Powers to prescribe given to nurses
The Irish Medicines Board (Miscellaneous Provisions) Act, 2006 contains, for the first time in this country, a provision allowing for the prescription of drugs by nurses. This facility has, for some time, been available in other jurisdictions but is subject to strict regulation. As the Bill passed through the various legislative stages it was repeatedly stated that the facility will be limited by regulation. However, we do not yet know if the power will be given to nurses who have reached a certain level of experience or whether it will be based on some sort of educational standard. Brian Lenihan, Minister for State in the Department of Health was careful to point out in the Dáil that it is not the government’s intention that the power to prescribe will be given to all nurses. Given the focus on all levels of medical staff in the country’s Accident and Emergency departments it will be interesting to see how this power will be used and whether it will have any effect in resolving “trolley-gate”.
The second interesting point of note arising from the Act is the strengthening of the powers of the Irish Medicines Board. Powers previously exercised by the Minister for Health in relation to licensing and authorisation of drug use have now been transferred to the IMB. The Act also gives the IMB the power to carry out inspections of premises including those of doctors and dentists pursuant to misuse of drugs laws. This power has obvious consequences for record-keeping of all varieties ranging from records of drug stocks to patients’ clinical records.
Finally, the 2006 Act makes the IMB something of a European watchdog. The board is now charged with ensuring compliance with EU laws in relation to medical devices, over the counter cosmetic products, precursor drugs, clinical trials of drugs directed for human use and also standards of practice in relation to the handling of human tissues and cells.
The IMB now has serious muscle in the contentious area of misuse of clinical drugs. The power of inspection permitted by the Act gives the Board a big set of pearly white teeth to back up its muscle. We shall have to wait and see if and when the IMB chooses to flex these muscles.
Hilary Muldowney
June 2006