Dáil Éireann debate -
Tuesday, 9 Oct 2001

Vol. 541 No. 4

Adjournment Debate. - Medical Practitioners Act, 1978.

Mr. B. O'Keeffe

I draw the Minister's attention to the fact that restrictions in the Medical Practitioners Act, 1978, may be discriminatory and contrary to EU employment law. In order to study medicine in the United Kingdom or the North of Ireland, after completing a degree, a graduate cannot obtain a place as an intern in an Irish hospital because of the provisions under section 37(2) of the Act. We are discriminating against Irish nationals who want to work at home. In the past we did not have sufficient places for them to attend medical school in Ireland and they were forced to accept places in Northern Ireland or the United Kingdom.

Ironically, non-nationals who pursue medicine in UCD, UCC, NUIG, TCD or the Royal College of Surgeons can obtain such places in Irish hospitals. UCD has a conferring arrangement for medical students in universities in Malaysia. It is possible for a Malaysian student conferred by UCD to come to Ireland to practise as an intern in Irish hospitals, even though an Irish person is debarred because he or she has trained in the United Kingdom.

Funnily, UK students who study medicine in Ireland can act as interns in Irish hospitals. Therefore, the Minister will understand the frustration, anger and sheer bewilderment of Irish parents with the provision in an Act which they believe favours non-nationals and discriminates against their son or daughter.

One case has come to my notice. It pertains to a young girl who graduated in June 2000 with an honours degree in medicine. She already held an honours degree in physiology and is a graduate of UCC. She is a Cork native and married to a Corkman. She has been travelling to and from the United Kingdom at weekends to ensure her marriage survives. She applied for an internship in Ireland, but was refused on the basis of the appendix under the provisions of the Act. In June, if she applies for an internship in the United Kingdom, it means she will be away from her husband for another year.

In June 2002 she will be unemployed, although, statistically, she has two honours degrees. The present section of the Bill is inequitable. It is out of date, nor is it in line with the tenets of any Anglo-Irish agreement put in place. Surely, it must be contrary to EU law pertaining to the freedom of movement of workers. Fortunately, it is possible through ministerial regulation for the Minister to change the appendix by declaring that medical students who qualified at recognised medical colleges in Northern Ireland and the rest of the United Kingdom can and should be competent to act as interns in Irish hospitals. This is possible by regulation and by holding discussions with the Medical Council. It is not necessary to change the Medical Practitioners Act to allow fair play to an Irish person who is extremely competent and well trained and wants to come home and work here in a system which needs such outstanding graduates.

Mr. Martin

I thank Deputy Batt O'Keeffe for raising this issue because it gives me the opportunity to go through the various points he made.

Ireland has a very strict regulatory regime which ensures only competent and properly qualified medical practitioners can work in this country. No doctor is allowed to practise medicine in Ireland unless he or she is registered on the Register of Medical Practitioners. The overriding rationale behind these requirements is to ensure the protection of the public.

Under the Medical Practitioners Act, 1978, the Irish Medical Council is the independent body charged with regulating medical registration. Under the Act a person who wishes to become a registered medical practitioner must first obtain a certificate of experience from the body that granted him or her his or her primary degree. To obtain a certificate of experience the applicant must have been employed in a training hospital as a medical resident or intern for a period specified by the Medical Council. The training hospital must also be approved as such by the council.

The situation the Deputy referred to arises when a person wishes to carry out his or her internship training in Ireland having obtained his or her primary qualification abroad. Section 37 and the Fourth Schedule of the Medical Practitioners Act requires that the primary qualification required to qualify for internship must be obtained from an Irish university. Where a person does not hold such a primary qualification, he or she cannot be granted the provisional registration which allows him or her carry out his or her internship in Ireland. I have made inquiries of the Irish Medical Council in regard to the issue raised by the Deputy and it has confirmed that the situation is as I have outlined.

As the Deputy may be aware, we are conducting a review of the Medical Practitioners Act. In the 23 years since the Act was enacted many changes have taken place in the practice of medicine. The expectations of the public as regards the nature and quality of its medical care have grown, issues such as competence assurance, clinical audit, reaccreditation and evidence based medicine have come to the fore, the need for more accountability from public services and bodies has been acknowledged and the need for public confidence in the ability of the medical profession to regulate itself and the requirement to deliver a quality assured, patient centred service have become issues.

The review of the Medical Practitioners Act is being carried out in light of these developments. Consultation has been widespread with many interested groups, including the Irish Medical Council, the training bodies and bodies representing the medical professions and patients. I assure the Deputy that I am aware of the issue he has raised and it will be addressed as part of this review. In light of his representations this evening, I will see if we can do something in the interim by way of regulation. We hope that draft heads of a new Medical Practitioners Bill will be published before the end of the year.