of the 12 members of Bord Altranais which he appoints. I can see no reason why it should not be written into the legislation that one of the two persons appointed from the Department of Health should not be the nursing adviser. The Minister said there could be a vacancy and that these might not be anyone to fill it. When the Minister took office there were three nursing advisers in the Department but now, directly as a result of the embargo, two of the posts became vacant and were not filled. That is why there is only one nursing adviser there at present. Surely the Minister does not contemplate doing away with the post of nursing adviser altogether. From what he said today it would appear that we can expect that if a vacancy occurs it may not be filled for a long time. Therefore there would be no nursing adviser in the Department and consequently there would be a vacancy on the board. The Minister was responsible for reducing the number from three to one and I would have thought that if a vacancy occurred it would be filled rapidly and that the board would not suffer as a result.
I ask the Minister to reconsider that. If the role of nursing adviser means anything surely that person should be on the board which will regulate the nursing profession. She should be in a position to know their views on the various aspects of nursing activity so that in the preparation of legislation, regulations or whatever she would be in a better position to advise the Minister.
We welcome the amendments as far as they go.
If the Minister speaks now, that will conclude the contribution on these amendments.
I wish to offer.
Just to clarify the position, on Report Stage the Member who tables the amendment has the right to speak in introducing them and has the right to reply to the debate. However, when he speaks for the second time in replying to the debate there can be no further contributions on those amendments.
As Deputy O'Hanlon so ably put it in relation to the proposed amendments, we would like to know where these people will be appointed from and what their role will be. The Minister is aware that in the constituency of Dún Laoghaire we had a full discussion, lasting for over two hours, with a very large and representative group of the nursing profession. Loughlinstown, County Dublin, is probably one of the finest hospitals, in medical and staff terms, which we have in the country. If that meeting is representative of the views of the medical profession nationwide the Minister would be wise to take account of what Deputy O'Hanlon said.
I support Deputy O'Hanlon, the Fianna Fáil spokesman on Health, in relation to what he said and I ask the Minister to take serious note of it.
I am not certain whether the Minister was present but there was a very strong undercurrent of dissatisfaction and disaffection at that meeting in relation to the membership of the board and the type of representation which would be given on the board. If we are dealing with a Nurses Bill it should be nurse-orientated, and the professionals, in the final analysis, are the people to be consulted and subsequently appointed. If there are to be additions to the board, nurses should be appointed and that is the thrust of the contribution by the Opposition spokesman for Health. That is a good point in the sense that he is supporting a profession which the nation has not taken into account over the years. I put the nursing profession on a par with the medical profession and that is paying both of them a compliment.
I support Deputy O'Hanlon and ask the Minister to take account of the fact that there is a very strong feeling in the constituency of Dún Laoghaire and south County Dublin generally regarding the views expressed by Deputy O'Hanlon. I am not attempting to intimidate the Minister by saying that and anyway I do not think he would be intimidated. If the Minister has a point of view in relation to any area he should stick by it, taking account of the views expressed by various groups, in this instance, the nursing organisation in his own constituency. If he does not agree with them, so be it. We appreciate the Minister's integrity and I am not attempting to move him in a direction in which he does not want to be moved. I also wish to pay the Minister this tribute, that when he makes up his mind to do something he does it.
I welcome the amendments on the basis that they consititute an improvement in the representation on the board. Having regard to the tremendous implications in the Bill and the importance of having a confident, contented nursing profession, an improvement in the representation on the board is obviously worth while.
I agree with the sentiments expressed by Deputy O'Hanlon and Deputy Andrews in relation to this matter but I should also like to refer briefly to the queries raised by Deputy O'Hanlon in relation to the particular categories of nurses which might be represented. Would it be at senior or junior level? Would there be representatives at matron or junior training level? This is important because the constitution of the board will affect their attitudes and it is important that the nurses represented have confidence in the people appointed to represent their views in so far as they can. I fully appreciate the Minister's right to ensure that all aspects of the services, especially health services, are updated and streamlined to meet modern requirements to provide an efficient and effective health serivce. It is, nonetheless, equally important to have the confidence and support of the people involved in providing the service as, without that, it could be extremely difficult to implement it. I hope that the Minister will ensure that the nursing profession are adequately represented at all levels in the service, thereby giving a fair representation.
I also welcome these amendments. On Committee Stage there was quite a long discussion on the representation of nurses and I had a number of amendments down in this area. While this amendment does not fully meet the provisions of my amendment, it goes some way towards them because my main argument is that the vast majority of nurses are in the general nursing and psychiatric areas and the representation given to them in the original Bill was not in accordance with their numbers. Much higher representation was given to nurses engaged in training, administration and so on. In regard to the general body of nursing, there will be one extra from the general nursing and clinical practice and one extra from those engaged in the practise of psychiatric nursing. Those two areas absorb perhaps 90 per cent of nurses and, while they are not represented in accordance with their great weight of numbers, they certainly have a stronger representation.
I should like to assure Deputy O'Hanlon that I am not excluding ward sisters from eligibility for the administrative or teaching panels of the board. Regarding the issue raised by Deputy Andrews and Loughlinstown Hospital, one of the biggest problems in the Bill has been the quite exceptional difficulty I have had in explaining to the nursing profession what has happened since 1950 and what is needed now in terms of a body which is not a negotiating body. It is not composed of 50 per cent from the employer side and 50 per cent from the workers' side. It is not a joint industrial council. Many nurses at the trade union end of the INO or the psychiatric nursing organisations hold that view but this body are essentially dealing with the question of training and fitness to practise, registration of nurses and the general provision for education of nurses and persons engaged in those differing professions.
This body will consist of 29 people, a very large board. There will be five nurses on the board engaged in training nurses — one from general nursing, one from paediatrics, one from the psychiatric side, one from the mentally handicapped side and one from midwifery. These are speciality areas and we have to have one from each. Then there are five nurses engaged in nursing administration — one general nursing administrator, one from the administration of public health nursing, one from the administration of psychiatric nursing, one from the midwifery side and one from the mentally handicapped side. As amended, now there will be seven on the clinical side — one from each of the following specialities: general, psychiatric, midwifery, public health and mental handicap. There has to be a balance because all hell would have broken out if the various specialities did not have representation. I know general nurses ask why they do not have greater representation but the purpose is to develop the profession, not simply to have a pro rata representation in accordance with the number of general nurses in the overall profession.
I can see the point which has actively stirred the minds of a large number of nurses and I can see why so many ask why they should be told what to do in their professional practice by nurse administrators or by the three doctors on the board of 29. One doctor will be a specialist on the psychiatric side, one on the obstetric side and one on the general side. In this country, unfortunately — and I want to repeat this — we have a fragmentation of professional isolation. Politicians themselves are an example of this. Everybody wants to be closetted exclusively in his own professional role and is very reluctant to have an interaction with other professional structures.
With the 17 directly elected nurses and three doctors there will be representatives from the following specialists: one from the management of health boards, one from the management of hospitals, other than hospitals administered by the health boards, obviously a person from the voluntary hospital, two representative of the Department of Health, one person from the nursing side and one experienced in the field of education, two representing the interrests of the general public, one representing third level educational establishments, and one additional nurse. I think the profession is very effectively represented in a balanced way in section 9 and accordingly I recommend the amendments to the House. Amendment agreed to.
I move amendment No. 2:
In page 8, line 34, to delete "five" and substitute "seven".
Amendment agreed to.
I move amendment No. 3:
In page 8, line 36, to delete "one" and substitute "two".
Amendment agreed to.
I move amendment No. 4:
In page 8, line 38, to delete "one" and substitute "two".
Amendment agreed to.
Amendment No. 5. Amendment No. 6 is consequential on No. 5. Amendments Nos. 5 and 6 will be taken together by agreement.
I move amendment No. 5:
In page 15, between lines 18 and 19, to insert the following:
"(4) Every person who is a national of a Member State and has been awarded a qualification in nursing in a Member State which, pursuant to the provisions of any Directive adopted by the Council of the European Communities, the State is obliged to recognise, shall, on making an application in the form and manner specified in rules made by the Board, and on payment of such fee as may be so specified, be registered in the register.".
These amendments provide for the deletion of section 29 and the inclusion in section 28 of qualified EC nationals. The amendments arise out of the Committee Stage debate on those two sections which led to questions being asked about two issues: first, whether the persons mentioned in section 28 (3) will be automatically registered and, secondly, if the saver provision in section 28 (4) is intended to cover EC nationals at present referred to in section 29. I indicated on Committee Stage that I would consult with the parliamentary draftsman before Report Stage. I have now done so and have been advised that it would be preferable to delete section 29 which is not, as at present drafted, included in the provisions of section 28 (4) and recast section 28 to include EC nationals among the other categories of persons eligible for registration comprehended in that section. This would also mean that all persons eligible for registration would be subject to the provision in subsection (4). The effect of the amendment is to tighten up the functions of the board in relation to registration and to bring the provision into line with the analogous provisions in the Medical Practitioners Act and in the Dentists Bill.
I support this amendment because its effect will be to ensure that everybody who registers will have to fulfil the same conditions. In the original Bill a nurse who is a national of a member state of the European Community could conceivably be registered without having fulfilled the same conditions as other nurses. But why did the Minister change the wording from "Every nurse who is a national of a member state and has been awarded a qualification in nursing in a member state..." to "Every person who is a national of a member state and has been awarded a qualification in nursing...". Is there any specific reason for that?
I welcome this amendment, but will it mean that State-enrolled nurses will qualify under this heading? This has been a contentious issue for some considerable time and begs the question whether this will allow State-enrolled nurses to compete for registration alongside State-registered nurses.
The Minister mentioned a drafting point in the proposed amendment. My colleague, Deputy Geoghegan-Quinn, said this is lifting the first part of section 29 to become section 28 (4). As I said, this is a drafting point and I do not wish the Minister to think that I am being pernickety about this, but sometimes the intended meaning is lost in the drafting. That is why I offer my piece of wisdom, or unwisdom as the case may be, in relation to this drafting point. "Every person who is a national of a member state and has been awarded a qualification in nursing in a member state which, pursuant to the provisions of any Directive adopted by the Council of the European Communities, the State is obliged to recognise..." I think the words "the State is obliged to recognise" are wrongly placed in this sentence. This is awkward drafting. I would juxtapose the phrase "that the State is obliged to recognise every person whom the State is obliged to recognise" and "who is a national of a member state" and so on. I appreciate that the parliamentary draftsmen or women have to do their job and have to produce the meaning which the Minister intends to give to a particular section of a Bill. I offer my views in the sense of helpfulness rather than obscurantism or obstruction. For that reason I would ask the Minister to comment on the suggestion of the proposed curing, as I would see it, of what appears to be a defect in the continuity of the sentence.
I also welcome the Minister's amendment. Deputy O'Hanlon and I, on Committee Stage, pressed strongly that what was section 29 of the original draft be included under section 28. The Minister promised to come back on Report Stage if it was felt to be necessary. I am glad that he has done so.
Could I ask the Ceann Comhairle for a ruling on a point of order in regard to Report Stage? Are we confined merely to discussing the sections for which there are amendments put down, or can we refer now to sections which were discussed on Committee Stage and where the Minister made a reference to what he might do on Report Stage?
The debate is more confined than that, in fact. Contributions are confined to the amendment alone, but I imagine that it would be very hard to prevent Deputy Mac Giolla from saying something about the section out of which the amendment arises — certainly not beyond that.
On Committee Stage, at various points in the debate the Minister said that he would have a look at that matter on Report Stage. I marked a number of instances where he mollified the Opposition by saying this. Section 12 was one of these, where he said that it would be examined on Report Stage to suggest a date or time at which the first meeting of the board would be held. He has not commented. Would he comment on why he felt it was necessary to do that?
With regard to the amendment to section 28 to include the former section 29, I would refer to another point raised on Committee Stage on that section 28. The Minister has conceded and included this section, but subsection (4) of the old Bill which under the amendment would be after that amendment, says that "Nothing in this section shall operate to prevent the Board from refusing to register the name of any person,"— that would include any person referred to in this amendment —"who is otherwise entitled to be registered, on the grounds of the unfitness of that person to engage in the practice of nursing." I recall well and took a note that on Committee Stage it was suggested that the Fitness to Practise Committee should be consulted by the board before such a decision was made.
I remember that being dealt with on Committee Stage. That would open up an entirely new matter which is not being dealt with by the Committee, as far as this Chair can decide. The Chair will be ruling that we are now dealing only with amendments 5 and 6. Amendment 5 deals with the registration here of nurses qualified in other member states whose qualifications are acceptable here. Amendment 6 deletes amendment 29. If these were discussed it would open a wide debate on section 28, which was dealt with on Committee and which has not been questioned here.
Previously, people who are nationals of a member state and who have been awarded a qualification of nursing were not included under section 28.
If I might put it this way — as the Chair sees it, section 28 is accepted and has not been queried except in so far as the amendments now apply to that section to people it did not apply to before.
Right. Under section 26 before, it did not apply to persons who are nationals of a member state and have been awarded a qualification in nursing in that member state pursuant to provisions of any Directive adopted by the Council of European Community. By accepting this amendment on Report Stage, those people, despite the fact that they have a qualification in nursing in a member state, will now be covered by a clause in subsection (4) of section 28 which says that nothing in this section will prevent the board from refusing to register any of these people who have a qualification in nursing in a member state of the EC on the grounds of unfitness to engage in the practice of nursing. The board can still refuse to register them on the grounds of unfitness to engage in the practice of nursing.
I am suggesting that the board should not be entitled to refuse to register the names without referring to the Fitness to Practise Committee. This matter was raised on Committee Stage in connection with people in the nursing profession at home and was not accepted by the Minister. I am asking if he would accept that people who have full qualifications for nursing in member states could not be refused registration on the grounds of unfitness to practise without the board first having consulted the Fitness to Practise Committee. I do not see the purpose in having such a committee if the board can make decisions without consulting them on the particular issue of fitness to practise. We made this point on Committee Stage in relation to nurses generally on the register. I still feel that should be done with regard to such nurses. However, I am prevented from making that point now. I can only make the point in connection with the amendment——
The Deputy's contribution is quite in order and has been so for some time.
Since we have a fitness to practise committee I am asking that the board could not refuse to register the name of a person on the grounds of unfitness to practise without first consulting the committee.
I should like to be associated with the words of welcome for the change in this case. It is important not just that there should be common registration for every person, whether trained in the State or outside it or whether they are nationals or non-nationals, but it is also important that it should be seen to be done. Will the Minister confirm that the only reason the word "nurse" in section 29 has been changed to "person" in the new subsection is to bring it into line with the other subsections in section 28 which used the word "person" rather than "nurse".
Regarding the change from the word "nurse" to "person", I can assure Deputies that it is the view of the parliamentary draftsman that it would be a much more effective statement of statutory intent for the simple reason that a person who is a national of a member state is not a nurse until that person holds a qualification in nursing of the member state and then becomes a nurse. The reason for the change was to make the wording more precise. As Deputies know, the parliamentary draftsman jealously guards his right with regard not only to the composition of the section but also as far as wording is concerned. The change is purely for the purpose of clarification. The rest of the section differs slightly from earlier similar provisions in medical and dental legislation because different draftsmen were involved. However, the meaning is exactly the same.
With regard to the points raised by Deputy Mac Giolla, I know the amendment may give rise to comment on the need for protection for nurses or persons seeking initial registration against an adverse decision of the board under subsection (4). As Deputies will recall, there was considerable debate on Committee Stage about the advisability of the board notifying a person of their intention to make a decision under subsection (4) in order to give the applicant an opportunity to appeal to the board before the decision was made. The provision in the section is for the person to appeal to the High Court after the decision is made and notified to him. Deputy Mac Giolla in particular was anxious that the person concerned would have the same rights and protection as that afforded in the part of the Bill dealing with the fitness to practise committee with regard to the registration of nurses.
I agreed it was most desirable that the person be informed in advance of the intention of the board not to register him or her and I undertook to direct the board to incorporate procedures in their rules for registration to this effect. I want to convey that assurance to Deputies once again. I would be reluctant to build in all procedures into the Bill itself but they can be incorporated in the rules, especially in relation to persons applying for initial registration. It could happen that a person who was clearly unqualified would apply, in which case the board would be within their right to refuse registration. Deputy Kelly raised that point on Committee Stage.
I repeat to Deputies my assurance that I will insist on the board setting down procedures for informing qualified nurses of their proposed decision not to register. Perhaps I can write to Deputies with regard to the points raised by them. I have some difficulty in relation to the Bill because many points were raised on Committee Stage and I undertook to comment on them on Report Stage. However, under the rules of the House the debate is rather restrictive in that regard and I may have to write to Deputies on the points they raised.
Amendment agreed to.
I move amendment No. 6:
In page 15, to delete lines 40 to 46.
Amendment agreed to.
I move amendment No. 7:
In page 16, lines 7 and 8, to delete "or shall, whenever the Minister so requests,". As Deputies are aware, this section was opposed on Committee Stage by Deputies O'Hanlon, De Rossa and Mac Giolla and I indicated I would be prepared to delete the phrase "or shall whenever the Minister so requests". The effect of the amendment is substantial. It leaves discretion entirely to the board as to whether they will establish a register for ancillary personnel. I have gone part of the way towards meeting the wishes of Deputies in relation to section 31.
As the Minister has said, he has gone part of the way towards meeting the opposition to the section from this side of the House. Section 31 is probably the most important section in the Bill because under that section a decision will be made on who is entitled to have their name entered in a register of nurses. This section gives the board the power to register the names of persons in a profession or calling which is ancillary to nursing. We welcome the fact that the Minister has removed from the section the power he was given to whatever Minister would be in office to request the board to register; but I do not understand why the Minister has not removed the other part of the section that we wanted removed, namely, that his consent is still necessary. We asked the Minister to remove the words "with the consent of the Minister". The Minister has told us the discretion is now entirely with the board but that is not absolutely correct because they still need his consent. I do not see why that should be necessary. The end of this section reads:
and the provisions of this Act, subject to such modifications as may be specified in rules made by the Board, with the approval of the Minister, shall apply to any such registration.
That gives the Minister a certain amount of power — to which we are not objecting — in the rules that would be approved by him. I do not see that it is necessary for the Minister to give his consent to the board in regard to whom they might wish to register. We have already spent a long time debating the composition of the board and the Minister did amend the section to ensure that the board would be more representative. I believe we should show confidence in An Bord Altranais, leaving them discretion to decide whose name should be registered in a register of nurses. We believe that only those who are qualified nurses should be registered in a register of nurses. The Minister should delete the other part of that section we opposed at the time, namely, that his consent is necessary before the board register any person or category of persons in the nursing register.
I welcome the Minister's amendment, which appears to delete what is probably the most offensive phrase in the Bill as far as nurses are concerned. It is reasonable that the Minister would want to retain power at least to look at what the board might be doing in that matter and give his consent, but they would be initiating the proposals. What appeared in the original drafting was that the Minister could order the board to register whomsoever he wishes. That has been deleted and improves the section enormously.
In regard to the procedures on Report Stage, I am sure the Ceann Comhairle would not have stopped the Minister had he made a comment on the various sections on which he said he would comment or re-examine——
I am afraid I would have had to because, if I were to allow comment on each section, we would really be going back over Committee Stage.
There was considerable debate on a number of matters. For example, it is very unfortunate that the Minister could not comment on why, a few lines above that, he has not changed "whenever" to "before" which would have been a very important alteration and which would mean that people would know beforehand whether they were being struck off the register. It is unfortunate that promises were given on Committee Stage and we have gone over quite a number of sections where such promises were given by the Minister. What is the point of the Minister saying on Committee Stage that he will look at it again, requesting his draftsmen to re-examine it, if he does not then come back and comment on Report Stage? In the future I hope some method can be devised whereby, when the Minister says so, he will be enabled to adhere to his promise.
There is a method open to Deputies. In accordance with the rules they can put down amendments on Report Stage concerning matters raised on Committee Stage but which had not then been decided.
You are quite right, a Cheann Comhairle; it is understood now. But when one debates an amendment on Committee Stage over a long period and the Minister finally says "I will have a look at that again on Report Stage" one does not put down another amendment, one assumes that the Minister will do this. Now it is obvious that, in order to do so, one must put down the same amendment on Report Stage. I have learned that much. At least in regard to this section the Minister has done what he said he would do and it is much improved.
This was a very controversial section in the original Bill, as drafted, giving rise to much comment and anxiety on the part of Members who contributed on Second and Committee Stages. The amendment now proposed by the Minister overcomes the difficulty. The main problem, as I saw it, was that the Minister could request registration. These people were referred to as second class nurses, a sentiment with which I did not agree. The Minister's proposed amendment overcomes that problem. The Minister is correct in retaining a certain power to have a look at the register if the board decide to register people who are ancillary to nursing. That amendment should be acceptable to all concerned because it eliminates a power that could be abused by any Minister. This amendment means that the Minister reserves the right to have a look at it. The Minister should be entitled to retain that power.
I should like to support the amendment proposed by the Minister on the basis that it is not unreasonable to expect that a Minister will have some control or that there be some provision for the granting or withholding of his approval. His consent is acceptable. I fully agree with the deletion of the words "or shall, whenever the Minister so requests,". Were this phrase to remain it could lead to a certain amount of abuse or leave the way open to allegations of abuse. The Minister's amendment leaves sufficient room for control to be exercised by him and his Department, at the same time eliminating an area which might have led to suggestions of abuse of that control.
I have sympathy with Deputy Mac Giolla's points. I can assure him that I have delivered on any assurances in terms of actual amendments I promised on Committee Stage. I have put down no less than 13 amendments for Report Stage. There has been no reluctance on my part to elaborate repeatedly on various sections.
In regard to the viewpoint of Deputy O'Hanlon that ministerial consent should be removed from the first and second lines of this section, I might make the point that the consent of the Minister of the day is also necessary to the establishment of the named register in so far as the Minister must approve the rules of registration. It would be unwise of the House to suggest that that should be deleted from this or other sections. In very large measure An Bord Altranais is a self-regulated body. Unless the Minister of the day was a most pernickety or bureaucratic individual, or his officers deteriorated alarmingly in the interim, it is unlikely that there would be enormous circumspection exercised by the Minister over the rules. By and large, the consent of the Minister will be readily given on the vast majority of occasions.
That is why I am very anxious to get ahead with setting up the new Bord Altranais as quickly as possible. Therefore, I commend the section as now amendment to the House. I consider it a reasonable amendment. Section 31 is a forward looking amendment taking into account eventualities which may never happen but if they happened would at least provide a framework for dealing with them under the Bill.
Amendment agreed to.
Amendment No. 8. Amendments Nos. 12 and 13 are cognate. Amendments Nos. 8, 12 and 13 will be discussed together by agreement.
I move amendment No. 8:
In page 17, line 10, to delete "Every hospital, institution or body" and substitute "Every hospital or institution".
As a consequence of Deputy O'Hanlon's query on Committee Stage concerning the absence of a reference to "body" in section 35 (1) while it is included in sections 35 (3) and in 37 (1) (a) and (c) the parliamentary draftsman was consulted and his view was that the reference serves no useful purpose and should, accordingly, be deleted. The effect of these amendments is, accordingly, to remove the word "body" from sections 35 (3) and 37 (1) (a) and (c). The parliamentary draftsman considers that "institutions" adequately covers training areas other than hospitals.
Amendment agreed to.
I move amendment No. 9:
In page 17, line 26, after "nurse" to insert ", but in the selection of candidates for nurse training, no candidates shall be selected without the approval of the Training Schools".
This amendment is an amendment to section 36 (2) which states:
The Board may, if it so determines, establish a central applications bureau to process applications from persons wishing to undertake training as a nurse.
My amendment would add after nurse:
, but in the selection of candidates for nurse training, no candidates shall be selected without the approval of the Training Schools".
We would welcome the setting up of a central applications bureau to receive applications and to process them to ensure that the applicants qualify under subsection (1) of section 36 which gives the board the power to determine the minimum educational requirements necessary for entry to training as nurses. We believe it is only right that there should be some central method of receiving applications. The present method is most unsatisfactory, where the boy or girl who wants to train as a nurse writes to one of the training schools and usually receives a reply in the negative, that there are not any places or the training school are not taking in trainees in that particular year. We feel it is only right that applicants should apply to one central bureau for the purpose of having their applications processed.
This side of the House are very concerned that there would be a situation like there is in the universities where the central applications office decide the particular university the students will go to based on the number of points. People with a certain number of points go to one university and those with a lower number of points go to a different university. On Second Stage the Minister drew an analogy with the universities. The important thing about training of nurses is that it is an employer-employee relationship. The student nurse is an employee of the hospital and the hospital must have rights as an employer and must have those rights protected. It is also important in a hospital that the hospital should have the right to protect the character and ethos of that particular hospital. This was written into legislation in the Hospitals Federation and Amalgamation Act, 1961, which stated that "the Council shall take no action which would operate to interfere with the autonomy of a nursing school attached to any participating hospital of a particular denominational character". That was the sentiment expressed by this House in 1961. I have no doubt that it is still the view of the majority of Members of this House.
In this particular subsection we are moving away from that and we are giving the power to the nursing board to select students and to send them to any hospital they like without any reference to the character and ethos of the particular hospital and without giving any rights to the hospital as a training school attached to the hospital, which would be an employing authority, because it is an employer-employee relationship.
When we were discussing section 36 on Committee Stage the Minister said the central applications bureau must be something more if it is to have any meaning in the training of nurses, that it must mean something more than just collecting applications and processing them in relation to educational standards. When we were discussing section 52 and he was pressed by Deputy Tunney and Deputy Glenn, who were concerned about the effect of that particular section on the ethics of the hospital, the central applications bureau was debated again, and the Minister then said that he could assure the Deputies that section 52 "does not interfere with the freedom of health agencies — and voluntary hospitals are part of those agencies — to insist that their code of ethics shall predominate in respect of employment in their hospital. That is already there in terms of the common contract for consultants".
The Minister gave an assurance to Deputy Alice Glenn and Deputy Tunney that the status quo would be maintained at voluntary hospitals in respect of their right to select nurses or students whom they regarded as suitable to their particular requirements. I understand he also promised that he would confirm that assurance by letter. Deputy Tunney informs me that he has not received such a letter to date. He apologises for the fact that he cannot he here this morning to bring the matter up. There is nothing in section 36 which gives any rights to the training school or the hospital as an employing authority. If the Minister is serious that the Bill will not interfere in any way with the rights of training schools to have the final selection of their own students I believe it is only right that he should accept this amendment. The amendment seeks to insert in the Bill a view expressed by the Minister in reply to Deputy Tunney on 6 March when we were debating Committee Stage.
The amendment seeks to confer total control on the training schools. The Bill proposes the setting up of a board to examine applicants but the amendment seeks to give a right of veto to the hospitals or training schools. I do not think we should accept such a suggestion. I would be apprehensive about it and I am anxious to hear the Minister's views on it. With regard to the training of nurses I must point out that the method of selection and qualifications required leave a lot to be desired. Health board hospitals have a different method of selection from hospitals outside that system. I would like to see a standardisation of the qualifications required, whether they are based on the leaving certificate or not. We should decide if certain leaving certificate subjects are essential and if there is a need for additional qualifications in regard to subjects like mathematics and biology. If applicants do not pass those subjects in the leaving certificate they are almost totally excluded from consideration.
Many people apply for the few places in the training schools and more and more people are becoming disillusioned with the method of selection. For that reason I agree with the suggestion that we should have a type of central selection board. If we adopt Deputy O'Hanlon's amendment we will be brought back to the position that obtains now. While people may be accepted by the central bureau they may not be accepted by a hospital. I do not see any justification for some private hospitals objecting. I know they want to retain control in the selection of trainee nurses. Matrons, and boards, of some of these hospitals have had that important power for a long time. There has been equilisation in many other areas of selection to public service positions and I do not see any reason why we should not have equalisation in regard to selection of trainee nurses. While I am seriously concerned that we have a standardisation of the qualifications required, I believe that once a person is qualified and suitable for a position that person's selection should not be based solely on a points system. Other aspects must be taken into consideration when choosing an applicant for the nursing profession. Some people who had little more than the intermediate certificate in the past made excellent nurses.
The schools and the students should be made aware of the qualifications required so that those who apply are not disillusioned when they discover subsequent to the leaving certificate examination that they do not qualify for certain hospitals. When hospitals and health boards operate different methods of selection, confusion follows and that has been the position for many years. If a central selection board resolves that I would be in favour of it.
Many of the points made by Deputy Dowling have been agreed by both sides. Section 36 (1) clearly standardised the educational, or otherwise, qualifications needed from now on. We will not have training schools insisting on their own set of qualifications and we all welcome that. We have all experienced the same problems mentioned by Deputy Dowling in regard to training schools. I support Deputy O'Hanlon's amendment because I am aware of a number of things that have happened in regard to the central applications system that operates for entry to university.
The only training school I have had any experience of is that run by the health board in my area and I am aware that it has been outside of political interference as far as the training school is concerned. I am sure all Members will agree that interference, political or otherwise, is not successful in the section of candidates for nursing and that is welcome and essential.
Health boards have always been conscious of the need to have a full geographical spread of nurses to give all candidates a fair chance and in some health board areas it has to be realised that a substantial number of patients are fluent in the Irish language. It is important that their needs are catered for. For many years patients who wanted to communicate through the Irish language in hospital could not be catered for. One such case was well publicised some years ago. That did not arise through any fault of the hospital authorities but training schools did not take that into account when selecting trainees. I am concerned that that area is taken into consideration by the central applications bureau. It is important that the geographical spread and language requirements needed in different parts of the country are taken into consideration by the central applications bureau.
We are all happy with the way the training schools run by the health boards operate and it would be a tragedy to take their independence from them. I welcome the fact that from now on the board will determine the qualifications necessary.
The proposals to establish a central applications bureau is laudable but it appears to run counter to Deputy O'Hanlon's amendment. If we accept the amendment the training schools will have a right of veto. In that event why is there a necessity to set up a central applications bureau? A central applications bureau is the best way for administering the system and screening applicants. If we accept the amendment we will be maintaining the status quo and a training school can apply their own criteria and ensure that their line of thought prevails. It is a contradiction of what is proposed in the earlier sections of the Bill.
The House would be unwise to accept Deputy O'Hanlon's amendment. Deputy Máire Geoghegan-Quinn made a point in relation to some hospitals requiring as a pre-condition that a student nurse be proficient in Irish. Under this system to be inaugurated by An Bord Altranais those hospitals would have an opportunity to enforce that regulation. Both An Bord Altranias and the central applications bureau would be composed for the most part of representatives of the training schools and there would be an opportunity to refuse to take in a person who did not speak Irish on the grounds of unsuitability for employment.
We have to take this issue head on and at the same time take in a democratic and reasonable framework. There should not be privilege in selection for student training posts either in a private hospital, a public voluntary hospital or health board hospital. It is time that in relation to an area of employment, which is a huge area of employment, we did away with privileges. There are 26,000 nurses employed here and there should be absolute equality of opportunity for training posts in that area of public employment. It is public employment to the extent that the private hospitals for the most part are paid out of VHI moneys so there is public money going into them: the voluntary hospitals get 98 per cent of their budgets from the taxpayer and the health board system is wholly funded by the State. The amendment should not be accepted. On Committee Stage Deputy O'Hanlon tabled a similar amendment which read:
but the Training Schools shall select their own candidates for nurse training.
That was defeated here by 70 votes to 61. I do not accept that the CAB should be a sorting office with a vague reference system but at the same time we envisage that of the 20 members of the CAB about 150 will come from training schools. They would be appointed on the nomination of the nurse training schools and they would represent the teaching element, the administrative element and the service element in the nurse training schools.
The provision in this Bill is an enabling provision. I have not set out a CAB structure. This is a very big Bill which would be unending if we put everything into it. It will be for the board to specify the functions and the limitations of a central applications system. The board will be guided by the recommendations of the working party on general nursing who were very emphatic about the need for a central applications bureau, and they will take into account the views of the training schools on the operation of the bureau. It would be a tragedy if the concept were to fail because of unwillingness on the part of some training schools to overcome their reluctance to modify the selection procedures. There will be modifications and it will come in a beneficial way because for the first time An Bord Altranais will have the power to set down minimum standards of education for nurse training.
One advantage of a CAB is that there will be a known standard to be attained for entry into nurse training and individual hospitals will not be allowed under that system to impose their own special qualifications. This will be much fairer to students. At the same time it will not be draconian because a student may well get an option of three or four hospitals and the hospital will still have the opportunity to say she is not suitable, but they will not have the opportunity to select candidates from a closed circle. There is a great need to open up the prospect of equality of employment and training opportunity. The House will be doing a good day's work in devolving that responsibility on An Bord Altranais. I am surprised at the reluctance of some people to devolve that responsibility on the nursing profession. The overwhelming majority of those on An Bord Altranais are members of the nursing profession and it will be self-regulatory in that sense. Accordingly, I commend the non-acceptance of the amendment at this stage.
As regards the point raised by Deputy O'Hanlon, Deputy Alice Glenn asked me for an assurance that this procedure would not impinge on the general ethos of a particular hospital. That is the fear. It is an unnecessary fear but it is there. I wrote to Deputy Glenn assuring her that this interpretation could not be read into the section and that there is still ample opportunity for the employing authority to protect the general ethos of their own institution, the ethos of the employer. The applications go forward and a decision is taken on employment. There is a legitimate restriction in it. I will send Deputy Tunney a copy of that letter by way of explanation. I will also be writing to a number of Deputies outlining the interpretation of a number of different sections. I hope to do that in the next few weeks.
I should like to deal briefly with some of the points raised. Deputy Dowling agreed that there should be standardisation of qualifications. We all agree with that. Section 36 (1) makes it very clear that:
The Board may determine the minimum educational requirements necessary for entry for training as a nurse into a hospital or institution approved by the Board pursuant to section 35 of this Act.
We support that fully. Neither on Committee Stage nor on this Stage did we put down amendments or say anything which would lead anyone to believe we did not agree with that. We supported that fully all along the line. It appears from the debate here this morning that some people feel we are opposed to that section. We are not. My colleague Deputy Geoghegan-Quinn dealt with that.
Deputy Dowling raised the question of the small number of private hospitals involved. I would not see this amendment as being specific to any group of hospitals. We have large health board hospitals. We have large public voluntary hospitals. We have a small number of private hospitals. They employ stundent nurses. We wish to protect all of them. Deputy Geoghegan-Quinn made the point, with which I agree, that the health boards have been very meticulous about the manner in which they selected their trainee nurses. I was surprised to hear the Minister say he was not certain about some health board hospitals. I am not aware that there is any irregularity in the method of selecting nurses for the health board hospitals.
Deputy Durkan said that if the House accepted my amendment we would be giving the training schools the right of veto. That is exactly the purpose of my amendment. Nurses should not be imposed on a particular training school. I do not believe that if there are 500 vacancies this year, the central applications bureau should send 50 candidates to the Mater, 50 to Galway, 25 to the Adelaide and 25 to the Regional in Cork. I do not think that would be correct in the interests of the patients. The central applications bureau do not have to decide on each individual applicant and select each individual applicant. There is no reason why the central applications bureau should not receive applications from those wishing to become trainee nurses, assess the applications in terms of educational qualifications, and let the training schools and the health boards select their students as they do at the moment.
The Minister told us there was no agreed structure as to how the central applications bureau should work. He said the selection committee would be representative of the training hospitals. He mentioned 20 members of the central applications bureau. I wonder did he get that figure off the top of his head or has he some preconceived idea that there will be 20 members.
That was envisaged by the outgoing board. That is the general intention.
Then it appears there is some form of structure at the gestation stage at least, and that there is an intention to have 20 members of the central applications bureau. The Minister said public money was funding the voluntary hospitals. We accept that. In terms of selecting their own staff they have certain rights in relation to the common contract and the selection of medical staff, that is, the voluntary hospitals. What we are proposing here will not give them those rights in terms of selecting nurses. It is not correct to say in relation to the funding of the small private hospitals that the money paid out by the Voluntary Health Insurance Board is public money. The public subvention to the VHI has been removed, and they are now funded totally by the members of the scheme.
The Minister made the point, also made by Deputy Dowling, about standardisation of qualifications. We are not opposed to that. We fully support An Bord Altranais laying down the guidelines, particularly in relation to education, as to who may be trained as a nurse. I agree fully with the Minister that there should not be privilege in determining who should be trainee nurses. Everybody in the House will accept that nurses should not be trained on the basis of any form of privilege such as family connections with employees in an institution. That would be entirely wrong. I do not think it necessary to introduce what I would see as a draconian measure to get over that. We are concerned that each hospital in the State should be able to select trainee nurses who are suited to their needs. The needs of hospitals are different. Deputy Geoghegan-Quinn has pointed out the need for Irish speaking nurses in different parts of the country. The training school should have some rights in the selection of trainee nurses.
The Minister said he had written to Deputy Glenn and will be writing to Deputy Tunney assuring them that there will be no threat in the Bill to the character and ethos of any hospital. If we were to widen the debate and move into other sections like section 54, which gives the Minister power to abolish the nursing board, we could have quite a long debate on what protection there is for the character and ethos of any hospital.
There is nothing in the Bill that will give to hospitals the right either to select their employees or to protect their character and ethos. It will be a matter for the board and while I do not doubt the Minister's sincerity, he could abolish the board if he so wished. I would regard the passing of this legislation as a threat to the character and ethos of hospitals. We have quoted from previous legislation which set out clearly the manner in which the character and ethos of the Federated Hospitals was to be protected. There should be a similar section in this Bill.
Neither is there any provision in the Bill that is similar to the common contract for consultants. We regard the selection of trainee nurses as being the prerogative of the employing authority, that is, the hospital concerned. That right, too, should be protected. Our hospitals are all of the highest standard. They are fulfilling their functions admirably, and we as Members of this House owe it to them to protect their character and ethos. For that reason, the amendment should be inserted. It is not proposing any more than the guarantee promised by the Minister in a letter to Deputy Glenn.
Amendment put.
The Dáil divided: Tá, 60; Níl, 72.
Tá
- Ahern, Bertie.
- Ahern, Michael.
- Andrews, David.
- Aylward, Liam.
- Barrett, Michael.
- Blaney, Neil Terence.
- Brady, Gerard.
- Brady, Vincent.
- Brennan, Mattie.
- Browne, John.
- Burke, Raphael P.
- Byrne, Hugh.
- Byrne, Seán.
- Calleary, Seán.
- Collins, Gerard.
- Conaghan, Hugh.
- Connolly, Ger.
- Coughlan, Cathal Seán.
- Cowen, Brian.
- Daly, Brendan.
- Fahey, Jackie.
- Faulkner, Pádraig.
- Fitzgerald, Liam Joseph.
- O'Connell, John.
- O'Dea, William.
- O'Hanlon, Rory.
- O'Keeffe, Edmond.
- O'Kennedy, Michael.
- O'Rourke, Mary.
- Power, Paddy.
- Flynn, Pádraig.
- Foley, Denis.
- Gallagher, Denis.
- Gallagher, Pat Cope.
- Geoghegan-Quinn, Máire.
- Harney, Mary.
- Haughey, Charles J.
- Hilliard, Colm.
- Hyland, Liam.
- Kitt, Michael.
- Lenihan, Brian.
- Leonard, Jimmy.
- Leonard, Tom.
- Leyden, Terry.
- Lyons, Denis.
- McCarthy, Seán.
- McCreevy, Charlie.
- McEllistrim, Tom.
- Molloy, Robert.
- Morley, P.J.
- Moynihan, Donal.
- Nolan, M.J.
- Noonan, Michael J. (Limerick West)
- Reynolds, Albert.
- Tunney, Jim.
- Wallace, Dan.
- Walsh, Joe.
- Walsh, Seán.
- Wilson, John P.
- Wyse, Pearse.
Níl
- Allen, Bernard.
- Barnes, Monica.
- Barrett, Seán.
- Barry, Myra.
- Barry, Peter.
- Begley, Michael.
- Bell, Michael.
- Bermingham, Joe.
- Birmingham, George Martin.
- Bruton, Richard.
- Collins, Edward.
- Conlon, John F.
- Connaughton, Paul.
- Coogan, Fintan.
- Cooney, Patrick Mark.
- Cosgrave, Liam T.
- Cosgrave, Michael Joe.
- Coveney, Hugh.
- Creed, Donal.
- Crotty, Kieran.
- Crowley, Frank.
- D'Arcy, Michael.
- Deasy, Martin Austin.
- De Rossa, Proinsias.
- Desmond, Barry.
- Desmond, Eileen.
- Donnellan, John.
- Dowling, Dick.
- Doyle, Avril.
- Doyle, Joe.
- Dukes, Alan.
- Durkan, Bernard J.
- Enright, Thomas W.
- Farrelly, John V.
- Fennell, Nuala.
- FitzGerald, Garret.
- Flaherty, Mary.
- Flanagan, Oliver J.
- Glenn, Alice.
- Griffin, Brendan.
- Harte, Patrick D.
- Hegarty, Paddy.
- Hussey, Gemma.
- Kavanagh, Liam.
- Keating, Michael.
- Kelly, John.
- Kenny, Enda.
- L'Estrange, Gerry.
- McGinley, Dinny.
- Mac Giolla, Tomás.
- McLoughlin, Frank.
- Manning, Maurice.
- Mitchell, Gay.
- Mitchell, Jim.
- Molony, David.
- Moynihan, Michael.
- Naughten, Liam.
- Nealon, Ted.
- Noonan, Michael.
- (Limerick East)
- O'Brien, Fergus.
- O'Brien, Willie.
- O'Leary, Michael.
- O'Sullivan, Toddy.
- Pattison, Séamus.
- Prendergast, Frank.
- Quinn, Ruairí.
- Ryan, John.
- Sheehan, Patrick Joseph.
- Skelly, Liam.
- Spring, Dick.
- Taylor, Mervyn.
- Taylor-Quinn, Madeline.
Tellers: Tá, Deputies V. Brady and Barrett(Dublin North West); Níl, Deputies Barrett (Dún Laoghaire) and Taylor.
Amendment declared lost.
I move amendment No. 10:
In page 17, lines 27 and 28, to delete "Any hospital or institution approved of by the Board pursuant to section 35 of this Act may not" and substitute "If the Board establishes, pursuant to subsection (2) of this section, a central applications bureau, a hospital or institution approved of by the Board pursuant to section 35 of this Act shall not".
It will be recalled that on Committee Stage I was unable to accept Deputy O'Hanlons amendment because the intended provision of the subsection would be necessary if a central applications bureau were established. However, the intention of the provision at the time was not sufficiently clear, and this amendment is proposed in order to establish beyond doubt that training institutions may only accept students who are approved of and recommended by the board, that is those who come through the central applications system where the board establishes a central applications bureau. That is the nub of the amendment. They must first of all establish a CAB and only then can the process be developed. It follows that if a central applications bureau is not established this obligation will not be imposed on the training institutions.
I do not agree with the Minister's amendment or with the subsection because, if it is accepted, hospitals like the International Missionary Training Hospital, Drogheda, will be unable to take students from a Third World country, like, say, Africa without the prior consent of the board, which might not be forthcoming. I regard it as a retrograde step.
I am sure the Deputy remembers an amendment tabled on Committee Stage to delete subsection (3). I did not accept the amendment then but I said that I was prepared to examine it on Report Stage on the ground that the provision of the subsection would be administratively undesirable to operate if a central application bureau was not established. Accordingly, we introduced this amendment now. I assure the Deputy that the board are conscious of the need to provide for foreign students.
Amendment put and declared carried.
I move amendment No. 11:
In page 17, line 31, to delete "from time to time" and substitute "from time to time as occasion may require but, in any event, not less than once in every five years".
Deputies will recall that amendments were tabled by a number of Members, including Deputy O'Hanlon, in regard to this section on Committee Stage. They wished to delete the phrase "from time to time" and to insert "at least once in every four years". Deputy O'Hanlon wished to insert "but at least once in every five years". I indicated that I was amenable to an amendment, and I accept the arguments put forward by the Deputies in favour of inserting a minimum period in which the board should take steps to satisfy themselves as to the adequacy and suitability of nursing education and training programmes. In proposing this amendment, I have tried to strike a balance between the amendments tabled on Committee Stage by the Deputies.
Amendment agreed to.
I move amendment No. 12:
In page 17, line 33, to delete "hospital, institution or body" and substitute "hospital or institution".
Amendment agreed to.
I move amendment No. 13:
In page 17, line 38, to delete "hospital, institution or body" and substitute "hospital or institution".
Amendment agreed to.
I move amendment No. 14:
In page 24, line 33, after "Minister" to insert ", and, in the case of a person the name of whose employer is known to the Board, such employer".
The purpose of this amendment is to provide that in the case of an employed nurse, the name of whose employer is known to the board, the board will notify the employer of the relevant actions specified in the section in addition to notifying the Minister. While it would be expected that the Minister would take steps to notify the relevant authorities, it is accepted that it is desirable to make specific provision in the section in relation to employed persons.
Amendment agreed to.
Amendment No. 15 not moved.
I move amendment No. 16:
In page 28, lines 14 and 15, to delete ", after consultation with the Minister,".
This amendment arises out of a discussion on Deputy Mac Giolla's amendment on Committee Stage in connection with the method of filling casual vacancies. In response to a query from Deputy O'Hanlon as to the necessity for consultation with the Minister before the board would fill a vacancy among elected members, I indicated that I would consider removing the phrase "after consultation with the Minister" on Report Stage. Since I agree with the points made on Committee Stage I put down this amendment as I would have no function in the election of members or in relation to their replacement.
I welcome this amendment. We should like to see a practice established whereby the person next in line to the person elected is nominated to fill the next vacant position. If consultation with the Minister was necessary it could, in certain circumstances, interfere with that practice. I am not suggesting that Deputy Desmond would interfere, because I believe he supports that practice. However, this Act will possibly be in operation for 50 years, and perhaps some future Minister might interfere with what we hope will become the established practice in all bodies like this.
Amendment agreed to.
Question proposed: "That the Bill do now pass".
I wish to thank the Members of the House for their contributions to the lengthy and thorough debate which we had on this Bill since it came before the House almost 12 months ago.
Following Second Stage on 7 June 1984, the Committee Stage debate was spread over five days and involved many hours debate. We also had many hours discussion on Report Stage. Consequently, we are all agreed that the Bill is much improved. On Committee Stage, I accepted a number of amendments suggested by Deputy O'Hanlon and from other Deputies which, together with my amendments — many of which were engendered by the debate — have served to produce cohesive and comprehensive legislation.
I also wish to thank the nursing profession and the many representative bodies and individuals who made representations to me and to Members on all sides of the House in relation to the Bill. From the early stages, I invited comments from interested parties on the Bill and I certainly receive them in abundance, both written and verbal, since the Bill was initiated. It was gratifying to Deputy O'Hanlon, Deputy Geoghegan-Quinn and to me to find such an extraordinary interest in the Bill among nurses at every level and from every discipline of the profession. Although our exchanges have not been without contention, that is part of the democratic framing of a Bill, and I would have been very concerned if the Bill had been received apathetically by nurses.
I wish to thank the Ceann Comhairle and you, Sir, for your assistance in facilitating a constructive debate on this Bill. I also wish to thank the Assistant Secretary of the Department of Health, Mr. O'Dwyer, and the Assistant Principal Officer, Sylvia Kelly, who, over a substantial period, have done outstanding work in relation to the Bill. I should also like to thank Mr. Noel Daly, CEO of An Bord Altranais, who has been most helpful in relation to the Bill. I hope it will have a speedy passage through the other House and that the new Bord Altranais will be elected in the near future.
Question put and agreed to.