I move that this Bill be read a Second Time. The purpose of this Bill is to make a number of amendments to the Medical Practitioners Act, 1927, which experience has shown to be desirable. The amendments are, in the main, minor ones which deal with the financial activities of the council and remedy certain difficulties which have arisen. The only innovation in the Bill is in Section 3 which will permit persons from abroad to be temporarily registered as medical practitioners.
The Medical Practitioners Act of 1927 established the Medical Registration Council as the statutory supervisory body for medical practitioners in this country. Provision had been made under the medical Acts of the last century for the registration and supervision of persons practising medicine in Ireland but these functions were exercised in this country, prior to 1927, by an Irish branch of the British General Medical Council. The 1927 Act, which was the outcome of an agreement with the British authorities, transferred the function of keeping a register of medical practitioners for this country to the new body.
The Act provided that the Medical Registration Council should consist of representatives of the universities and other bodies awarding degrees or diplomas which entitled their holders to practise medicine, two persons elected by medical practitioners, and two persons appointed by the Government. The latter have, in all cases, been medical practitioners.
The council were given power to establish a register of medical practitioners and to include in it the names of those persons whose medical qualifications entitled them to be registered. Power was given to the council to hold inquiries into the actions of medical practitioners alleged to have committed certain offences and, if the council were satisfied that it was necessary, to remove these practitioners from the register. In addition to holding inquiries of its own, the council were given power to act, if they so thought fit, on the report of an inquiry held by the British General Medical Council into the actions of a medical practitioner registered in both the British and the Irish Registers.
The council were required further to satisfy themselves that the standard of medical education given by the bodies awarding diplomas in this country which entitle persons to practise medicine was such as would guarantee the possession by these persons of the skill and knowledge necessary to enable them to practise their profession.
To carry out their functions, the council were given power to recruit and pay staff, subject to the approval of the Minister for Local Government and Public Health and the consent of the Minister for Finance. The power of the Minister for Local Government and Public Health was since transferred to the Minister for Health. For some years, the council have argued that, as their only income is derived from registration fees and that the State has, therefore, no stake in their funds, they should be given greater autonomy in their expenditure and in the control of staff, subject to certain safeguards.
By Section 2 of the Bill the term of office of the present council is being extended to the 31st December, 1957. At present the council goes out of office during the month of October and it must meet in July or August to arrange an election of the two direct representatives. As Deputies will appreciate, this meeting and the election are held in a period when many of the electors and other persons concerned are on holidays, and this makes for an unsatisfactory poll and for inconvenience to those holding the election. The amendment now proposed will mean that the statutory council meeting can be held in October to arrange the election, and that the election will take place at a much more convenient time for those concerned.
Sections 3 and 4 together provide for temporary registration of persons who hold foreign medical diplomas. The Government, on the recommendation of the Medical Registration Council, has power at present to make arrangements with other countries for the reciprocal recognition of medical qualifications. A considerable amount of time and work is involved before such agreements can be made and, generally speaking, they are not often justified by the number of persons likely to benefit from them. There is, however, at the moment a small but constant number of foreign practitioners, who come to this country for post-graduate training, mainly in midwifery and in mental diseases. As the qualifications which they possess do not entitle them to be registered here, certain disabilities are imposed on these practitioners in carrying out their work. They cannot, for example, sign certificates which are statutorily required nor can they prescribe dangerous drugs.
To meet these difficulties the Medical Registration Council has suggested that provision should be made for registering such doctors during the period for which they are employed in hospitals in this country. Such registration will not entitle them to set up in practice here, but it will give them, while they are working in the hospital, the same privileges and benefits which general medical practitioners enjoy.
Section 5 is mainly a re-enactment of Section 16 of the 1927 Act. A new provision is that which will require the council to publish its accounts and the auditor's certificate and report on them within a specified period. The period proposed in this Bill is six months from the receipt of the auditor's report. In circumstances which I will explain on Committee Stage, I propose to ask the House later to extend that period to 12 months. It is now provided that publication should take place "as soon as may be".
Section 6 contains the other amendments which it is proposed to make in the 1927 Act. Some of these provide for the removal of certain ministerial controls over the financial activities of the council. In the first year of its existence the council was assisted from voted moneys, but for many years it has not been in receipt of public moneys and the controls are no longer required.
Sub-section (2) makes it clear that fees may be paid to the members of the council for attendance at meetings of its committees.
Sub-section (3) provides that the registration fees, from which the council's income is derived, and which are fixed by regulations, shall in future require the approval of the Minister.
Sub-section (4) of Section 6 will remedy a difficulty arising out of the British Medical Act of 1950. Before that Act came into operation the British General Medical Council held inquiries into professional misconduct of medical practitioners on the British Register and, as I have already pointed out, our own Medical Registration Council were authorised by the Act of 1927 to take action, if they so thought fit, on the report of such an inquiry in relation to a person who was on the Irish Register as well as the British Register. The British Act of 1950 transferred the power of the General Medical Council to hold inquiries to a special medical disciplinary committee and this sub-section is necessary to enable the Medical Registration Council to act on a report of that committee. The alternative would be for the Medical Registration Council to hold their own inquiry into such cases.
Section 7 of the Bill makes an amendment in the Act of 1951 which is required as a corollary of those amendments made in the Act of 1927 which remove ministerial controls over the council's financial activities.
I have dealt in some detail with the provisions of this Bill so that Deputies may be fully aware of its implications. The amendments which it is proposed to make in the earlier Acts are, I think, reasonable and necessary and it is on that basis that I recommend it to the House for a Second Reading.
