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Dáil Éireann debate -
Wednesday, 9 Nov 1977

Vol. 301 No. 4

Medical Practitioners Bill, 1977: Committee Stage (Resumed):

Question again proposed: "That section 40, as amended, stand part of the Bill".

Would the Minister consider either deleting the section completely or, if he decides to leave it in, putting it in another section on Report Stage on the matter of the Exchequer providing funds to help to defray the cost of this new extended council? Or would he consider as a third option "after consultation with the medical organisations"—if he likes to specify them—to ensure that there will be acceptance by the profession as a whole of this annual retention fee?

I cannot delete the section as a whole, because that would deprive——

No. I am sorry, part of it.

I presume the Deputy is referring then to the subsection dealing with the removal of a practitioner's name because of failure to pay the retention fee. I cannot accept that, and I have sought to establish that what is proposed throughout the Bill is reasonable, that the medical profession are being given statutory capacity to govern their own profession, look after their affairs, their training, their education, their discipline and their professional integrity. We suggest it is reasonable in those circumstances, that as they have done up to now, the professional should be responsible for carrying the cost of administering the council's normal affairs. I have gone so far as to say that if I or a successor in title asks the council to perform some function which is not contemplated within the ambit of the Bill, then it would be appropriate that funds should be made available to them from the Exchequer to cover the costs of any such function.

Further than that, I suggest that if the Deputy still wishes to pursue the matter he should put down an amendment for Report Stage or, alternatively, in order to facilitate the Deputy, if he gives me, between now and Report Stage, an indication of the amendment he wishes to put down, I will consider it.

On every occasion that I have put an amendment down the Minister has not accepted it. If I pursue the same line as I have been pursuing to date on Report Stage, the Minister will not accept my amendment. However, there will be another opportunity for the Minister, having considered my amendment, to put something else in. I would be glad to suggest privately to the Minister the type of amendment that could be put in.

Question put and agreed to.
Sections 41 and 42 agreed to.
SECTION 43.

I move amendment No. 38:

In page 21, line 27, to delete "A person whose name" and to substitute "The name of any person which".

Amendment agreed to.
Question proposed: "That section 43, as amended, stand part of the Bill."

If a medical practitioner was convicted in a road traffic accident case, what would happen there?

Section 43 deals with that situation where a registered medical practitioner is convicted of an offence not necessarily connected with the performance of his duty as a medical practitioner.

Section 43 says:

(1) Where a registered medical practitioner is convicted in the State of an offence triable on indictment or is convicted outside the State of an offence consisting of acts or omissions which would constitute an offence triable on indictment if done or made in the State, the Council may decide that the name of such person should be erased from the register.

I am taking about a road traffic conviction.

If it is an offence under the Road Traffic Acts which is indictable, in other words which would be dealt with by jury, not a summary conviction; summary conviction is dealt with in the District Court.

My knowledge of the law, while elementary, does extend to that, and after three years of lectures in law I do not think I am too bad. If a medical practitioner was convicted of manslaughter and it had no relation to the practice of his profession, would that debar him?

The whole process of section 43 comes into operation.

The section says: "may". It is not mandatory.

Yes. In the case where a medical practitioner is convicted of an indictable offence, then the process in section 43 comes into operation. The council can take note of that, decide to erase his name from the register, and he has the right of appeal to the High Court and so on.

It seems to be a rather unjust procedure for an indictable offence that would have no relation to the practice of his profession. I know is says: "may", but, again, we give the council arbitrary power to decide. It could conceivably happen that a man could be found guilty of manslaughter in driving a car. If a civil servant or an employee in industry is found guilty of manslaughter, he does not lose his job on that account, but the medical practitioner loses the right to practise his livelihood.

Only through the High Court.

I am not too convinced about this point on the High Court. The fact is that the council will proceed to erase his name. Then he has recourse to the High Court, as we can all challenge everything in the High Court.

If he does not challenge it, then they, in effect, must go to the High Court to have his name erased. The section says "may" but, as I have already indicated, in these circumstances that is equivalent to "will" or "shall".

I do not think it gives the man the protection to which he is entitled in a situation like that. I am just taking the case of an indictable offence such as manslaughter.

I accept that there are many different aspects to it. Again, I think we can only rely on the common sense and responsibility and judicial capacity of the council. One would not visualise the council moving to strike off a medical practitioner because he was found guilty in the courts of an indictable offence which none of us would regard as particularly serious.

It could be serious but——

However, the doctor being the sort of person he is, if he is convicted of an indictable offence of a certain category, even though it is nothing to do with his fitness to practise, it is important that the council would have the right to move to have his name erased from the register, subject, of course, to the protection of the High Court, which is afforded to the medical practitioner in question.

The Minister is convinced that there is ample protection for the medical practitioner?

I think so.

Question put and agreed to.
Section 44 agreed to.
SECTION 45.
Question proposed: "That section 45 stand part of the Bill."

What is the purpose of this section?

I think it is exactly what it says, that where the council want to do so, where it is in the public interest, they may apply to the High Court for an order in relation to any person registered in any register maintained under this Bill that, during the period specified in the order, registration of that person's name in that register shall not have effect. It is just giving them power to go to the court and suspend the registration of somebody on the register.

It gives a constitutional stamp to the powers of amendment, suspension, or modification of qualifications. Is that the reason for it?

No. It is a sort of emergency power.

Does that mean the council could apply to the High Court to have a man suspended?

It is a procedure which will be invoked only in an emergency situation. One can imagine a situation in which the council would want to act quickly and, in those circumstances, the High Court would grant an interim or interlocutory injunction.

That is giving the council very wide powers.

It is giving the court powers.

It is giving the council powers too because the council can apply for this. I am wondering what protection an individual would have in a case where there might be abuse of such powers by the council. They might apply to the court in circumstances which might seem important to them but might not in reality be so very important at all. If it is clearly spelled out that will be all right. I am just considering the implications of it. There is the danger that we might be using a sledge hammer to kill a fly. That is what I am worried about.

I accept there is that danger but we must give the council some sort of emergency powers to act in circumstances, for instance, in which a practitioner is suddenly discovered in the process of committing a serious crime or something comes to light which makes it urgently necessary that he should be removed from the register. There is a danger that an injustice could be done, but I think everyone will accept that situations could arise where the council must act quickly and urgently. In such circumstances it is almost certain the court would grant only an interim or interlocutory injunction pending full investigation.

But will it be the full council who will do this?

That is involved. It says "where the council is satisfied it is in the public interest".

I must tell the Minister something arising out of my own experience.

Pray do not hesitate.

The council will be made up of men who are very busy. Indeed, I remember a member who was abroad most of the time and a great deal of the work was done not by the chairman or the council. These will all be academics, very busy people, consultants involved in research, all trying to eke out a meagre living. God knows, it is meagre enough. Now I am wondering could we incorporate here something like "the council by a majority decision" to ensure that one person on behalf of the council does not do this. Remember, it could be a vindictive act.

I will examine it.

On that point, I would have thought from the definition section that the council would have to be the elected or appointed council and I would take it that all the other references to the council all through refer to the council rather than to an employee acting on behalf of the council but, as the point has been raised by Deputy O'Connell, it would be as well to clarify it.

It might be as well to put in "after due consideration".

If that is necessary in this section it is equally necessary in the other sections.

This is an emergency section.

I think it means the elected council but I am a little taken aback to discover the kind of circumstances in which this sort of section might be necessary because, as was pointed out, it could take the council some little time to come together to seek a High Court order. I am not clear as to whether a more permanent order could be made. I am wondering about the length of time it would take to convene the council. Would it not be virtually as quick for the Fitness to Practise Committee to look into the matter? I appreciate the section would only be used in emergency situations but it would have a prejudicial effect on any subsequent investigation by the Fitness to Practice Committee if that committee were investigating the conduct of a member or a complaint about a member against whom their council had got an interim order in the High Court. I do not think that would improve the doctor's case and, from that point of view, I am wondering just how necessary it is.

It is not difficult to visualise a situation where some very serious malpractice or crime would be revealed and it would be essential for the council to act immediately. It dispenses therefore with all the normal procedures. The Fitness to Practise Committee has to hold inquiries and so on and the matter might be so serious that the council would not wish to wait to go through all the formality of holding an inquiry and so they would go to the court and ask to have the name removed immediately from the register and then it would be a matter for the court to decide. It might make an interim injunction or refer the matter back to the council or insist that the Fitness to Practise Committee inquiry be held. This is designed to give the emergency power to the council to apply to the court. I think it is necessary.

A doctor could play ducks and drakes with the council and drag the whole thing out for years.

Does the section give power to the court to make a permanent order?

Yes. You cannot control the court. The court will do what it sees fit to do.

Will the Minister consider putting in the words "by a majority decision"?

I will consider some qualification. The subsection does say "whenever the council is satisfied". It will have to be legally satisfied and the matter will have to be in the public interest. The decision will have to be a very formal, serious decision by the council.

Could we not put that in? One member could act on behalf of the council.

There is a quorum in the Second Schedule.

What constitutes a quorum?

It is No. 7 in the Schedule and it is seven people.

There are 25 members of the council and in a matter like this seven might not be sufficient.

We can consider that when we come to the particular Schedule.

Oh, no. The Minister might consider something like "by a majority decision of the council" not only to ensure that justice is done but that justice is seen to be done.

A majority decision would not meet the point the Deputy is making.

Something like "a decision by a majority of the council".

Question put and agreed to.
SECTION 46.
Question proposed: "That section 46 stand part of the Bill."

I should like to mention on this section that I may be putting forward an amendment on the Report Stage.

In relation to?

To extending privilege to section 43 proceedings.

Question put and agreed to.
Section 47 agreed to.
SECTION 48.
Question proposed: "That section 48 stand part of the Bill."

What is the purpose of notifying the Minister? Is it just a formality?

It is a formality, but it is very important for my Department to have on its records the names of doctors who have been struck off, erased or suspended and so on.

They are just waiting in that Department for my name to be removed.

Question put and agreed to.
SECTION 49.

As amendments Nos. 39 and 40 are related they may be discussed together.

I move amendment No. 39:

In page 22, line 27, after "erased" to insert "or whose registration was suspended".

These are just drafting amendments the purpose of which is quite clear. Amendment No. 39 is to cover the situation where a person's registration is suspended as distinct from being erased. Amendment No. 40 is to cover the case where the suspension is terminated.

Amendment agreed to.

I move amendment No. 40:

In page 22, line 30, after "register" to insert "or terminate the suspension, as the case may be".

Amendment agreed to.
Question proposed: "That section 49, as amended, stand part of the Bill."

This section says: ".... on the payment of a special fee .." and again it does not disclose what the fee may be. We are left in the dark. The Minister might consider elaborating on this or ensuring that it is decided.

Is the Deputy asking me to reconsider the whole question of the special fee?

In line with the Minister's decision regarding the retention fee.

I shall afford it the same degree of reconsideration.

Question put and agreed to.
Section 50 agreed to.
SECTION 51.
Question proposed: "That section 51 stand part of the Bill."

It seems utterly ludicrous to talk in terms of a register published at intervals of not longer than five years. With a new Bill and the new powers to erase a doctor's name for non-payment of his retention fee, a register published at intervals of not longer than five years would be completely out of place.

There are annual supplements.

It talks of "in every other year". What happens about doctors erased meanwhile? I can see quite a number happening. Will the Minister not consider annual supplements?

It is an annual supplement for four years and a register every fifth year. Is that not what is meant?

I do not think "every other" means an annual supplement.

It means every other year, other than a fifth year.

Every other year could mean every second year.

I would think that in any year when it does not publish a register it must publish a supplement.

If there is any doubt about it we shall straighten it out on the Report Stage.

There is doubt about it.

Question put and agreed to.
Section 52 agreed to.
SECTION 53.
Question proposed: "That section 53 stand part of the Bill."

Again, this section creates serious difficulties because unless we can solve this problem of the retention fee we can find a fully qualified doctor who is fully competent deprived of his right to prescribe.

I suggest the Deputy has made his point in that regard.

There it is again.

Question put and agreed to.
SECTION 54.
Question proposed: "That section 54 stand part of the Bill."

The same problem again arises.

Question put and agreed to.
SECTION 55.
Question proposed: "That section 55 stand part of the Bill."

This is the section that sets out what is or is not an offence in relation to a person making a false declaration or falsely holding himself out to be registered as a medical practitioner. It brings us back to a point I have made several times as to whether we should not try to introduce other areas of control in an effort to protect the general public. Again, I invite the Minister to consider that before Report Stage.

In relation to subsection (2), it is amazing how well the 1927 Act has stood the test of time. It is an Act of 50 years ago and so was drafted a little earlier than that. For instance, sections 53 and 54 are virtually rewrites of sections 33 and 34 of the 1927 Act. Quite a number of sections right through this Bill are virtually copied line by line from the original Act of 1927. We all agree that one of the failures of that Act that has come about through the passage of time is in regard to the penalties, which do not bear any relation to present-day circumstances. The fine was £25. It is suggested here that the fine should be up to £500. I disagree with this sort of figure being written into legislation. We have had problems very often in regard to grants and in other areas, where income limits or grants limits are written into legislation. We know it takes a long time for legislation to be amended. Grants and income limits or monetary fines that are relevant in today's terms may be hopelessly out of date in five years' time. In all those instances, if a figure is contained in a Bill, the Bill should also have a subsection allowing the Minister afterwards by order to vary the figure.

With due respect to the Deputy, that would be most objectionable. Where the criminal law is concerned entirely different considerations apply. I can understand the Deputy's point of view about the grants or anything of that nature but there would be very real objection to not stipulating by statute what the appropriate fine is where criminal matters are concerned.

I am suggesting that the appropriate fine be stipulated in the appropriate subsection but that there should be another subsection allowing the Minister by a draft order or regulation to vary it. That could be debated if need be.

Perhaps that would be more convenient but there is something more fundamental than convenience involved here. This gets to the very root of parliamentary democracy. When one is dealing with the criminal law with the capacity to put a person to jail for not paying a fine, it should be spelled out in detail——

For not paying retention fees.

We do not put a person to jail——

Yes, you do.

We take him off the register.

And he can go to jail.

Perhaps in very rare circumstances. We are dealing here with the criminal law where you can deprive a person of their liberty or property under the criminal code. It is well established as good and proper parliamentary procedure that in that case you must spell out the fine in the statute. That is a very desirable principle to adhere to. If necessary the statute can be amended, but where it is a fine or a term of imprisonment it must be stipulated in the statute.

Question put and agreed to.
Sections 56 and 57 agreed to.
SECTION 58.
Question proposed: "That section 58 stand part of the Bill."

This section empowers the Minister to make regulations and to lay them before the Houses of the Oireachtas. Section 9 refers to draft regulations and I wonder whether reference to the draft regulations should be made here as they are of a different nature to the remainder of the regulations in the other section.

This is in relation to the 21 days regulations.

It refers to every regulation made under the Act. All the other sections where regulations are referred to are governed by section 58. As I was going through the Bill I wondered why there was not the requirement about the 21 days. Then I came to section 58 and discovered that it covered all the regulations in the other sections. Section 9 on the appointment of the council refers to draft regulations and I wonder whether subsection (3) of section 9 ought to have been referred to because it is the section that refers to draft regulations which would not come into force until they have been passed.

A different procedure is envisaged under section 9.

Section 58 says every regulation.

That is every regulation which is made. The other concerns the laying of draft regulations before the House.

So that the draft regulations are covered all right.

Question put and agreed to.
Sections 59 and 60 agreed to.
SECTION 61.
Question proposed: "That section 61 stand part of the Bill."

How long is it envisaged that this agreement will be force?

Not very long, we hope. We are very anxious to have the new regime brought into operation as quickly as possible.

Could the changeover be by January next year?

I doubt it very much. We are relying on the authorities in the UK to bring their proposals forward before we can abolish this agreement.

Question put and agreed to.
SECTION 62.

I move amendment No. 41:

In page 24, subsection (2), line 18, after "profession" to insert "and the public".

The purpose of my amendment is to bring the public into this. The Minister said this morning that this new expanded council will work for the public and with the public, but he has not accepted any of my amendments.

The Deputy did most of the talking about the public.

The Minister went to great lengths to explain to Deputy Browne that this new council would have to have money for the new expanded work. I assumed that while the Minister did not accept my amendments he accepted the spirit of them and would bring them in on Report Stage. In line with the Minister's thinking on this I would ask him to include this amendment to say that it shall be a function of the council to give guidance to the medical profession and to the public generally. As the Minister said this morning, this council will not be hidden away in some obscure place but will make its presence felt and the intention will be to keep the public informed. It would be in the public interest for the Minister to accept this small amendment.

It would be too sweeping in the terms in which the Deputy has put it, but I will look at this subsection again to see whether there should be some expansion of it. At the moment the terms of the subsection are confined exclusively to the council guiding the medical profession. Whether we could expand it in some way to enable the council to give more information about public rights or professional behaviour is something I shall consider.

I have detected right through the Committee Stage of this Bill that it is not the Minister's intention to accept any of my amendments, but I think he accepts the spirit of them. I would appreciate it if the Minister would reconsider this amendment on Report Stage.

To add some public information dimension to subsection (2)?

That is right.

Amendment, by leave, withdrawn.
Section agreed to.
FIRST SCHEDULE.
Question proposed: "That the First Schedule be the First Schedule to the Bill."

We should consider three instead of five years for the term of office and a quorum of seven out of 20 is a bit small.

The First Schedule only applies to Acts— withdrawal of Acts, changed enactments, or the repeal of Acts. It is probably the next Schedule the Deputy is referring to.

Question put and agreed to.
SECOND SCHEDULE.
Question proposed: "That the Second Schedule be the Second Schedule to the Bill."

In the best interests of democracy the Minister should consider a three-year term of office which would ensure a much broader representation of the profession. Each term of office should be not longer than three years and a person should not be allowed to serve more than two consecutive terms of office. We are religiously following the 1927 Act on this, but a three-year term of office can be very effective and it would not add enormously to the expense of the council to have an election once every three years. This would also be in the best interests of the council.

The quorum for the meeting is listed as seven. This is not good. Seven out of 20 is not sufficient and I would like to see more.

I am inclined to favour a quorum of one.

This is the great danger. That is what I was talking about earlier, the danger of a dictatorial approach. An officer or council representative might on behalf of the council make application to the High Court for an injunction or an order against a medical practitioner and in this respect it is very dangerous. That is why I ask for a decision by the majority of the council. I note that three members could call a meeting of the council.

They can convene a meeting but they must have a quorum.

Yes, and the quorum must be seven. Would the Minister consider a quorum of ten instead? If people seek election to this council they should be prepared to attend the meetings. After all they only have to attend at least four meetings in the year. The information I have to date is that they have never exceeded their statutory requirement and there have been four meetings a year only. I would advocate a quorum of ten. I mention merely in passing about there being four meetings a year; that is the statutory requirement. I would also advocate a term of office of three years. That is all I am asking for.

I would not be inclined to agree with Deputy O'Connell at all in relation to the suggestion that the term of office of the members should be limited to three years. I would have thought five years was a fairly standard length of time for appointment to quite a number of bodies such as this one. That would be fairly reasonable. There is the requirement that no person should be allowed hold office for more than two consecutive periods of five years, ensuring that there is no danger of a person being on the council for a great length of time.

Ten years.

Ten years is the maximum at any one time. Many of us are members of bodies having a membership of approximately 25. The usual quorum is seven or eight; that is a reasonable number. It is very rarely that a body fails to meet through lack of a quorum. I do agree that there be a stipulation of a minimum four meeting annually.

In this Bill we have given to the new council very many more duties than had the previous council as the Minister was at pains to point out earlier today. Usually the requirement to meet four times a year is one that is placed on a body that has not got very many functions. In view of the numerous additional functions that will be assigned to the new council on foot of this Bill we ought to require them to meet at least once every two months —which would be six times a year. But, instead of saying six times a year, we should say once every two months ensuring that they meet on a regular basis throughout the year. There is also the tendency in some of these organisations required by statute to meet only three or four times a year to realise towards the end of the year that they have had two meetings only so that in the last month or six weeks they meet, perhaps, twice to fulfil their statutory requirement. Therefore, it might be better to require them to meet every alternate month.

In relation to the Second Schedule, the conditions in relation to the appointment of a president, the resignation of members and so on are fairly standard ones usually found in relation to bodies such as this.

Paragraph 15 of the Second Schedule reads:

Minutes of the proceedings of all meetings of the Council shall be drawn up and entered in a book kept for that purpose and such minutes shall be signed by the chairman of the next ensuing meeting.

Some of the functions of this council will be very important. They may well affect the livelihood of doctors and may involve far-reaching proposals in relation to the training and education of doctors in the graduate and post-graduate areas. There ought to be contained in that paragraph a specification as to who is to draw up the minutes and, more importantly, that the minutes should be circulated to the members and agreed at the next meeting. It is not sufficient to say minutes should be entered in a book and signed by the chairman at the next ensuing meeting if the chairman and majority of members at the next meeting do not agree that they are an accurate record of what took place.

I know the council have been given power to drawn up their own standing orders. It always intrigues me when we set out, in statute, to draw up what is really two-thirds of the standing orders of a body and finish off by saying: "We now give this body the power to draw up its own standing orders" because it has not got very much power to draw up standing orders after taking into account the restrictions the Oireachtas has placed on it. But it is important that the minutes of a council such as this, which will be taking very important decisions, should be agreed by its members as being an accurate record and only then signed by the chairman.

I shall deal with Deputies' points in the order in which they were raised. First of all, a quorum is normally a quarter of the membership. That is usual, standard practice. A quarter of 25 is six and a quarter, so we make it seven. I am not prepared to squabble about the difference between seven, eight or nine. I will consult again with the various bodies concerned to ascertain what they might think would be appropriate. To settle on a quorum of seven is reasonable. We have got to try to maintain a balance. Deputies of this House know how difficult it is to get quorums. It is very difficult in this House to get sufficient members together to provide a quorum. It is not wise to pitch the number too high. On the other hand, the number should be sufficient to ensure a reasonably representative meeting. More or less standard practice in these areas is to settle for a quarter of the membership as a quorum. However, I shall take another look at that.

I think four meetings a year are sufficient. The existing stipulation is for two meetings a year. We are increasing that to four.

I should like Deputies to bear in mind that a great deal of the work of the council can be done by committees. An active member of the council will almost certainly be attending much more than four meetings a year. Therefore, for a full, normal meeting of the council itself a stipulation of four meetings a year is sufficient. They will probably hold more but to make a mandatory minimum of four is sufficient for our purposes.

I should not like to go below five years for the life of the council. As Deputy O'Connell pointed out, the members of this council will be busy men and women carrying on their own practices, working in hospitals, doing their job, going on courses, undergoing post-graduate education and so on. Doctors are very busy people right across the board of the profession. Therefore, the minimum amount of upset there is the better. I think five years is just about right. It is sufficiently long to ensure stability and continuity without being too long. In fact, it coincides with a lifetime of the Dáil and, perhaps, that is not a bad standard to go by.

I can understand there being different opinions about what is the optimum in these areas, or what may be the most desirable standard to adopt. Without wishing to defend every comma in the Bill—the House will understand I have no wish to do that— on this aspect the Bill is fairly sound— four meetings a year minimum, a quorum of a quarter of the membership and a lifetime of five years. Particularly when one takes into account the election aspect, it will be seen that these will cost some money; they will cost some deflection of time and energy. Therefore, we should not have them too often. On the other hand, we should make sure that the council do not become moribund and out of touch.

Will the elections not be paid for by the retention fee?

Five years is a reasonable compromise. Would Deputy Boland remind me what was the other point he made.

The minutes of the meetings.

Again, we have got to let the council settle their own practices. It is enough if we stipulate that minutes must be kept. There must be an official record of the council's proceedings.

I felt it would have been better not to stipulate anything about minutes rather than stipulate something about them and not stipulate that they be agreed minutes.

Perhaps we could insert some word like "accurate" or something like that.

Normally minutes are agreed at the first ensuing meeting.

All we are concerned with here is that minutes should be kept. Normally, there is a statutory obligation on the council to keep minutes. That is important. How they keep them, what they put in or do not put in and so on is something we can safely leave to them. I would be prepared to go so far as to insert some word or words like "accurate minutes" or something of that kind.

I am thinking that they would be recording decisions in relation to the removal of doctors from the register or something like that.

What we want to ensure is that a record is kept of their proceedings.

The record cannot be challenged. That is why I am making the point.

Of course, it can be challenged. The normal procedures operate to ensure that the minutes will have to be adopted, changes made, or reservations put in and so on. This would be normal practice. Statute concerns itself with ensuring that an accurate record is kept. I will go so far as to put in the word "accurate".

We are talking about a quorum of seven. It is a meeting of the council that can decide to erase the name of a doctor or bring the case to court and seek an injunction against him. It requires only four people out of seven to make that decision and that is a very serious matter. We are talking about a meeting that may be concerned with erasing a doctor's name from the register and four people out of a council of 25 could decide this. A decision by four people out of seven would be a majority.

There are four of us here out of more than 140 Members.

We cannot guarantee the same quality and calibre on the council. The Minister should consider this matter. Perhaps he could insert some wording on the lines of "by decision of the majority of the council". A person may be wrongfully accused and on a vote of four to three he could have his case brought to the High Court and be deprived of the right to practise. All I am interested in is the question of rights. I do not think that four people should make the decision.

I see some merit in the case put forward by the Deputy but I should not like to alter the size of the quorum just to meet his case. The Bill should specify that the decision should be by a majority of members of the council.

Perhaps the Minister would consider the matter between now and Report Stage. There is also the question of the five-year period. We are talking about a profession of 3,000 persons. By reducing the term of office to three years we could ensure that many members of the profession could serve a time on the council. It might be in the best interests of the council that all members get an opportunity to serve on it and to formulate proper guidelines for themselves. The reason I suggested the three years was to give a broader representation over a specified period.

Question put and agreed to.
THIRD SCHEDULE.
Question proposed: "That the Third Schedule be the Third Schedule to the Bill."

Is the licentiate of the Apothecaries Hall gone?

Yes. Deputy Briscoe pointed out that was the origin of the phrase "gone to pot".

Question put and agreed to.
TITLE.
Question proposed: "That the Title be the Title to the Bill."

This is the point I have been making to the Minister throughout our discussion. The Title purports to represent the Bill as being:

An Act to provide for the setting up of a council ... which shall provide for the registration and control of persons engaged in the practice of medicine ...

In our discussions on Committee Stage the Minister agreed that this Bill does not control persons engaged in the practice of medicine. Only persons who are registered with the council are controlled. The Title also states:

... and to provide for other matters relating to the practice of medicine and the persons engaged in such practice....

I agree with the Title and I think it should describe what is in the Bill. The Title purports to make this an Act of Parliament eventually that will control persons engaged in the practice of medicine, but on Committee Stage the Minister admitted that it will not have this control. I want to draw his attention once again to this area and to suggest that the Bill should contain provisions to match the laudable purpose and intention set out in the Title.

Would the Minister not agree that when we talk about the practice of medicine what we really mean is the practice of orthodox medicine? The practitioner of unorthodox medicine may call it herbalism, transcendental meditation or any name he likes.

I am not talking about these people.

The Deputy is talking about quacks really. They could call themselves anything. Nobody has yet defined what is a practitioner of medicine. We could indulge in semantics about this——

I agree that gynaecologists were only admitted in 1928 to be doctors.

There are three primary qualifications set out in the Third Schedule. I am talking about the person who may represent himself as holding one of those qualifications when he does not.

There is provision for that.

This Bill does not control such a person. It only controls people who falsely represent themselves as being registered with the Medical Council. Let us take the case of a person who has a qualification and who is taken off the register. We agreed there is nothing to stop him carrying on a practice as a surgeon although the Medical Council have removed him from the register.

He will not be employed.

There is nothing to stop him operating in a private nursing home as a surgeon.

He would be open to criminal charges.

I am talking about a person who has one or more primary qualifications but who has not registration because of some act he has committed.

I thought the Deputy was talking about people who had no qualifications.

A doctor who has been removed from the register still has his medical qualifications. If he operates a private nursing home, and if people are gullible enough to go to him, he can carry on practising as a surgeon although his peers on the Medical Council and the court will have seen fit to confirm that his name should be removed from the register. He can still practise medicine and prescribe certain drugs. That is why I say that if the general public see the Title of this Bill and see that it claims to control persons engaged in the practice of medicine, when we are all agreed that a man struck off the register but who holds a degree——

Or who was never on the register.

Yes, or who was never on the register——

We are not setting out to stop anybody practising medicine.

I think we are and according to the Title——

To register and control.

According to the Title the Medical Council shall provide for the registration and control of persons engaged in the practice of medicine. I am saying that what is contained in this Bill does not match what is in the Title.

Question put and agreed to.
Bill reported with amendments.
Report Stage ordered for Wednesday, 23rd November, 1977.
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