1. Professional Regulation in Ireland Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona

2. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Speaker Contact Information Speaker name: Eugene Donoghue Organization: An Bord Altranais Address: 31/32 Fitzwilliam Square, Dublin 2, Ireland Phone: 00353 1 6398528 Fax: 00353 1 6763348 E-mail: edonoghue@nursingboard.ie Website: www.nursingboard.ie

3. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona History of Regulation Medical Act, 1858; Medical Act, 1886; Medical Act, 1927; Medical Practitioners Act, 1978. Pharmacy Act (Ireland) 1875; Pharmacy Act, 1951; Pharmacy Act, 1962 Dentist’s Act, 1878; Dentists Act, 1921; Dentists Act 1928; Dentists Act, 1985. Nurses Act, 1917, Midwives Act, 1950; Nurses Act 1985; Health Professions Bill, 2005

4. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona History of Regulation Original regulatory legislation in Ireland was derived from United Kingdom judicial systems. From the 19 th century and the beginning of the twentieth century laws were enacted in Ireland regulating health care professions, and such legislation focused primarily on establishing registers for those who completed approved Education and Training Courses. Boards were appointed by the government which included representation from the professions.

5. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona History of Regulation After independence was established in 1921 those regulatory laws for Nurses and Midwives and other health professionals continued to operate. In the case of Nurses and Midwives the Irish Government passed a Nurses Act, 1950, which established An Bord Altranais and put in place systems regulating Education and Training, the Maintenance of a Register, Fitness to Practice Procedures and Guidance to the Profession.

6. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona History of Regulation The Nurses Act was further revised in 1985 when for the first time elected nurses and midwives held a majority on the Regulatory Board.

7. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Purpose of Professional Regulation The general purpose of professional regulation is to protect the public through the promotion of high standard of professional education and training and professional conduct.

8. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Operational Environment Government Health Service Executive Representative Organisations Public Professional Regulation

9. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona

10. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Regulation is Statutory Statutory Boards are representative of professions, public interests, health services and educational providers Boards appointed by election and appointment Regulatory bodies are autonomous subject to high court confirmation of decisions affecting the Constitutional right of a person to be employed.

11. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Functions of Regulatory Bodies Education and Training – Standards and Requirements of practitioners Maintenance of a Register Fitness to Practise - Disciplinary Guidance to the Profession

12. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Education and Training Approval of Institutions Approval of courses (site visits; curricula approval) Entry Requirements Scope of Practise Continuing Competency Ethics

13. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Ireland is obliged by virtue of membership of the European Union and Directives enacted by the Union to put in place systems for the mutual recognition of diplomas, certificates, and other evidence of formal qualifications of nurses and midwives, doctors, pharmacists and dentists.

14. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Registration Member States (25) are obliged to apply Directives Sectoral Directives (No. 80/154/EEC and No.77/452/EEC) which stipulate for particular professions ther dureation and content of programmes leading to Registration throughout member states; General Systems Directives which provide member states with legal requirements which must be satisfied in processing applications of professionals from other member countries in accordance with their own national standards; New Directive – signed into law 7 th September 2005.

15. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona The Process: Registration Applications are appraised on an individual basis and verification of compliance with European Law is sought independently from the Competent Authority in the country of origin Applications from outside the European Union are assessed individually and applicants must suppy to the competent authority: a current registration certificate (license), employment history, two character references and passport number

16. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona The Process: Registration (cont’d) Nurse applicants from some countries who are otherwise qualified to enter the Register are required to undertake a period of adaptation in a hospital approved by the Board and a recommendation is required from the Director of Nursing before full registration is granted. Dentists/Doctors/Pharmacists require non E.U. candidates to sit examinations.

17. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Registration New E.U. Directive Common platforms where possible Member states set standards Adaptation systems Language requirement Security emphasised

18. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Fitness to Practice The Act provides for the establishment of a Statutory Fitness to Practice Committee which requires the committee to enquire into allegations of professional misconduct or unfitness to practice because of physical or mental disability.

19. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Fitness to Practise Committee Named and Registered Nurse Application for Inquiry Grounds for Inquiry: -Alleged professional misconduct -Alleged unfitness by reason of physical or mental disability

20. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Fitness to Practice Findings of the committee are reported to the Board whose role it is to administer sanctions. These range as follows; Removal from the Register; Suspension from the Register; Attachment of conditions; Advise, Admonish or Censure. Decisions of the Board effecting a nurse’s employment are not effective until confirmed by the High Court. A nurse has right of appeal against decisions for up to 21 days after the Court has confirmed the decisions of the Board.

21. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Fitness to Practice Inquiries are held in camera, and appeals are heard in open court. In general the Irish constitution provides that only the High Court can impose sanctions which effect a citizen’s right to earn a living. Regulatory Bodies operate within the limits of the constitution.

22. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Fitness to Practice A nurse may apply to the Board at any time to have her/his name restored to the register and The Board may at any time remove in whole or in part the conditions attached to the retention of the name o any person on the register.

23. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Section 44 of the Nurses Act, 1985 Board Function Public interest at risk Seek Order from High Court preventing practice pending completion of fitness to practise procedure

24. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Guidance to the Profession In providing guidance to the profession the Board publishes a Code of Professional Conduct for each Nurse and Midwife The Board has also published a Scope of Practice Framework which empowers nurses and midwives to practice in accordance with their education and training, experience and competence. Currently the Board is examining in consultation with others the regulation of Nurse and Midwife Prescribing.

25. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Funding of Professional Organisations Annual fees paid by professionals to maintain their name on the Register Other fees; -Overseas application fee -Restoration fee -Verification fee -Additional Qualifications -Reactivation of file -Duplicate certificate -Sundry charge

26. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona General Observations Continuing competence - proposed Language Requirements – IELTS / TOEFL Professional Conduct leading to Inquiries Professional misconduct Health Problems

27. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona THANK YOU