Nurses and Midwives Bill 2010: a further step in assuring patient safety


The regulation of midwifery and nursing is set for modernisation in line with other healthcare professions following the publication on 22 April 2010 of the Nurses and Midwives Bill 2010. The Bill is the result of a consultation process between the Department of Health and Children and key stakeholders and the public and, if passed in its current form, it will repeal the Nurses Act 1985 and will put in place a modern statutory framework for the regulation of nursing and midwifery professions. It is hoped that the Bill will be enacted at an early date, according to Department sources.

The key elements of the Bill are as follows:

A new governing body

An Bord Altranais will be replaced by An Bord Altranais agus Cnaimheaschais na hEireann (the Nursing and Midwifery Board of Ireland) whose 23 elected and representative members will be drawn from a broad base including the professions of nursing and midwifery, the public, stakeholders, educational bodies and nominees of others bodies involved in the provision and monitoring of health services. The Bill provides for a “lay” majority the Board i.e. a majority of non nurses and midwives.

The explicit object of the Board will be to protect the public in its dealing with nurses and midwives as well as the protection of the integrity of the practice of nursing and midwifery through the promotion of high standards of education, training, practice and professional conduct.

Requirement to register

Nurses and midwives are required to register with the Nursing and Midwifery Board of Ireland and there is a prohibition on unregistered individuals performing the practice of nursing or midwifery.

Recognition of midwifery as a profession

Midwifery will be recognised as a profession in its own right and will be subject to clinical supervision. In a statement at the time of publishing the Bill the Department of Health and Children explained that clinical supervision was a process that allowed a midwife to reflect on and consider his or her practice, to identify any gaps in his or her education or practice and to ensure that women and babies were in the care of competent midwives.

The Bill provides for the setting up of a Midwifery Committee of at least 5 members by the Board in relation to all matters pertaining to midwifery practice and it is anticipated that this Committee will advise the Board on matters related to the practice of midwifery.

It will be an offence for anyone who is not a registered midwife with adequate clinical indemnity insurance, not a registered medical practitioner, or not an individual training to be a midwife, medical practitioner or obstetrician to attend a woman in childbirth. This prohibition will not apply in cases of emergency.

The current situation regarding midwife indemnity is that individual midwives employed by service providers are indemnified under their employer’s indemnity and self employed community midwives working within an agreed HSE framework are covered by the Clinical Indemnity Scheme. The Bill now expressly requires practising midwives to have adequate indemnity insurance.

Competence assurance

The Board may make rules for a professional competence scheme but from the date of commencement of the Act nurses and midwifes will be obliged to maintain their professional competence on an ongoing basis and to demonstrate this to the Board if required. Employers of nurses and midwives will be obliged to facilitate the maintenance of their professional competence, and in particular to provide learning opportunities in the workplace.

Fitness to Practice

The complaints and investigation process has been refined. A Professional Practice Committee (PPC) will review complaints made about a nurse or midwife and will decide whether or not to refer the matter to the Fitness to Practice Committee (FPC). This is effectively a screening process. Again, the Bill provides for a “lay” majority on both the PCC and FPC.

In common with Medical Council fitness to practice inquiries, the FPC inquiry will be held in public unless the nurse, midwife or other witness (including the complainant) applies for all or part of the inquiry to be held in private. A private hearing is not automatically granted upon request and it is for the FPC to decide whether it is warranted in the circumstances. The new Bill also provides for the possible resolution of complaints by mediation or information means.

At the conclusion of an inquiry and following the FPC’s report to the Board, the Board has a number of sanctions available to it that can be imposed including written censure or admonishment, a fine not exceeding €2,000, the attachment of conditions and/or restrictions to practice, suspension and cancellation of registration.

The text of the Bill can be viewed at http://www.oireachtas.ie/documents/bills28/bills/2010/1610/b1610d.pdf.

If you have any queries in relation to the proposed bill, please contact Martha Wilson on mwilson@hayes-solicitors.ie or any member of the Healthcare team.