Regulated Professions (Health and Social Care) (Amendment) Bill 2019: From the Seanad

The Dáil went into Committee to consider amendments from the Seanad.

Amendments Nos. 1 to 3, inclusive, 8 to 10, inclusive, 20 to 22, inclusive, 28 to 30, inclusive, 35 and 37 to 45, inclusive, 53 and 54 shall be taken together by agreement.

Seanad amendment No. 1:
Section 8: In page 14, line 33, to delete "speciality to which the qualification relates is a speciality" and substitute "specialty to which the qualification relates is a specialty".

I am pleased to report these final amendments to the House. The Bill contains important patient safety measures and I know from the earlier Dáil and Seanad debates that there is strong support across the House for this legislation and a common desire to support its progression. The Bill makes significant changes to the five health profession regulatory Acts, particularly in the areas of fitness to practise and registration, and is keenly awaited by stakeholders.

I propose to take amendments Nos. 1 to 3, inclusive, 8 to 10, inclusive, 20 to 22, inclusive, 28 to 30, inclusive, 35, 37 to 45, inclusive, 53 and 54 together. These are minor typographical and drafting errors which were identified during the Bill's progress through the Seanad. I appreciate that this is a large number of amendments but the Bill introduces complex changes across multiple Acts. Deputies will agree that it is important to be as thorough as possible and to take the opportunity to make corrections where needed.

This group of amendments do not make any substantive changes to the Bill. They include: the correction of a drafting error in the Nursing and Midwives Act 2011, which makes reference to the wrong section; removal of a reference to a section in the Medical Practitioners Act 2007 which is incorrect; correction of a minor drafting error in the Bill which relates to the internal numbering of section 71A of the Medicinal Practitioners Act 2007; and correction of the spelling of the word "specialty". Several sections of the Bill are also being renumbered following the addition of sections to the end of the Dentists Act 1985, the Health and Social Care Professionals Act 2005, the Pharmacy Act 2007 and the Medical Practitioners Act 2007 by the Emergency Measures in the Public Interest (Covid-19) Act 2020 which was enacted in March this year.

Seanad amendment agreed to.
Seanad amendment No. 2.
Section 8: In page 14, line 39, to delete "speciality" and substitute "specialty".
Seanad amendment agreed to.
Seanad amendment No. 3.
Section 8: In page 16, line 17, to delete "speciality" and substitute "specialty".
Seanad amendment agreed to.
Seanad amendment No. 4.
Section 15: In page 23, to delete lines 10 to 12 and substitute the following:
" "(1A) A decision under subsection (1) to advise, admonish or censure a person shall not take effect unless—
(a) the decision is confirmed by the High Court on an application under subsection (4), or
(b) the 21 days referred to in subsection (4) within which the person may apply to the High Court for the cancellation of the decision expires without the person making such application.",".

I propose to take Seanad amendments Nos. 4 to 6, inclusive, 17 and 18, 24 to 26, inclusive, 46 to 49, inclusive, 59 and 60 together. Regulators can impose a range of sanctions on a practitioner following a fitness to practise inquiry. The most serious of these include cancelling a person's registration, suspending the registration for a period of time or attachment of conditions to a person's practice. Before these sanctions take effect they must be confirmed by the High Court. Regulators can also choose to impose minor sanctions such as advice, admonish and censure. Currently, these minor sanctions do not require a High Court confirmation but cannot be appealed to the court. The Bill changes this such that any sanction can now be appealed to the courts. The Bill, as initiated, introduced amendments to the five Acts to provide that the minor sanctions would in future require High Court confirmation before taking effect. Concerns were expressed in this House at the earlier Stages of the Bill that this measure would impose an unnecessary additional cost, would delay the finalisation of proceedings and may bring an additional degree of publicity to registrants on whom the most minor of sanctions were being imposed. Having reviewed the matter and consulted with stakeholders, the Minister introduced these Seanad amendments to the Bill, which remove the proposed requirement for a High Court confirmation of the minor sanctions. This was welcomed by Senators across the House. The Bill, of course, continues to provide the new right of appeal for minor sanctions.

Seanad amendment agreed to.
Seanad amendment No. 5.
Section 15: In page 23, to delete line 31 and substitute "borne.".".
Seanad amendment agreed to.
Seanad amendment No. 6:
Section 15: In page 23, to delete lines 32 to 38, and in page 24, to delete lines 1 to 7.
Seanad amendment agreed to.
Amendment No. 7:
Section 19: In page 27, to delete lines 6 to 8 and substitute the following:
"(a) advise the public—
(i) when any measure referred to in section 47(1)(a) to (e) takes effect under this Part in respect of a person whose name is entered in a register maintained under this Act, and
(ii) if satisfied that it is in the public interest to do so, when any measure referred to in section 47(1)(f) takes effect under this Part in respect of a person whose name is entered in a register maintained under this Act,”.

I propose to take amendments Nos. 7, 19, 27, 50 and 61 together.

As with the previous amendments, these relate to the treatment of the minor sanctions of advice, admonish and censure. The Bill initially provided that regulators would in future be required to publish information in all cases where these sanctions were imposed. Colleagues in both Houses expressed concern that this measure would have a disproportionate impact on those receiving minor sanctions. Following consultation with the regulators and representative bodies, it was agreed that the publication of minor sanctions will instead be subject to a public interest test to be applied by the regulator. This will allow regulators to exercise discretion and only publish information relating to minor sanctions where they are satisfied that it is in the public interest to do so. These amendments were warmly welcomed by stakeholders and by Senators on all sides of the House when introduced.

Seanad amendment agreed to.
Seanad amendment No. 8:
Section 23: In page 29, line 34, to delete “section 68” and substitute “section 69”.
Seanad amendment agreed to.
Seanad amendment No. 9:
Section 23: In page 29, line 36, to delete “69. (1) The” and substitute “70. (1) The”.
Seanad amendment agreed to.
Seanad amendment No. 10:
Section 23: In page 30, line 35, to delete “70. (1) Where” and substitute “71. (1) Where”.
Seanad amendment agreed to.
Seanad amendment No. 11:
Section 29: In page 33, line 9, to delete “following subsection” and substitute “following subsections”.

I propose to take amendments Nos. 11 to 15, inclusive, together.

These amendments are consequent on Dáil amendments on Committee Stage. They relate to section 29 of the Bill, which amends the Health and Social Care Professionals Act 2005 to allow a small cohort of practitioners to apply for registration with the Physiotherapists Registration Board. The Bill as passed by the Dáil amends the 2005 Act in two ways. It deletes a restrictive date requirement for receipt of a particular qualification and, consequently, extends the time allowed for persons to apply for registration with this board from 31 December 2019 to 31 December 2021. However, as currently drafted, extending the registration window from 31 December 2019 to 31 December 2021 was dependent on the Bill being enacted before the end of 2019. This did not happen and the registration window closed on 31 December 2019.

If the Bill is enacted as currently drafted, it will incorrectly imply that the registration window has remained open. Accordingly, the amendment proposed here is a corrective measure. It addresses the fact that there is now a period when a cohort of applicants is unable to apply for registration with the Physiotherapists Registration Board. It also allows applications which were received by Health and Social Care Professionals Council, CORU, prior to 31 December 2019 but where no decision has been reached by the board on them to be considered as valid applications, removing the need for an applicant to make a second application. Furthermore, it extends the window of registration for qualifying applicants from the date of the commencement of the Bill until 30 June 2022, which I trust will provide adequate time for these applicants to avail themselves of these registration provisions.

The amendment also clarifies that any application received during the current period when the application window is closed, that is, between 31 December 2019 and the commencement of the relevant section in the Bill, is not to be considered by the registration board, although it is open to any applicant to reapply when the application window reopens. Finally, the amendment also provides that applicants seeking registration under this provision will be required to comply with return-to-practise by-laws in the same way as is required for other applicants for registration on the Physiotherapists Registration Board.

Seanad amendment agreed to.
Seanad amendment No. 12:
Section 29: In page 33, line 12, to delete “applies” and substitute “subject to subsection (2FA), applies”.
Seanad amendment agreed to.
Seanad amendment No. 13:
Section 29: In page 33, line 14, to delete “31 December 2021” and substitute “30 June 2022”.
Seanad amendment agreed to.
Seanad amendment No. 14:
Section 29: In page 33, line 19, to delete “section 31(1)(fa)(i)” and substitute “section 31(1)(fa)”.
Seanad amendment agreed to.
Seanad amendment No. 15:
Section 29: In page 33, line 27, to delete “that Institute.”.” and substitute the following:
“that Institute.
(2FA) (a) Paragraph (b) applies to a person who has made an application—
(i) referred to in subsection (2F)(a), as in force before the relevant commencement, on or before 31 December 2019, and
(ii) which has not, before the relevant commencement, been determined by the Physiotherapists Registration Board.
(b) The Physiotherapists Registration Board may, on or after the relevant commencement, determine the application without the person having to make a further application referred to in subsection (2F)(a).
(c) Paragraph (d) applies to a person who has made an application referred to in subsection (2F)(a), as in force before the relevant commencement, on or after 1 January 2020 but before the relevant commencement.
(d) The Physiotherapists Registration Board may not, on or after the relevant commencement, determine that application but without prejudice to the person’s right to make a further application referred to in subsection (2F)(a).
(e) In this subsection, ‘relevant commencement’ means the commencement of section 29(b) of the Regulated Professions (Health and Social Care) (Amendment) Act 2020.”.”.
Seanad amendment agreed to.
Seanad amendment No. 16:
Section 41: In page 40, to delete lines 14 to 17 and substitute the following:
"Amendment of section 67 of Act of 2005
41. Section 67 of the Act of 2005 is amended by the substitution of the following subsection for subsection (2):
“(2) If the registration board was directed to impose a disciplinary sanction, the notification under subsection (1) must also specify—
(a) the time allowed to the registrant for bringing an application to the Court for cancellation of the direction, and
(b) in the case of a disciplinary sanction other than an admonishment or a censure, the time allowed to the Council for bringing an application to the Court for confirmation of the direction.”.”.
Seanad amendment agreed to.
Seanad amendment No. 17:
Section 42: In page 40, to delete lines 18 to 20 and substitute the following:
“Amendment of section 68 of Act of 2005
42. Section 68 of the Act of 2005 is amended—
(a) by renumbering the existing section as subsection (1),
(b) in subsection (1), by the substitution of “not being” for “other than”, and
(c) by the insertion of the following subsection after subsection (1):
“(2) A direction under section 66 to impose a disciplinary sanction (being an admonishment or a censure) on the registrant does not take effect unless—
(a) the direction is confirmed by the Court on application under section 69, or
(b) the 30 days referred to in section 69(2) within which the registrant may apply to the Court for an order cancelling the direction expires without the registrant making such application.”.”.
Seanad amendment agreed to.
Seanad amendment No. 18:
Section 44: In page 40, to delete line 33 and substitute the following:
“(a) in subsection (1), by the substitution of “not being” for “other than”,”.
Amendment agreed to.
Seanad amendment No. 19:
Section 46: In page 42, line 6, after “paragraph” to insert “(h) or”.
Seanad amendment agreed to.
Seanad amendment No. 20:
Section 50: In page 43, line 9, to delete “section 97” and substitute “section 98”.
Seanad amendment agreed to.
Seanad amendment No. 21:
Section 50: In page 43, line 12, to delete “98. (1) In” and substitute “99. (1) In”.
Seanad amendment agreed to.
Seanad amendment No. 22:
Section 50: In page 45, line 5, to delete “99. (1) Subject” and substitute “100. (1) Subject”.
Seanad amendment agreed to.
Seanad amendment No. 23:
Section 53: In page 47, to delete lines 25 to 36, and in page 48, to delete lines 1 to 3 and substitute the following:
“53. Section 7 of the Act of 2007 is amended in subsection (1)—
(a) by the insertion of “and pharmaceutical assistants” after “pharmacists” in paragraph (d), and
(b) by the substitution of the following paragraph for paragraph (e):
“(e) to—
(i) supervise compliance with this Act, and
(ii) supervise compliance by pharmacists, pharmaceutical assistants and pharmacy owners in their respective capacities as such, with—
(I) the Poisons Acts 1961 and 1977,
(II) the Misuse of Drugs Acts 1977 to 2017,
(III) the Animal Remedies Acts 1993 and 2006,
(IV) the Irish Medicines Boards Acts 1995 and 2006,
(V) the Health (Pricing and Supply of Medical Goods) Act 2013,
(VI) any statutory instrument made under any of those Acts, and
(VII) the European Communities (Animal Remedies) (No. 2) Regulations 2007 (S.I. No. 786 of 2007),
and”.”.

This amendment relates to pharmaceutical assistants and was proposed and supported by a number of Senators. It will amend the Pharmacy Act 2007 to provide two new functions for the Pharmaceutical Society of Ireland. Specifically, the Pharmaceutical Society of Ireland will be required to ensure that pharmaceutical assistants undertake continuous professional development and that they comply with specific legislation related to enactments for which it supervises compliance. Officials continue to engage with the Pharmaceutical Society of Ireland to ensure that the voted amendments can be carried into practise in a safe and effective manner that serves the public interest. This amendment will enhance patient safety by promoting continuous professional development by pharmaceutical assistants and will be welcomed by those in the profession. They have played an important role in supporting pharmacies over many years and I wish to acknowledge the service they provide to the public and our health services overall.

Seanad amendment agreed to.
Seanad amendment No. 24:
Section 66: In page 57, to delete lines 5 to 8 and substitute the following:
“Amendment of section 49 of Act of 2007
66. Section 49 of the Act of 2007 is amended by the substitution of the following subsection for subsection (2):
“(2) If the Council has imposed a disciplinary sanction other than a disciplinary sanction arising out of measures referred to in section 48(3), the notification under subsection (1) must also specify—
(a) the time within which the registered pharmacist or pharmacy owner may apply to the High Court for cancellation of the decision,
and
(b) in the case of a disciplinary sanction other than an admonishment or a censure, the time within which the Council may apply to the High Court for confirmation of the decision.”.”.
Seanad amendment agreed to.
Seanad amendment No. 25:
Section 67: In page 57, to delete lines 9 to 11 and substitute the following:
“Amendment of section 50 of Act of 2007
67. Section 50 of the Act of 2007 is amended—
(a) by renumbering the existing section as subsection (1),
(b) in subsection (1), by the substitution of “not being” for “other than”, and
(c) by the insertion of the following subsection after subsection (1):
“(2) A decision under section 48 to impose a disciplinary sanction (being an admonishment or a censure) does not take effect unless—
(a) the decision is confirmed by the High Court on application under section 51, or
(b) the 30 days referred to in section 51(2) within which the registered pharmacist or pharmacy owner concerned may make an application to the High Court for an order cancelling the decision expires without the registered pharmacist or pharmacy owner making such application.”.”.
Seanad amendment agreed to.
Seanad amendment No. 26:
Section 69: In page 57, to delete lines 23 to 27 and substitute the following:
“Amendment of section 52 of Act of 2007
69. Section 52 of the Act of 2007 is amended—
(a) in subsection (1), by the insertion of “(not being a decision to impose the disciplinary sanction of an admonishment or a censure)” after “decision”, and
(b) by the insertion of the following subsection after subsection (4):
“(5) The High Court may direct how the costs of an application under this section are to be borne.”.”.
Seanad amendment agreed to.
Seanad amendment No. 27:
Section 71: In page 58, line 36, after “paragraph” to insert “(h) or”.
Seanad amendment agreed to.
Seanad amendment No. 28:
Section 76: In page 60, line 12, to delete “section 76” and substitute “section 77”.
Seanad amendment agreed to.
Seanad amendment No. 29:
Section 76: In page 60, line 15, to delete “77. (1) In” and substitute “78. (1) In”.
Seanad amendment agreed to.
Seanad amendment No. 30:
Section 76: In page 62, line 22, to delete “78. (1) The” and substitute “79. (1) The”.
Seanad amendment agreed to.
Seanad amendment No. 31:
Section 81: In page 69, lines 20 and 21, to delete “different grounds founding a complaint” and substitute “complaints referred to that Committee”.

I propose to take amendments Nos. 31 and 55 together.

These amendments are technical in nature and relate to the sections of the Medical Practitioners Act 2007 and the Nurses and Midwives Act 2011 that enable the respective regulators to make rules. The Bill inserts a new subsection (15)(c) into section 20 of the Medical Practitioners Act 2007. This section deals with the membership, functions and procedures of committees of council and subcommittees of committees. The new subsection (15)(c) provides that subcommittees of the fitness to practise committee may perform any of the functions of that committee as if it were the fitness to practise committee. However, section 11 of the Medical Practitioners Act 2007, which sets out the power of the Medical Council to make rules, does not reflect the breadth of functions intended by the new subsection (15)(c). The Committee Stage amendment in the Seanad replaces the wording "different grounds founding a complaint" with "complaints referred to that Committee", which ensures that the regulator's powers to make rules for committee are consistent with the functions that are assigned to those committees. An identical amendment is being made to section 13 of the Nurses and Midwives Act 2011.

Seanad amendment agreed to.
Seanad amendment No. 32:
Section 81: In page 70, to delete lines 23 to 30 and substitute the following:
“ “(3A) Without prejudice to the generality of subsection (2)(g), rules made under that subsection may provide that—
(a) the chairperson of the Preliminary Proceedings Committee, or such other member of that Committee who is authorised by the rules to do so, may establish, in accordance with the rules, a subcommittee referred to in subsection (2)(g)(i), or
(b) the chairperson of the Fitness to Practise Committee, or such other member of that Committee who is authorised by the rules to do so, may establish, in accordance with the rules, a subcommittee referred to in subsection (2)(g)(ii).”.”.

I propose to take amendments Nos. 32 to 34, inclusive, and 56 to 58, inclusive, together.

The Bill as passed by the House amends the Medical Practitioners Act 2007 and the Nurses and Midwives Act 2011 to provide that where subcommittees of the preliminary proceedings committee, PPC, and the fitness to practise committee, FPC, are established pursuant to rules, these subcommittees can perform any of the functions of the respective committees as if they were the committees. This was aimed at better utilising the time of both the PPC and the FPC and facilitating the more expeditious processing of complaints. This will be of benefit to all those involved, patients, their families and practitioners. The amendments provide additional clarity regarding the procedures for the establishment of those subcommittees. Specifically, they provide that, in accordance with the rules, the chairperson or such other committee members as may be designated by rules can establish a subcommittee of the respective committee.

As drafted, the provision could be interpreted as meaning that the entire committee is required to establish a sub-committee. These amendments remove any risk of ambiguity or uncertainty around the mechanism for establishing sub-committees.

Seanad amendment agreed to.
Seanad amendment No. 33:
Section 84: In page 71, lines 13 to 15, to delete all words from and including “where” in line 13 down to and including “subcommittee”where it firstly occurs in line 15 and substitute the following:
“where a subcommittee of the Preliminary Proceedings Committee is established pursuant to rules made under section 11”.
Seanad amendment agreed to.
Seanad amendment No. 34:
Section 84: In page 71, lines 21 to 23, to delete all words from and including “where” in line 21 down to and including “subcommittee” where it firstly occurs in line 23 and substitute the following:
“where a subcommittee of the Fitness to Practise Committee is established pursuant to rules made under section 11”.
Seanad amendment agreed to.
Seanad amendment No. 35:
Section 90: In page 87, line 6, to delete “sections 38 and” and substitute “section”.
Seanad amendment agreed to.
Seanad amendment No. 36:
Section 90: In page 87, between lines 8 and 9, to insert the following:
“Amendment of section 38 of Act of 2007
91. Section 38 of the Act of 2007 is amended—
(a) by the substitution of “A person does not contravene section 37(1)” for “A medical practitioner does not contravene section 37(a)”,
(b) in paragraphs (a), (b), (c) and (d), by the substitution of “the person” for “the practitioner”,
(c) by the deletion of paragraph (e), and
(d) in paragraph (f)—
(i) by the substitution of “the person” for “the practitioner”, and
(ii) by the substitution of “paragraphs (a) to (d)” for “paragraphs (a) to (e)”.”.

Section 36 of the Medical Practitioners Act addresses areas of overlap between the practice of medicine and other health professions. Under existing legislation, where a person holds a dual qualification in medicine and another health professions, for example, dentistry, this section allows them to lawfully practice those areas of dentistry which overlap with medicine without having to be on the register of medical practitioners.

Section 37 provides that a person must be registered with the Medical Council in order to practice medicine in the State. The amendment clarifies that the requirements of section 37 do not apply to a person registered as a dentist, nurse or so on who was practising medicine when carrying out tasks in the context of the other specified health profession. This amendment, recommended by the Office of the Attorney General, makes clear that a person, irrespective of whether they are a medical practitioner, is not unlawfully practising medicine when carrying out tasks in the context of the other specified health profession and so they are not contravening section 37 of the Medical Practitioners Act.

Seanad amendment No. 51:

Section 132: In page 113, to delete line 14 and substitute the following:

“(ii) in paragraph (a)(i)—

(I) by the insertion of “where appropriate,” before “approve, approve subject to conditions”, and

(II) in clause (I), by the deletion of “basic”,”.

Seanad amendment agreed to.
Seanad amendment No. 37:
Section 91: In page 87, line 16, to delete “speciality” and substitute “specialty”.
Seanad amendment agreed to.
Seanad amendment No. 38:
Section 91: In page 87, line 18, to delete “speciality” and substitute “specialty”.
Seanad amendment agreed to.
Seanad amendment No. 39:
Section 95: In page 89, line 39, to delete “speciality” and substitute “specialty”.
Seanad amendment agreed to.
Seanad amendment No. 40:
Section 96: In page 91, lines 5 and 6, to delete “speciality other than the speciality” and substitute“specialty other than the specialty”.
Seanad amendment agreed to.
Seanad amendment No. 41:
Section 108: In page 102, to delete lines 1 to 3 and substitute the following:
“(i) in paragraph (a)—
(I) in subparagraph (i), by the substitution of “a person who has permanently ceased to be a fit and proper person to continue to practise medicine” for “permanently unfit to continue to practise medicine”, and
(II) by the substitution of “section 71(1)(f)” for “section 71(f)”,and”.
Seanad amendment agreed to.
Seanad amendment No. 42:
Section 120: In page 109, line 2, to delete “71A” and substitute “71A(1)”.
Seanad amendment agreed to.
Seanad amendment No. 43:
Section 123: In page 110, to delete lines 4 and 5 and substitute the following:
“(b) in subsection (1)—
(i) by the substitution of “Subject to subsection (2), in the case” for “In the case”, and
(ii) by the substitution of “section 70(b)(ii)” for “section 70(b)”, and”.
Seanad amendment agreed to.
Seanad amendment No. 44:
Section 124: In page 110, to delete lines 10 to 13 and substitute the following:
“Amendment of section 72 of Act of 2007
124. Section 72 of the Act of 2007 is amended—
(a) in subsection (1)—
(i) by the substitution of “section 71(1)(b), (c)” for “section 71(b), (c)”, and
(ii) in paragraphs (a), (b), (c), (d) and (e), by the substitution of “section 71(1)”for “section 71”,
and
(b) in subsection (2)—
(i) by the substitution of “section 71(1)(f)” for “section 71(f)”, and
(ii) in paragraph (a), by the substitution of “a person who is not a fit and proper person to practise medicine” for “unfit to continue to practise medicine”.”.
Seanad amendment agreed to.
Seanad amendment No. 45:
Section 125: In page 110, to delete lines 10 to 13 and substitute the following:
“Amendment of section 72A of Act of 2007
125. Section 72A of the Act of 2007 is amended—
(a) by the substitution of “section 71A(1)(b), (c)” for “section 71A(b), (c)”, and
(b) in paragraphs (a), (b) and (c), by the substitution of “section 71A(1)” for “section 71A”.”.
Seanad amendment agreed to.
Seanad amendment No. 46:
Section 125: In page 110, to delete lines 14 to 21 and substitute the following:
“Amendment of section 73 of Act of 2007
125. Section 73 of the Act of 2007 is amended by the substitution of the following subsection for subsection (2):
“(2) Where the Council has decided to impose a sanction on a registered medical practitioner (other than a sanction arising from measures referred to in section 71(2) or 71A(2)), the Council shall give notice in writing to the practitioner of the practitioner’s entitlement, under section 75, to appeal to the Court against the decision.”.”.
Seanad amendment agreed to.
Seanad amendment No. 47:
Section 126: In page 110, to delete lines 22 to 25 and substitute the following:
“Amendment of section 74 of Act of 2007
126. Section 74 of the Act of 2007 is amended—
(a) by renumbering the existing section as subsection (1),
(b) in subsection (1), by the substitution of “(not being a sanction referred to in section 71(1)(a) or 71A(1)(a) or arising from measures referred to in section 71(2) or 71A(2))” for “(other than a sanction referred to in section 71(a) or 71A(a))”, and
(c) by the insertion of the following subsection after subsection (1):
“(2) A decision under section 71(1) or 71A(1) to impose a sanction (being a sanction referred to in section 71(1)(a) or 71A(1)(a)) on a registered medical practitioner shall not take effect unless—
(a) the decision is confirmed by the Court on an application under section 75, or
(b) the 21 days referred to in section 75(1) within which the practitioner may appeal to the Court against the decision expires without the practitioner making such appeal.”.”.
Seanad amendment agreed to.
Seanad amendment No. 48:
Section 127: In page 110, line 30, to delete “section 71 or 71A” and substitute “section 71(1) or 71A(1)”.
Seanad amendment agreed to.
Seanad amendment No. 49:
Section 128: In page 111, to delete lines 1 to 3 and substitute the following:
“(a) in subsection (1), by the substitution of “(other than a sanction referred to in section 71(1)(a) or 71A(1)(a) or arising from measures referred to in section 71(2) or 71A(2))” for “(other than a sanction referred to in section 71(a) or 71A(a))”, and”.
Seanad amendment agreed to.
Seanad amendment No. 50:
Section 130: In page 112, line 16, to delete “paragraph (a)(ii)” and substitute “section 84(1)(k) or (l) or paragraph (a)(ii)”.
Seanad amendment agreed to.

I propose to discuss Seanad amendments Nos. 51, 52 and 62 together.

Sections 88 and 89 of the Medical Practitioners Act set out the duty of the Medical Council in respect of education and training for medical qualifications. They require the Medical Council to approve programmes of training and the bodies which deliver the training. However, while the Act is explicit that the council may refuse to approve a body as a body which may deliver undergraduate or postgraduate training programmes, the Act does not explicitly provide for the council to refuse to approve an individual training programme. A similar issue arises in section 85 of the Nurses and Midwives Act in respect of the training of nurses and midwives. This is problematic for both regulators in that while they can attach conditions to a programme, they do not have the express power to refuse to approve a training programme which does not meet the required standard. Both the Medical Council and the Nursing and Midwifery Board of Ireland have identified this as a weakness to their respective Acts and accordingly these technical amendments give both regulators the express power to refuse to approve training programmes.

Seanad amendment No. 55:

Section 142: In page 120, lines 28 and 29, to delete “different grounds founding a complaint” and substitute “complaints referred to that Committee”.

Seanad amendment agreed to.
Seanad amendment No. 52:
Section 132: In page 113, between lines 22 and 23, to insert the following:
“Amendment of section 89 of Act of 2007
133. Section 89 of the Act of 2007 is amended, in subsection (3), by the substitution of the following paragraph for paragraph (b):
“(b) refuse to approve—
(i) a programme of specialist training in relation to that medical specialty, or
(ii) a body as a body which may grant evidence of the satisfactory completion of specialist training in relation to that medical specialty.”.”.
Seanad amendment agreed to.
Seanad amendment No. 53:
Section 139: In page 117, line 33, to delete “section 109” and substitute “section 111”.
Seanad amendment agreed to.
Seanad amendment No. 54:
Section 139: In page 117, line 34, to delete “110. (1) Where” and substitute “112. (1) Where”.
Seanad amendment agreed to.
Seanad amendment agreed to.
Seanad amendment No. 56:
Section 142: In page 120, to delete lines 33 to 37 and page 121, to delete lines 1 to 2 and substitute the following:
“ “(3A) Without prejudice to the generality of subsection (2)(h), rules made under that subsection may provide that—
(a) the chairperson of the Preliminary Proceedings Committee, or such other member of that Committee who is authorised by the rules to do so, may establish, in accordance with the rules, a subcommittee referred to in subsection (2)(h)(i), or
(b) the chairperson of the Fitness to Practise Committee, or such other member of that Committee who is authorised by the rules to do so, may establish, in accordance with the rules, a subcommittee referred to in subsection (2)(h)(ii).”.”.
Seanad amendment agreed to.
Seanad amendment No. 57:
Section 143: In page 121, lines 18 to 20, to delete all words from and including “where” in line 18 down to and including “subcommittee” where it firstly occurs in line 20 and substitute the following:
“where a subcommittee of the Preliminary Proceedings Committee is established pursuant to rules made under section 13”.
Seanad amendment agreed to.
Seanad amendment No. 58:
Section 143: In page 121, lines 25 to 27, to delete all words from and including “where” in line 25 down to and including “subcommittee” where it firstly occurs in line 27 and substitute the following:
“where a subcommittee of the Fitness to Practise Committee is established pursuant to rules made under section 13”.
Seanad amendment agreed to.
Seanad amendment No. 59:
Section 170: In page 138, to delete lines 11 to 14 and substitute the following:
“Amendment of section 72 of Act of 2011
170. Section 72 of the Act of 2011 is amended—
(a) by renumbering the existing section as subsection (1),
(b) in subsection (1), by the substitution of “not being a sanction referred to in section 69(1)(a) or arising from measures referred to in section 69(2)” for “other than a sanction referred to in section 69(1)(a) or (2)”, and
(c) by the insertion of the following subsection after subsection (1):
“(2) A decision under section 69 to impose a sanction (being a sanction referred to in section 69(1)(a)) on a registered nurse or a registered midwife shall not take effect unless—
(a) the decision is confirmed by the Court on an appeal under section 73, or
(b) the 21 days referred to in section 73(1) within which the nurse or midwife may appeal to the Court against the decision expires without the nurse or midwife, as the case may be, making such appeal.”.”.
Seanad amendment agreed to.
Seanad amendment No. 60:
Section 172: In page 138, to delete lines 21 to 23 and substitute the following:
“(a) in subsection (1), by the substitution of “or arising from measures referred to in section 69(2)” for “or (2)”, and”.
Seanad amendment agreed to.
Seanad amendment No. 61:
Section 175: In page 140, line 13, to delete “paragraph (a)(ii)” and substitute “section 82(1)(k) or (l) or paragraph (a)(ii)”.
Seanad amendment agreed to.
Seanad amendment No. 62:
Section 176: In page 140, between lines 27 and 28, to insert the following:
“Amendment of section 85 of Act of 2011
176. Section 85 of the Act of 2011 is amended, in subsection (2)(a)(i), by the insertion of “where appropriate,” before “approve, approve subject to conditions”.”.
Seanad amendment agreed to.
Seanad amendment No. 63:
Section 183: In page 144, to delete lines 6 to 34, and in page 145, to delete lines 1 to 3.

The Bill, as passed by this House, amends the Health Act 2004 to give the Minister for Health the power to designate the HSE as the competent authority to compare the equivalence of non-Irish qualifications with the qualifications assessed for certain health professions. These are professions which are not regulated on a statutory basis but which are regulated for the purpose of the EU professional qualification directive and for which the Minister is currently the competent authority. Concerns were raised on Committee Stage in the Seanad on behalf of the Environmental Health Association of Ireland regarding the HSE being the competent authority for environmental health officers, EHOs, one of the professions for which the HSE would become competent authority if so designated. I understand that the Environmental Health Association of Ireland believes this would be a conflict of interest if the HSE were to act as both employer and deciding body in respect of qualification recognition. The association is also concerned about the appropriateness of the HSE acting as competent authority for environmental health officers when the executive is not the exclusive employer of the EHOs, with many employed outside the health sector including, for example, by local authorities.

The Department received advice from the Office of the Attorney General on how to eliminate any potential conflict of interest arising in respect of the HSE undertaking the dual role of employer and competent authority. However, the Minister recognises the concerns raised by the Environmental Health Association of Ireland and these will need to be reviewed and fully considered by officials. Until such time as these can be fully considered, the Minister is satisfied that it is appropriate and safe for the status quo to remain and it is proposed, therefore, to remove this provision from the Bill.

Seanad amendment agreed to.
Seanad amendments reported.

Agreement to the Seanad amendments is reported to the Houses and a message will be sent to Seanad Éireann acquainting it accordingly.

Sitting suspended at 9.18 p.m. and resumed at 9.48 p.m.