I propose to take Questions Nos. 489 and 559 together.
The provision of supports in special schools is an issue which involves both the health and education sectors. Special schools provide for those children with the most complex special educational needs who require specialised educational provision beyond that which can normally be provided for them in mainstream education. These schools are mainly attached to non-statutory disability service providers which are funded by the HSE. These services have been developed by individual local providers and reflect their experience and expertise. Special schools have support staff, including in some cases nurses, in place. Nurses in special schools would provide support to a small number of children who require high levels of support. The nurse's role, may include guidance in relation to the role carried out by Special Needs Assistants, which come under the Department of Education and Skills, in the area of care support.
Professional accountability of nursing staff and their adherence to proper and standardised clinical procedures in special schools is relevant in this overall context. It should be noted that all nurses are legally required to be registered with the Nursing and Midwifery Board of Ireland and are accountable to the public though the Board. They must adhere to a Code of Professional Conduct and a Scope of Practice guidance document. The Scope of Practice sets out the range of roles, functions, responsibilities and activities which a registered nurse or registered midwife is educated, competent and has the authority to perform. This is the case for all nurses, regardless of their employment setting, from a hospital to a special-school.
The National Council for Special Education, in policy advice to the Minister for Education and Skills last year recommended a more consistent approach to accessing nursing support, for children with high medical needs in special schools through dedicated health service funding. This recommendation raises very complex and significant issues for the Health and Education sectors. The stakeholders involved including the HSE, the Departments of Education and Skills and Health, will need to examine this issue fully, including the financial and employment resource and overall policy implications involved.