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Savage health cutbacks undermining nursing and midwifery and hurting patients – Ó Caoláin

20 May, 2010 - by Caoimhghín Ó Caoláin TD


Speaking on the Nurses and Midwives Bill in the Dáil today (Thursday) Sinn Féin Dáil leader and Health & Children spokesperson Caoimhghín Ó Caoláin TD slammed the savage health cuts of the Fianna Fáil/Green Coalition. He said:

“The professions of nursing and midwifery in this State are going through their worst experience since the 1980s due to the savage cutbacks being imposed on our health services by the Fianna Fáil/Green Government.

“The Nurses and Midwives Bill comes before us in the context of those cuts. In the week the Second Stage of the Bill commenced in the Dáil we had the announcement of 52 bed cuts in Beaumont Hospital and the axing of virtually all dental services for medical card patients. This is to be followed shortly by another Bill to undermine the medical card system, the Prescription Charges Bill, imposing charges for medicine on medical card patients.

“The people on the frontline who have to cope with the outcome of the cuts in terms of patient care are the nurses and midwives. I want to pay tribute to them for the superb work they do in caring for people in our health services. They carry out that work despite being hampered by a fundamentally flawed system, by mismanagement at Government and HSE level and by the current cuts.

“Nurses and midwives constitute a large section of the public service workers who have been so much vilified in recent times. The crass catch-cry is ‘Aren’t they lucky to have jobs?’ The answer is ‘No’. It is we the Irish people who are lucky that every nurse employed in the public health service has a job because we rely on them for our hospital and community care. In fact there are not enough of them. The Government moratorium on staffing in the public health service has seen the non-replacement of over 1,900 nursing and midwifery posts.

“If this Government gets its way the recruitment ban will continue and a further 6,000 posts in the public health services will be lost in the next three years and 3,500 acute hospital beds will be cut.

“I commend the over 40,000 members of the Irish Nurses and Midwives Organisation who have campaigned not only against the unjust pay cuts imposed on them, but very importantly against the many cuts in services to patients over recent years. It is most often the nurses who have blown the whistle on the HSE and the Government, exposing malpractice, the reality of A&E overcrowding and the myriad other effects of Government cutbacks.” ENDS

Full text follows:
Nurses and Midwives Bill 2010
Second Stage
Caoimhghín Ó Caoláin TD

I welcome this Bill which has been awaited for a very long time. It has been a permanent fixture on the list of promised legislation for years. It is ironic that the Bill appears now as the professions of nursing and midwifery in this State go through their worst experience since the 1980s due to the savage cutbacks being imposed on our health services by the Fianna Fáil/Green government.

New legislation to replace the Nurses Act of 1985 was recommended by the Commission on Nursing in 1998. The Government Health Strategy ‘Quality and Fairness – A Health System for You’ in 2001 promised that “provisions for the statutory registration of health professionals will be strengthened and expanded”. It set a target date of 2003 for new legislation on nurses.

The question has to be asked as to why it has taken seven years longer than the target date to produce this legislation. What does it say about Government health policy and the condition of the Department of Health & Children? The symptoms are alarming and the diagnosis is certainly not good.
The same Health Strategy set a target date of 2002 for new legislation to provide for clear statutory provisions on entitlement to health services. Eight years later all we have got is the name of a Bill – the Eligibility for Health & Personal Social Services Bill – on the list of promised legislation and the Government is still telling us that heads of the Bill have yet to be approved and it is not possible to indicate when it will be published.

It is not hard to see the reason for the suppression of this commitment in the Health Strategy. The last thing this Government wants to do is to debate – let alone set out in legislation – the people’s entitlements to health services. To do so would undermine the basis of the wholly inequitable two-tier public-private system over which successive Governments have presided. It would also expose the gross unfairness of the health cuts currently being imposed by this Fianna Fáil/Green administration.

The Nurses and Midwives Bill comes before us in the context of those cuts. In the week the Second Stage of the Bill commenced in the Dáil we had the announcement of 52 bed cuts in Beaumont Hospital and the axing of virtually all dental services for medical card patients. This is to be followed shortly by another Bill to undermine the medical card system, the Prescription Charges Bill, imposing charges for medicine on medical card patients.

The people on the frontline who have to cope with the outcome of the cuts in terms of patient care are the nurses and midwives. I want to pay tribute to them for the superb work they do in caring for people in our health services. They carry out that work despite being hampered by a fundamentally flawed system, by mismanagement at Government and HSE level and by the current cuts.

Nurses and midwives constitute a large section of the public service workers who have been so much vilified in recent times.

The crass catch-cry is “Aren’t they lucky to have jobs?”

The answer is ‘No’.

It is we the Irish people who are lucky that every nurse employed in the public health service has a job because we rely on them for our hospital and community care. In fact there are not enough of them. The Government moratorium on staffing in the public health service has seen the non-replacement of over 1,900 nursing and midwifery posts.

If this Government gets its way the recruitment ban will continue and a further 6,000 posts in the public health services will be lost in the next three years and 3,500 acute hospital beds will be cut.

I commend the over 40,000 members of the Irish Nurses and Midwives Organisation who have campaigned not only against the unjust pay cuts imposed on them, but very importantly against the many cuts in services to patients over recent years. It is most often the nurses who have blown the whistle on the HSE and the Government, exposing malpractice, the reality of A&E overcrowding and the myriad other effects of Government cutbacks.

It is no surprise then that the INMO is recommending rejection of the Croke Park deal. The INMO and the other health unions last winter went the extra mile in the pre-Budget talks with the Government. They were and are prepared to help implement far-reaching changes in working practices to enhance the public health services. But that deal was rejected by Government when it staged its mock back-bench revolt. It baffles me why in those circumstances the leaders of the public service unions returned to the talks and accepted such a fundamentally flawed deal as that now before the membership for balloting.

This is the very serious backdrop against which we debate this Bill. But it is more than a backdrop. Such is the attack on our public health services that the profession of nursing and midwifery itself is being undermined. With its anti-public service agenda and its drive to privatisation the Government has damaged nursing as a profession, as a calling to provide care on the basis of need, as a service to the people.

We should take the opportunity of this Bill to reassert the role of nursing as a public service.

I commend the stated purpose of the Bill to enhance the protection of the public in its dealings with nurses and midwives and to ensure the integrity of the practice of nursing and midwifery. It aims to provide for a modern, efficient, transparent and accountable system for the regulation of nursing and midwifery, ensuring that all nurses and midwives are appropriately qualified and competent to practice in a safe manner and on an ongoing basis.

I welcome the provisions for the establishment of Bord Altranais agus Cnáimhseachais na hÉireann – the Nursing and Midwifery Board of Ireland. The composition of the new board as set out in the Bill seems representative and I welcome some of the more open procedures for the appointment of members, including the election of eight nurses or midwives by nurses and midwives themselves.

The enhanced recognition of midwifery is welcome. However concerns have been raised already that the representation of midwifery on the new Board is not sufficient and about the legal requirement for indemnity for midwives. There is concern that the Bill may not go far enough in recognising midwifery as a distinct profession.

The requirements for proper qualification, registration, complaints procedures and sanctions where necessary are appropriate. These are detailed sections and will require careful scrutiny at Committee Stage.

Section 86 outlines the duties of the HSE to facilitate education and training of student nurses and midwives. The Bill will provide the legal basis for this. The big question is will the HSE be able to fulfil this mandate in the context of major cuts to public health services. Nurse training places have been cut back in recent years and training and education have been undermined as a result.

Similarly will the HSE, as an employer, be able to fulfil the obligation under Section 92 to facilitate the maintenance of professional competence of registered nurses and midwives pursuant to a professional competence scheme. The Bill also states that the employer ‘may’ facilitate this by providing learning opportunities in the workplace. Again, how realistic is this under the current regime and its attacks on our health services?
As the INMO has stated in relation to the Bill, we need to ensure that the necessary infrastructure for nurse and midwife undergraduate and post-graduate education is in place and maintained.

In conclusion, I commend the Bill and look forward to its enactment.

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