Health and Social Care Professionals Bill 2004: Committee Stage (Resumed).
SECTION 9.
Question again proposed: "That section 9 stand part of the Bill."
Question put and agreed to.
Sections 10 to 25, inclusive, agreed to.
SECTION 26.
Amendment No. 6 not moved.
Question proposed: "That section 26 stand part of the Bill."
This section relates to the establishment of the registration boards, which will be extremely important. I am sure Members and the Minister of State will want to ensure that these boards operate in line with their international counterparts and that they will not cover people for whom provision is not made internationally. I was concerned on the previous occasion when the Minister of State said that we must be careful about protecting people's livelihoods. The boards will not take anyone else's livelihood away; they will be concerned with the protection of people's titles. If a person is not entitled to be with a particular board, that does not mean they cannot make a living. No one is trying to prevent them from doing so. These individuals will merely not be able to refer to themselves by the title conferred by registration with the board in question. People will be required to have certain training, experience, etc., before they can register with any of the boards.
The registration boards will make their own rules. However, I understood that the philosophy behind the Bill is to introduce professional registration in respect of the professionals to which it refers while simultaneously protecting the general public by ensuring that only those registered will be able to refer to themselves by whatever may be the relevant appellation. There is no question that we are trying to take away anyone's livelihood. I previously stated that we can establish as many registration boards as we like but that people will be free to refuse to take notice of them.
Senator Glynn also previously referred to the outrageous behaviour of certain individuals who were members of professional boards. If people want to seek help from such individuals, there is nothing we can do about it. All we can do is point out that they are not registered with the various registration boards. If, when the boards are established, it is believed that certain people already on the registers should be struck off, the boards will be empowered to remove them.
It is important to recall the philosophy behind the Bill which, in my view, is to establish registers for the various professions, require professional qualifications from anyone wishing to register and allow for further professions to be catered for at a later date. No one is trying to take away anyone else's livelihood. The important matter with which the Bill deals involves people's use of titles. Members of the general public should be in a position to consult registers to see if people who refer to themselves as holding particular professional appellations are included on those registers.
This is one of the more important Bills to come before this House in my seven years as a Member. Professional qualifications should be jealously guarded. These are people who have gone through the rigours of studying for anything up to seven years to attain a professional title. This Bill is designed to protect those titles. Apart from the 12 professional groupings mentioned therein, the Minister has also provided in the legislation the power to incorporate other groupings. It is imperative and it cannot be stressed enough that professional standards are very high. Both the Minister of State and I would insist that all the professional groupings are stand-alone professions and must be recognised as such. I commend the Minister of State on his view and he is also a professional person. It is imperative that the titles are protected.
We must also ensure that consumers are protected and treated by people who are qualified to treat them and whose qualifications have de facto recognition by the State. As an Irishman and as a Member of the Oireachtas I am in favour of that protection and believe it must be ensured. Some groupings have expressed their concerns to me. I have spoken to the Minister of State and I am satisfied that he is on the right track. Senator Henry is also correct and I support her view. The Government is not trying to do anyone down because that is not its role. This Bill will protect those who have gone through the rigours of pursuing a professional career and earning a qualification. The Houses of the Oireachtas will enact legislation to protect the professional qualifications and titles and also the consumer.
Question put and agreed to.
SECTION 27.
Amendments Nos. 7, 8, 14 and 15 are related and may be discussed together by agreement.
I move amendment No. 7:
In page 21, subsection (3)(a), line 7, after “maintain” to insert “on an up-to-date basis”.
These are straightforward amendments to ensure that once the register of members has been drawn up it will be updated on a yearly basis, for instance, so that the public would know that the professional people were properly qualified and had not been struck off or been out of action for other reasons. The amendments will ensure that the registration boards update the register on a frequent basis. Amendment No. 8 proposes to make the register available for inspection by members of the public which is their right. They could ascertain that the person they intend to engage or whom they are consulting is a member of the appropriate registration board and is certified as a result, thus ensuring the public gets the proper service it deserves.
There is great sense in Senator Browne's amendments as there is in my own. It can be presumed that new people will be coming on to the register every year as they qualify and those who have died will no longer appear. My amendment proposes an update on a yearly basis. I support Senator Browne's amendment that the register be available for inspection by members of the public. I prefer my own proposal of yearly rather than on an up to date basis, which could mean yearly but then it might also mean more than yearly, which would be an onus on the registration board. Any sensible kind of register must be updated on a yearly basis. The amendment proposing that the public be allowed see the register is very important.
The maintenance of a comprehensive, accurate and up-to-date register of practitioners is a main function of each registration board and is clearly pivotal to the effective discharge of the role of each board. The registrants also have an important responsibility to keep the relevant board informed of any changes in their registration details. Section 44 specifies a number of detailed responsibilities of both the registrant and the board to ensure that the register of practitioners is correct and remains correct and fully up to date at all times. Section 45 sets down requirements for the publication of the register consistent with the objective of Senator Browne's amendment.
It is considered that these provisions give adequate scope and flexibility to the registration boards to publish the registers as often as required, including on the web, for example. Limiting publication to once a year, as proposed by Senator Henry, would preclude the registration board from providing real time information on its registered practitioners to members of the public. This would be seen to impact on the board's primary objective of protecting the public. In my view, real time information would provide a more up to date version of the register.
The Minister of State is such a nice man so I will not say that is a likely story or something like that. I can see his point. Could the phrase "at least yearly" not be included? I ask the Minister of State to consider my proposal. Registers exist which are left saecula saeculorum and I know some of them. I am not be happy with the looseness of this section of the Bill.
Senator Browne's proposal for access by the public has not been dealt with. The Minister of State's proposals are not satisfactory. I am an agreeable woman but the section must include a phrase such as "at least on a yearly basis" or something stronger if the Minister of State wants it more up to date, which would be splendid. I have known of registers which have not been reprinted for years in some cases. It is very important to include this proposal.
I presume the Senator is not referring to voters' registration. I am not aware of and I would be delighted if the Senator could inform me of any register that has not been updated. My understanding of the professions is that the registers must be updated annually. I have no problem with adding the phrase "on an annual basis" to section 45, which states, "publish its register in the manner, and at the times, that it considers appropriate." I am not aware of any professional body which does not do so. My own profession of pharmacy has a statutory obligation to publish its register. I presume the medical profession and others must publish on an annual basis.
The Minister of State is correct, they are statutory and that is the reason I wish this to be statutory. I have in mind the electoral rolls for the university seats. The Minister of State's suggestion of an annual basis would be perfect.
The Minister of State did not answer the question about public inspection of the registers which is an important point.
Section 45(1) states:
Subject to subsection (2), a registration board shall—
(a) make its register available for inspection by members of the public at all reasonable times,...
I presume this covers the Senator's requirements.
Does the term "reasonable times" refer to what the public regards as reasonable or what the board decides is reasonable? This is an important point.
Any reasonable person would understand the term to mean that the register will be available for inspection during office hours, rather than 3 a.m. on a Sunday, for example. From my experience this is also the practice.
Amendment, by leave, withdrawn.
Amendment No. 8 not moved.
Amendments Nos. 9, 19 and 20 are related and may be taken together by agreement.
I move amendment No. 9:
In page 21, subsection (3), between lines 9 and 10, to insert the following new paragraph:
"(c) to make or forward complaints to the Council under section 51,”.
The amendment clarifies that members of the public have an option to make complaints directly to the council. The legislation is vague in this area, although the matter is clarified in section 51(3), which states that registration boards can and should receive complaints. It is important, however, to include this provision earlier in the Bill. In the interests of the public and to ensure that people are aware that they have rights, I propose to insert this paragraph at this point in the Bill as the similar provision later could otherwise be missed.
That is a good point and I ask the Minister of State to consider the matter.
As the Senators will be aware, given the potential implications for a practitioner's livelihood, all decisions of the council in the disciplinary area are subject either to appeal or confirmation by the High Court. It is essential in this regard that the council behaves at all times strictly in accordance with the principles of due process.
The fitness to practise procedures contained in the Bill are, therefore, designed to differentiate clearly between the distinct and separate roles of the various constituent elements of the disciplinary process. The role of the council is broadly to initiate the investigation of a complaint and dictate an appropriate sanction based on the recommendations of a registration board following the substantiation of a complaint against a registrant.
Conferring a broad power on the council to initiate and carry out an investigation into a complaint, as proposed by Senators Browne and Henry, would circumvent the detailed fitness to practise system and run the risk of rendering the disciplinary committee superfluous or at least confer a lower order of importance on the committee. It could also undermine the objective of the Bill to develop a more modern approach to the investigation of fitness to practise complaints through the introduction of a mediation route and allowing a practitioner to accept a complaint to preclude a full hearing in less serious cases. Moreover, there could be concern among practitioners regarding the scope for potential abuse of the complaints system in circumstances that an investigation could be commenced in the absence of a complaint being made.
The requirement that there be scope for the regulatory system to initiate a complaint against a registered practitioner is reflected in section 51(3), which allows the registration board to make a complaint to the council. The proposed amendment is, therefore, not accepted.
The Minister of State's response makes good sense. However, the House has on previous occasions expressed concern regarding notorious cases in which none of the individuals concerned made a complaint, whether due to embarrassment about complaining about someone they trusted or for other reasons. The health boards were in the position — I do not know what the position is since their abolition — to initiate barring orders and so forth if a matter was believed to be getting out of hand, for instance, in circumstances in which a woman repeatedly makes complaints against her husband, only to withdraw them.
While I accept the logic of the Minister of State's argument, perhaps he or his officials could devise a way to deal with issues of this nature when they arise. There have been notorious cases in the medical profession in which it was well known that certain individuals were behaving improperly, yet no one complained. This is a difficult issue and perhaps it does not come within the scope of the Bill. Perhaps we are seeking to protect people from themselves too much. A problem arises, however, when one cannot find anyone to make a complaint against a person behaving in a professional matter, even when it is widely known. It is even more difficult to find complainants in small localities than in cities.
I understand the Senator's views on this issue and she is correct that we are all aware of cases that arose in the past. The professions and the general public accept that much of what happened in the past was not correct. I understand that the medical practitioners Bill and other legislation to come before the Houses will include whistleblower provisions in that there will be an onus on members of the professions who are aware of malpractice or unethical behaviour to come forward. They will not be able to plead ignorance. While I understand the Senator's views on past events, the Bill will ensure that complaints regarding members of the 12 professions covered by the legislation will be dealt with in an orderly fashion. It will not be necessary for individuals to make complaints against members of the professions.
I have not seen the relevant part of the medical practitioners Bill. Is it possible to include a provision on whistleblowers in this legislation? I will not labour the point but I ask the Minister of State to consider that option. We are all anxious about this matter and I know the Minister of State and his officials are not trying to be unhelpful. Perhaps provisions similar to the relevant sections of the medical practitioners Bill could be included in the Bill.
Those people who could make a complaint will have a medical condition and people in such circumstances are invariably embarrassed about coming forward. This area is not as straightforward as other areas of life where one can air one's grievances. People may not be physically able to make a complaint or may find it awkward to reveal aspects of their medical histories. The purpose of the amendment is simply to ensure that no one who reads section 27 will mistakenly conclude that the council does not have a role in the complaints procedure. The amendment spells out that its role will be to receive complaints. While this is referred to in greater detail in section 51(3), the problem is that anyone reading section 27 could get the wrong impression.
Section 51(3) states: "The complaint must be in writing or in any other form acceptable to the Council and it may be made by or on behalf of any person or by a registration board."
I believe this addresses the concerns of Senator Browne. As he will agree, we must ensure there is due process and avoid frivolous complaints.
I do not propose to get involved in that area. If section 27 were to refer to section 51(3), anyone with a complaint who read the legislation would be directed to the relevant provision. Without such a reference, they might not become aware of it. They could link both sections or draw someone's attention to it. If somebody had a complaint in a few year and read section 27 he or she might not be clear on how to proceed. Our amendment is intended to clarify the steps involved. Section 51(3) clarifies this in detail but section 27 is vague. That is why the amendment refers to section 51.
I appreciate the Senators' attempt to ensure that what should obtain will obtain but when the boards are set up they will all be on a statutory footing. No one will blow the whistle as quickly as a member of a profession who sees another member bringing it into disrepute. That is my experience and it will surely obtain in this instance. I have every confidence in all the professions, not alone the 12 mentioned in the Bill but the ones that will ensue because this is enabling legislation. They will keep a very close eye on members of their professions both registered and unregistered.
It is useful to point to section 51(3) but it does not say whether the person must give permission. If the person is a minor or has a mental impairment or illness the complaint must be made on his or her behalf but there is nothing there to indicate that the person must give permission, which might be a problem.
I take the Senator's point and will consider the matter for Report Stage.
Amendment, by leave, withdrawn.
Section 27 agreed to.
Sections 28 to 30, inclusive agreed to.
I wanted to say a couple of words on section 28.
Very well, I will say it on the next section I can.
The Senator might be able to make her point on Report Stage.
The section is agreed and we cannot go back on it.
Many representations have been made to me to the effect that the professions wished they were in the majority on these boards. I explained this was not to be and the Minister of State has explained that the Medical Council and the nurses will receive the same treatment.
SECTION 31.
I move amendment No. 10:
In page 23, after line 46, to add the following new subsection:
"(2) The Competition Authority shall be invited to periodically review the bye-laws made under subsection (1).".
The purpose of the amendment is to ensure that these professions do not become closed shops like others, particularly one which is receiving bad publicity in a new television programme on Monday nights. We want to ensure that this Bill will not over-regulate and lead to a reduction of competition which would be bad for everyone concerned.
Regulation often tends directly or indirectly to reduce competition unless adequate safeguards are put in place to prevent it. There is a substantial body of informed literature in Ireland and elsewhere demonstrating that professional regulation can all too easily result in restrictions with adverse economic impacts. In the Bill the level of lay representation on the council and the individual registration boards is intended to ensure that the work of the council and the boards is open, transparent, accountable and supports competition while ensuring that the public is protected, properly informed and guided. Notwithstanding the significance of this innovation in view of the potential competition impacts of the exercise of the powers of the council and registration boards respectively, the principle set out in the amendment is important.
Following consultation with the Competition Authority I intend to table amendments on Report Stage to provide that the authority should competition-proof the code of professional conduct and ethics in advance of it becoming binding on registrants and that rules of the council and by-laws of registration boards should be made public. Such amendments are intended to address the issue raised by Senator Browne's amendment.
I withdraw the amendment and acknowledge the Minister of State's generous offer.
Amendment, by leave, withdrawn.
Section 31 agreed to.
Sections 32 to 36, inclusive, agreed to.
SECTION 37.
I move amendment No. 11:
In page 26, subsection (3), line 19, after "state" to insert "or an Irish national".
This amendment is to reassure me that wherever the Bill refers to citizens of member states it includes Irish people. I hope it is unnecessary.
I put it down to reassure myself that it was because I presume where the Bill refers to a member state it does not refer only to other member states of the European Union but includes us as well.
The definition of a member state set out in subsection (6) on page 27, line 14, includes Ireland, therefore, a national of a member state includes an Irish national.
That is fine, I thank the Minister of State.
Amendment, by leave, withdrawn.
Question proposed: "That section 37 stand part of the Bill."
It has been put to me that the acceptance of qualifications from some other countries is very open. This arose decades ago in connection with medical qualifications and the freedom of movement in Europe but there is very little we can do about it. If we are entitled to work in other places, people are entitled to come and work here. I was asked whether this was not too open but I am not asking the Minister of State to do anything about it because he cannot do so.
Question put and agreed to.
SECTION 38.
Amendments Nos. 12 and 13 are related and will be discussed together by agreement.
I move amendment No. 12:
In page 27, between lines 38 and 39, to insert the following new paragraph:
"(b) the person—
(i) has previously been registered within the preceding 24 months, or
(ii) has not been registered within the preceding 24 months and has provided evidence of
having attended and successfully completed in the past 3 months relevant, accredited refresher training.".
If somebody has been out of practice for approximately two years this amendment requires that he or she would produce evidence of being brought up to date with the latest developments in his or her area of expertise. A two-year gap would be considered quite a long interval in some respects. We have not been too specific with this because every case is different. We could leave it to the discretion of the registration boards to ensure to their satisfaction that the person has either attended a refresher course or has been briefed on any developments in his or her profession in that time.
I share Senator Browne's concern that people might come back on to the register following a significant gap. There is very little in the Bill to cover continuing professional development or training, or whatever one wishes to call it. Perhaps it is being left to the boards but it does appear possible for someone to return to a register after quite a long gap. The practice of medicine changes rapidly and the people we are discussing are mainly paramedical practitioners.
If there has been a gap of some duration, some evidence of continued competence should be required of the person who seeks to go back on the register.
I understand what both Senators are alluding to. The section dealing with the continuing education of professionals is extremely important. The main objective of this Bill is to protect the public. The circumstances in which a practitioner who has discontinued his or her registration should be restored to the register warrants very careful consideration. Section 31(1)(g) provides that each registration board may make by-laws relating to the criteria for restoration to the register of that profession.
Section 38 provides that a person's name will be restored to a register if, among other requirements, that person meets the criteria established by by-law for restoration to the register. The issues in these proposed amendments by Senators Browne and Henry are therefore appropriate for inclusion in the criteria that each individual board develops on governing restoration to the register. In order to ensure consistency across registration boards under section 31, the council has a role in approving a registration board's by-laws. I do not propose to accept the amendments because it can be covered this way.
Of course it is in the registration board's powers and it is terribly important. The council will have a great duty to ensure that the powers in those sections are very carefully supervised. They are of extreme importance to the general public.
Amendment, by leave, withdrawn.
Section 38 agreed to.
Amendment No. 13 not moved.
Sections 39 to 44, inclusive, agreed to.
SECTION 45.
I move amendment No. 14:
In page 30, subsection (1)(b), line 23, after “register” to insert “yearly”.
We have come to an understanding that the word "annual" will be inserted in the text on Report Stage as a Government amendment. I am sure the Minister of State will give me full credit for having thought of it.
Amendment, by leave, withdrawn.
Amendment No. 15 not moved.
Question proposed: "That section 45 stand part of the Bill."
This section deals with access to and publication of registers. It would be a worthwhile gesture to include the Internet in that respect. We are in an era when information technology drives much of the economy and the Government. It is a medium through which people should be expected to declare whatever they need to. It is an avenue of knowledge that was not there for a number of years, but most households use it now and it would be appropriate if the Minister included that in the section.
Having sat beside Senator Quinn for over ten years, I feel that electronic means should be considered when publishing the register.
I thank both Senators for bringing this matter to our attention. I have no problem with the suggestion made and we will try to facilitate it.
Question put and agreed to.
Section 46 agreed to.
SECTION 47.
Question proposed: "That section 47 stand part of the Bill."
Section 47 is about the recognition of education and training programmes. I say that in the company of a former Minister for Education and Science. Do sections 47(6) to (8), inclusive, mean that the Minister can make the council recognise a course? If that is the case, is there a similar provision in courses like law, medicine and engineering?
It can be done in the context of other higher professions.
Question put and agreed to.
Sections 48 and 49 agreed to.
SECTION 50.
Amendment Nos. 16 to 18, inclusive, are related and may be taken together.
I move amendment No. 16:
In page 33, subsection (4), line 31, to delete "A majority" and substitute "At least one third".
In order to ensure that the work of the committees is not only seen to be fair, but is actually fair, a visible degree of independence is required. That is why Fine Gael proposes to reverse the proportions in the composition of the committee. The committee shall comprise a majority of non-registrants, with one third being registrants.
I was concerned at the looseness of these committees. We should at least state what constitutes a quorum, in case a couple of people were deciding on extremely important issues to do with a person's livelihood. It might have been wise to state the minimum size of a committee because there is nothing more important than the disciplinary committees. I am not hung up on the size of the committee, but we should state the minimum size as well as a quorum. Nothing could be more important for someone on a register than coming before a disciplinary committee. To find that it might be two people and that there is nothing in the legislation to state that that cannot be the case is a poor idea.
I would like the Minister of State to elaborate on this section. My amendment states that the committee should consist of at least nine members, while the quorum should be five. That is quite a large number, but we are trying to ensure that one third of them are registrants. That is not possible with seven as we would end up with part of a person. A little more delineation is required to ensure that we have set up a suitable committee in fairness to the person that has to go before it. I am particularly anxious about the fact that the committee could be very small. There is nothing in the legislation that states that a committee of two cannot sit.
The composition of committees of inquiry is critical to the credibility, transparency and accountability of the proposed regulatory system. The committees must have the expertise, capacity and commitment to effectively discharge the key responsibilities assigned to them in the Bill. They must also strike a balance between the requirement to ensure that the professional and clinical dimensions of any investigation are fully understood and the need to focus on the patient or client perspective. In assessing what this balance might be, a particular consideration must be that the work of a committee of inquiry, by its nature, will be a review of the professional or clinical conduct of a practitioner. Where non-registrants were in a majority in this process, particularly where the committee of inquiry had a small membership, this could contribute to a situation where the work of a committee might not be carried out in an efficient, effective and timely manner.
Notwithstanding the particular background in expertise of the lay membership, there is scope for the inquiry to be delayed by excessive consideration of technical and professional matters. The Bill does not lay down any strict quantitative restrictions on committees of inquiry. In some cases, a committee of three may suffice. In other circumstances there may be good grounds for a substantially larger committee of inquiry.
It is appropriate that the council should have the power to exercise discretion in this regard. I accept the principle underlying the Senators' amendments, which is that the public interest should be specifically identified as a distinct constituent of a committee of inquiry. I propose, therefore, to table an amendment on Report Stage proposing that the council should have regard to the requirement for appropriate representation of the public interest when establishing a disciplinary committee.
Can we think about the need for a minimum number of people on the committees? The Minister of State's comments make good sense, but we should ensure that each committee comprises a minimum number of people. Nothing could be more important.
Section 22(1) provides that the council "may make rules" to provide for the "membership, functions and procedures of committees". It is expected that such rules would relate to matters such as quorums. The Department will examine Senator Henry's suggestion.
I thank the Minister of State.
Amendment, by leave, withdrawn.
Amendments Nos. 17 and 18 not moved.
Section 50 agreed to.
SECTION 51.
Amendment No. 19 not moved.
Question proposed: "That section 51 stand part of the Bill."
Section 51(2) of the Bill states that "a complaint may be made under subsection (1) on the grounds of professional misconduct or poor professional performance even though the matter to which the complaint relates occurred outside the State.” If something happens outside this jurisdiction, how can it be pursued and investigated here? What grounds would there be for such an investigation? Would resources be made available? It might not be possible to achieve such an investigation because of its international dimension. I am interested to hear the Minister of State’s thinking on the matter.
Any citizen of Ireland who is a member of a profession has a constitutional right to a fair hearing, irrespective of where an alleged offence may have taken place. It is important to include the provision in section 51(2) to cover that matter.
I note the Minister of State's reply, but it is important to ensure that the provision in section 51(2) is realistic. I refer, for example, to the functions which are available and the legal ambit in which such an investigation would take place. We need to be mindful of this matter in the context of the remaining Stages. We need to be assured that it will be possible to pursue a complaint outside this jurisdiction.
A similar provision was included in the Air Navigation and Transport (International Conventions) Act 2004, which was passed by the House when I was Fine Gael's Seanad spokesman on transport. Under the Act, a citizen can pursue a case in the State in respect of an aeroplane crash that happened outside the State. The former rule was that a case could be pursued in the state in which the disaster happened, or in the state in which the airline is based. Perhaps the Minister of State will examine the Act to ascertain whether there are similarities and whether we can learn from it. I am sure that is exactly what Senator McCarthy was talking about. Like the legislation before the House, the Air Navigation and Transport (International Conventions) Act 2004 makes provision for events outside the State which affect citizens of the State. The Department of Transport has done a great deal of research in this area.
Question put and agreed to.
SECTION 52.
Amendment No. 20 not moved.
I move amendment No. 21:
In page 35, between lines 30 and 31, to insert the following new subsection:
"(7) In the event that the Council receives a complaint regarding a registrant who is also a member of the Council, that member shall absent himself or herself from any meetings, discussions, investigations or votes pertaining to the investigation of such a complaint.".
It is obvious that if one is accused of something, one cannot be the judge and the jury in that case.
There would be a conflict of interest.
I support Senator Browne's amendment, which addresses the kind of unfortunate case that can happen. It would be right to make clear that a registrant against whom a complaint has been made should not be present at meetings of the council at which the complaint is being discussed.
It is integral to the standing, authority and credibility in the eyes of the public, including registrants, of the health and social care professionals council that it should maintain and be seen to maintain the highest standards of probity and integrity. An issue would arise, therefore, if a complaint were made about a member of the council. I accept the principle of Senator Browne's amendment on that basis. I do not consider that section 52 is the most appropriate place in which to include such a provision, however. I propose to incorporate the principle of the Senator's proposal in an amendment on Report Stage, after I have discussed the most appropriate place for it with the Office of the Chief Parliamentary Counsel. It may be included in Part 2. Given that the board is required under the Bill to recommend an appropriate sanction to the council when a complaint has been upheld following a hearing, a similar issue would arise if a member of a registration board were the subject of an inquiry into his or her fitness to practice. Therefore, it is proposed to table a further amendment on Report Stage to make provision for members of registration boards.
Amendment, by leave, withdrawn.
Section 52 agreed to.
SECTION 53.
Question proposed: "That section 53 stand part of the Bill."
Can I make an observation about section 53, which relates to the preliminary filtering of complaints? The section states: "If the preliminary proceedings committee is of the opinion that there is not sufficient cause to warrant further action being taken in relation to a complaint, it shall inform the Council of that opinion." However, it does not refer to malicious complaints.
We are all aware that malicious complaints can be made, for example, against members of the Garda Síochána. If I go into any Garda station to make an allegation against a garda, he or she may be suspended almost immediately while the complaint is investigated. There is no system of insulating gardaí against complaints, even though it is possible that the complaints might be malicious and baseless. Gardaí do not receive any protection when a person, of his or her own volition, makes a malicious complaint against them. We need to consider including strong references and explicit detail in this legislation to deal with malicious complaints. Such a provision needs to be included in the Bill.
This matter is covered by section 52.
The Bill does not seem to state that a person whose complaint was found not to warrant further action should be informed as well.
Section 52(6) states:
Before forming an opinion on whether there is sufficient cause to warrant further action being taken in relation to the complaint, the preliminary proceedings committee shall consider—
(a) any information supplied under this section concerning the complaint, and
(b) whether the matter is trivial or vexatious or the complaint is without substance or made in bad faith.
There is a preliminary arrangement.
Senator McCarthy's point is fair.
Does the Minister of State think the complainant should be informed if the complaint is found not to warrant further action?
Perhaps an amendment to that effect can be made on Report Stage.
I thank the Minister of State.
Question put and agreed to.
Sections 54 to 56, inclusive, agreed to.
SECTION 57.
I move amendment No. 22:
In page 37, lines 33 to 35, to delete subsection (3), and substitute the following new subsection:
"(3) A hearing before a health committee shall be held otherwise than in public, unless—
(a) the registrant requests that all or part of the hearing be held in public, and
(b) the committee is satisfied that it would be appropriate in the circumstances to hold the hearing or part of the hearing otherwise than in public.”.
I am learning from the Taoiseach, who stole the clothes of Deputy Joe Higgins lately.
It is not as if Fine Gael has a problem with that.
In this case I was in SenatorHenry's wardrobe. On Second Stage she made a very clear point about hearings being held in public instead of private. I picked up on it on Committee Stage. It obviously makes sense to hear some cases in private, while at other times they are suitable to hear in public. It might suit a person being pursued in the profession to have a case heard publicly as it would put further pressure on the complainant. Safeguarding the complainant is an issue. As the Minister of State clearly said a moment ago, the Bill's purpose is to protect the public. We do not want to be prescriptive. We want to retain the option of private and public hearings, but we do not want the professions to abuse the option of having a hearing in public — I am not saying that they would — especially concerning medical evidence and personal and intimate details.
It is always very flattering to hear that another Senator remembers what one said, especially a person as busy as Senator Browne. However, the issue is important. I am not worried about hearings being in public from the registrant's point of view, but I am a little concerned about the complainant. I have seen in court cases — as I am sure has the Minister of State — that they do not realise what personal details may be brought out.
Owing to the potentially personal and sensitive issues that might arise in the course of conducting an investigation before a health committee, it is proposed in the Bill that its hearings be held in private, unless the registrant specifically requests otherwise regarding all or part of the hearing. It is accepted that, as is proposed in the case of an inquiry carried out before a professional conduct committee, it is appropriate that there be some checks and balances on a registrant's right to reverse the general principle set out in the Bill, particularly where sensitive personal matters relating to a complaint may be the subject of examination. The content of the proposed amendment from Senator Browne is acceptable, subject to drafting changes required by the Parliamentary Counsel, which I propose to present on Report Stage. In particular, the words "otherwise than" should be deleted from the proposed subsection (b).
It is very good that the Minister of State is taking that view. I presume he knows that we had a very serious problem with a physician who for a long time prevented a case against him going forward that involved video recording some of his adult female patients naked. He naturally tried to get the case held in public, and the women were not enthusiastic about it. What the Minister of State is trying to do is right. The complainant may not be deterred from pursuing the complaint because the registrant says that the hearing must be held in public.
Amendment, by leave, withdrawn.
Section 57 agreed to.
SECTION 58.
Question proposed: "That section 58 stand part of the Bill."
Section 58 deals with powers and protections relating to witnesses and evidence. I draw the Minister of State's attention to subsection (4)(c) regarding collecting evidence before a committee, which reads, “as otherwise allowed by those rules, including by means of a live-video link, a video recording, a sound recording or any other mode of transmission.”
Regarding giving evidence and allowing for due process and fair procedure, how is it intended to cross-examine a tape recording? I can understand how it might be done by the more obvious and practical means. Is it appropriate to include video recordings, although one cannot cross-examine them? It is a question rather than an observation, and perhaps the Minister might clarify matters.
I take that point, which I will have to discuss with the Parliamentary Counsel.
Perhaps the Minister will revisit the matter on the next Stage.
Question put and agreed to.
Sections 59 to 67, inclusive, agreed to.
SECTION 68.
Question proposed: "That section 68 stand part of the Bill."
This section concerns the need for the High Court to confirm any sanction against a member of any profession. If the person against whom the sanction is directed does not appeal, why need the matter still go to the High Court? For the sake of simplicity and to avoid the obvious demands and burdens that a High Court hearing might place on people, is it really necessary to go to the High Court if the sanction is not being appealed? Might it be wise to omit that reference in the section?
I understand that it is the person's constitutional right to go to the High Court if he or she wishes. That right must therefore be included in the Bill. If one omitted it or inserted something else, one could be deemed to be acting unconstitutionally.
In cases where the sanction is not being appealed, common sense should prevail. Perhaps the provision might not be used. I accept the Minister of State's reference to constitutional rights, which are reflected in that section. However, for the sake of simplicity, we must be clear on the issue.
Question put and agreed to.
Sections 69 to 77, inclusive, agreed to.
SECTION 78.
Amendment No. 23 in the name of Senator Quinn has already been discussed with amendment No. 2.
Senator Quinn asked me not to move it.
It has already been discussed with amendment No. 2.
Amendment No. 23 not moved.
I move amendment No. 24:
In page 47, between lines 16 and 17, to insert the following new subsections:
"(6) In this Act, the titles physical therapist and physiotherapist are synonymous and both titles use are restricted exclusively to those professionals who are registered as physiotherapists.
(7) In this Act, the titles Podiatrist andChiropodist are synonymous and both titles use are restricted exclusively to those professionals who are registered as Podiatrists."
This situation concerns the protection of titles. I had time to examine other legislation, particularly regarding physical therapists and physiotherapists. I have legislation from the United Kingdom and the State of Victoria in Australia before me. I will quote the latter first. Section 57 of the Physiotherapists Registration Act 1998 states: "A person who is not a registered physiotherapist must not take or use the title of registered physiotherapist or registered physical therapist or any other title calculated to induce a belief that the person is registered under the Act." The equivalent UK legislation provides under the section relating to protected titles for physiotherapist and physical therapist. I am sure I could have found other instances. The UK introduced the Health Care and Associated Professions Order 2001, which was made on 12 February 2002. That is up to date and it states; "A register should have one or more designated title ... physiotherapist and physical therapist."
This issue must be taken seriously. No one is trying to take away the livelihoods of a body of people who do good work but we must ensure our register is in line with other international registers. The Good Friday Agreement specified that the Republic should examine UK legislation in this area. Other registers will be created and, therefore, it should be ascertained what other nomenclature could be used for people who describe themselves as physical therapists. I told their representatives when I was contacted by them that they do extremely useful and good work. I know people who have attended such therapists and found them useful. Most of their work is hands on. It is not beyond the bounds of possibility to come up with a title that would be suitable to establish a register.
Only one school provides training for physical therapists and I do not know whether international bodies should be involved but a separate register must be established with the agreement of those who call themselves "physical therapists" otherwise we will run into trouble if this title is not recognised separate to that of physiotherapist. Their representatives have been saying this for the past ten years or more.
I also included podiatrists and chiropodists in the amendment, as they should be considered synonymous. Last week Senator Ryan stated someone without qualifications could call himself or herself a podiatrist under the legislation and, therefore, it is even more important to explain that podiatry and chiropody are synonymous but both are restricted to people with training and a registration board oversees their training.
Schedule 3 outlines the proper training for all these disciplines but the amendment is useful. I hope the Minister of State will examine it because title is a serious issue. I do not seek to deprive anybody of a living but I wish to ensure people who use a certain title live up to the international nomenclature. I hope the Minister of State will look favourably on the amendment. I am not a proud woman and if he cannot accept it, I am happy for him to reflect on it and ascertain whether he can do anything with it. However, it is worthwhile to tackle this issue because if we do not, something will have to be done down the line and we will have created more problems than we will have solved by creating sloppy registers. No one wants that.
I concur in the main with Senator Henry. All of us were contacted by the representative of the physical therapists association last weekend and we received e-mails and literature from him in which he states, "We are very concerned about the grave misrepresentations of our member physical therapists and the profession of physical therapy in Ireland conveyed during the recent Seanad debate." During the debate, I stated I had never heard of the term, which evoked great surprise in the gentlemen who called me last weekend. However, I have availed of the services of physiotherapists and found them professional and excellent.
I acknowledge the work of physical therapists is misunderstood and there is a need to tighten the title given to them, the training they undergo and the services they offer. The e-mail I received is not clear in this regard. Perhaps Senator Henry could decipher it more easily. For example, do they want to be physiotherapists?
If they wish to be known as physical therapists, their training, standards and work must be outlined. I looked into the chiropody and podiatry angle and I found that podiatry is a step beyond chiropody in the professional qualification one receives. However, there is no school for same in the State. One must attend a Belfast school to attain one's qualification, which highlights a deficiency in the medical system.
However, I worry about the issue relating to physiotherapists and physical therapists. It is difficult for a young person to become a physiotherapist because of the points needed under the CAO system and the onerous studies involved. We all know someone who has been through the system but I do not know the equivalent requirements to become a physical therapist. I was told by the nice man who called me that I should have known all about physical therapists but I did not. It is not like I live in an ivory tower. I knock about quite a bit but I have never met a physical therapist. Is it, therefore, equally difficult to become a physical therapist in terms of the points required or can one waltz into the profession?
I would like to know because the legislation is interesting and curious in its own way. I am aware of the purpose of the legislation and I very much support the demystifying of the 12 qualifications for the public so that people will know what to expect when they go through the door with the brass plate beside it. They will know the treatment they need and how they should be treated. Did the Minister of State's officials meet all the various groups affected by the legislation prior to its publication? I do not fault the officials but was that part of the process? Did they winnow through these difficulties with the representative groups prior to the publication of the legislation? This would be necessary with legislation such as this. I would like answers to these questions.
I have grave difficulty with the amendment. To answer Senator O'Rourke's question——
I did not put the question to the Senator.
Until two weeks ago I did not know what a physical therapist did and I am glad to know somebody as experienced as Senator O'Rourke did not know either. Now I know what they are and do and seem to hear about them every hour of the day. Physical therapists are a separate entity. As far as I know they get a pass degree but some go on and do postgraduate studies. They are in existence for the past 15 years. If we could turn back the clock to 15 years ago, we could ask physiotherapists why they did not object to the term physical therapist being used then? Perhaps that would have solved the problem now facing us. Unfortunately, we cannot turn the clock back.
Will the Minister of State confirm a point made to me yesterday, that it was only in the late 1980s that the degree for physiotherapists was developed? Until then the award was a diploma. The physical therapists made the point that just as the physiotherapists had been allowed to evolve, so should they. The Irish Association of Physical Therapists made a submission on the matter to the Department of Health and Children in June 2004. I understand the Department will have a meeting with representatives of the association tomorrow, which is welcome.
My understanding of this amendment is that if it were accepted, we would only allow physiotherapists to use the term physical therapist which would in effect disenfranchise and cut off the physical therapists.
The Minister of State is acutely aware that he is part of a coalition Fianna Fáil-Progressive Democrats Government.
A partnership Government.
I am sure he would not like to see it called a Fianna Fáil Government without acknowledgement of the Progressive Democrats. The physical therapists would feel the same way. They have a different system of operation. They do different work and the education and training is different. The work of both physiotherapists and physical therapists is important. Many of the top sports stars use physical therapists. I was interested to hear that Sonia O'Sullivan and Paula Radcliffe use physical therapists as do many of our county teams. It is important that we do not make any decision in this House that would adversely affect the physical therapists. I hope these points are useful and that the Minister of State can clarify the matter.
Many physiotherapists, many of whom are my constituents, for a long time have objected to me about the use of the title "physical therapist".
Was this before this Bill came about?
Yes, many years before. This Bill has been in gestation for some 15 to 20 years. The physiotherapists have been objecting about the matter for a long time. In the legislation in Northern Ireland "physiotherapist" and "physical therapist" are the protected titles.
Can we do something about those people here, who come from one small unit and comprise approximately 200 people? They do not need the same qualifications to get into that unit as one needs to qualify as a physiotherapist in the universities, one of the most difficult courses to get into as it requires some of the highest points. Those who run the Institute of Physical Therapy and Applied Science Limited, 17-18 Priory Hall, Stillorgan have been open with me about their courses. They do not require people to have anything like the admission requirements required for physiotherapy. The course is not the same in content or length. It is not a university qualification but is from a limited institute, which I am sure is very good. Most of the treatment the physical therapists give appears to be manual, which patients like because it is hands-on. Perhaps they could be called manual therapists.
The problem is not what the physical therapists are doing and is not concerned with trying to deny them a living. The problem is the protection of a title. I have quoted from two Acts, one from Australia and one from the United Kingdom. I am sure I could find more that show that the protected titles "physiotherapist" and "physical therapist" go together. We are supposed to be trying to ensure we are on a par with international title protection and nomenclature. Nobody is trying to harm the physical therapists. There must be some way to accommodate them. They should set up their own register and bring forward an agreed title. They should bring forward what they consider suitable training to the Department of Health and Children, to see if they can be set up and recognised. We will have to consider other people in the same manner, for example, psychotherapists and counsellors. Thankfully, it is the council that will have to do this, not us.
The issue must be examined. I provided the dates of the Acts from the United Kingdom and Victoria of which we must take account.
Senator Henry is correct that the two professions, physiotherapist and physical therapist, are totally different. They have different educational criteria and requirements for entry. Both also admit that they do separate jobs. I cannot understand how they could be synonymous in anyone's reading. My reading and the advice from the Department is that if the amendment is agreed, the issue will end in court. We would have a problem because two professions cannot be synonymous if they have different entry criteria.
That is what I would have thought.
This debate is interesting and useful. The Disability Bill is currently going through the Dáil. I have a great interest in that as Minister of State with responsibility for disability services. One of the problems I meet in my area is the lack of therapists in this regard. We need more therapists, not just in this area but in psychotherapy and many other areas. We need more professional people providing services required by the public.
The issue of protection of titles was discussed in detail last week on section 4. Senators will be aware that following this debate the Department agreed to undertake two courses of action; first, to contact the professional bodies representing physiotherapists and physical therapists to arrange a meeting to discuss the issues of protection of title; and second, to contact the four professional bodies representing chiropodists to ascertain their views and the appropriate title for their profession. Meetings have been scheduled with the Irish Society of Chartered Physiotherapists and the Irish Association of Physical Therapists tomorrow. The Department is awaiting formal response from two of the four professional bodies representing chiropodists. I suggest these amendments be withdrawn, pending these consultations.
We have also consulted with all the groups on many occasions in the course of drafting the Bill. However, it has not been possible to secure agreement on the issue. A report commissioned by the Department of Health and Children on this issue highlighted key areas of agreement between the two representative bodies concerned, which could provide a platform for achieving the practical and realistic long-term solution we need. My fear is that if Senator Henry's amendment were accepted, it would lead us straight into the High Court and we would have the problem of the amendment being immediately challenged. None of us would want that.
The report by the IPA highlighted the risk of public confusion owing to the international interchangeability of the two titles in the English speaking world. It also assessed the case that could be made on either side of the argument on economic grounds. This report is available should Senators wish to examine its contents.
It would be advisable to withdraw the amendments while the Department talks to both associations to try to find agreement. I fear that if the Seanad passed the amendment as proposed it could end up causing us all embarrassment.
Will the Minister of State inform us of the outcome of the meeting next week?
I support what the Minister of State said. I have been aware of physical therapists and from what I know of them theirs is a stand-alone profession, as is physiotherapy, podiatry andchiropody. Although some areas may need to be clarified, section 4 will enable other professional groups to be brought within the scope of the Act, which I welcome. I believe this also reflects the Minister of State's view.
I do not see why a separate board cannot be set up in future. The Minister of State has made clear that this can be done and I hope the discussions will clarify any confusion that exists and that an appropriate registration board will be set up for physical therapists. That is the way forward. They are entitled to that as they undertake a separate course and carry out a separate job. I do not see any reason they cannot be deemed to be separate. This may be addressed differently in other jurisdictions but who is to say they are right and we are wrong?
I recently pointed out that one could not claim back health insurance expenses from BUPA or the VHI for attending physical therapists. As far as I know the new insurance company, the name of which I have forgotten——
I thank Senator O'Rourke. It appears that Vivas does make payment for attendance at physical therapists so it is only a matter of time before BUPA and the VHI also cover this, which is a significant step.
Physical therapists already have a registration board in operation. I met a lady who is involved in it.
I am not sure of the extent of it but they do have a registration board to which one has to apply to become a member.
I do not think it would be covered under the law.
I accept that. It is an internal system of registration. They made the point that business is good and that in 15 years in operation no negligence case has been taken against them. As far as I know the Minister did not dispute this point the last day, which speaks for itself. The fact that business is good shows there is a need for it. People are going back to them for treatment. A physiotherapist might not work for some people and a physical therapist might not work for others. Medicine is a funny game as we all know.
I accept the point made by Senator Henry on jurisdiction. Ideally it would be preferable to have uniformity on terms. As I said, it is regrettable that we cannot turn the clock back 15 years to avoid this problem. Unfortunately, that is not possible. Physiotherapists should have been more active at that time. We might not be discussing the issue of the dual titles of physical therapist and physiotherapist if they had done so. At this stage we could not allow physiotherapists to have sole rights over the term "physical therapist" because that would prevent physical therapists from using it, which would be devastating for their profession.
I do not see how physical therapists could have been much more active, apart from giving out to me because the title was not protected. Protecting titles is one of the Bill's objectives. As the title was not protected, there was not much point in them giving out about people calling themselves physical therapists, except to me. People who are long retired complained to me about the situation.
I do not wish to prolong the debate any further. If it is the will of the House I am happy to take the Minister of State's suggestion and withdraw my amendments. Let us see what can be done behind the scenes.
For the information of the House, as none of the Senators referred to this, I understand physical therapists are employed by some health boards and are doing an excellent job for quite some time in situations where health boards could not employ physiotherapists because they were not available.
I suggested they should publicise themselves but they said they are a small body and do not have money.
Amendment, by leave, withdrawn.
Section 78 agreed to.
SECTION 79.
Amendments Nos. 25 and 26 are related and may be discussed together by agreement.
I move amendment No. 25:
In page 47, line 42, subsection (5), to delete "€2,500" and substitute "€3,000".
The amount of money involved here is quite small and should be increased. The fine should also be index linked. I subsequently discovered Deputy Jim O'Keeffe has initiated a Private Members' Bill on this area.
The index linking of fines.
Yes. I raised the matter of fireworks on the Order of Business and I am currently working on a Bill in that area. I believe the maximum fine in one area in this regard is £5. This shows how quickly legislation goes out of date. It would make sense to index link fines in all legislation.
That is very sensible. When I was responsible for the area of health and safety the fines for grievous negligence by employers were ridiculous because they had not been index linked. A composite Bill, as referred to by Senator Browne, would be very useful.
I am prepared to accept in principle the increase in fine proposed by Senator Browne in amendment No. 25, subject to further discussion with the Office of the Attorney General. If the office is in agreement I will table an appropriate amendment on Report Stage. However, in the case of the proposal that a provision be inserted to allow the Minister to increase the fine in accordance with inflation, it is considered that this is a broader policy issue that is more appropriate for consideration by the Office of the Attorney General. If this approach were adopted it should be adopted across all legislation and not just in regard to this Bill.
Amendment, by leave, withdrawn.
Amendment No. 26 not moved.
Section 79 agreed to.
Sections 80 to 89, inclusive, agreed to.
SECTION 90.
I move amendment No. 27:
In page 50, subsection (1), line 35, after "date" to insert "(subject to a minimum period of practice of 3 years)".
A period of five years, provided for here, is a rather long time. The Bill states: "who, at any time", it does not state, "who has been in practice during that period of five years". One could have someone applying at the 11th hour on the 11th day of the 11th month in the last year to point out that nearly five years ago they were in practice. One needs to keep up to date in these professions, especially clinical biochemists, medical scientists and orthoptists, where things change almost by the hour. The same is true of radiographers and radiotherapists. I consider five years to be quite a long time. I realise that what is termed the "grandparenting situation" is extremely important and that they will have to undergo assessments.
One other matter struck me which I will bring up at this point. As the Leader pointed out, there is no school for podiatrists in this country. Does it matter if five years pass after this Bill is enacted and there is still no school for such people? Three years would be better than five, in view of the fact that so many of these professions must keep up to date.
The operation of grandparenting provisions will be critical to the effective establishment of a system of statutory registration. If a person applies for registration under this section, that is through a grandparenting process, he or she must, in addition to possessing a listed qualification or alternatively completing a test of professional competence, satisfy the board that he or she is a fit and proper person to engage in the practice of the particular profession. It is considered that if a person had only been practising for a minimal period of time in the five year period proceeding the opening of a particular register, that registration board would have to satisfy itself as to the person's fitness to practise in order to engage in that profession.
It is envisaged that registration boards will adopt an inclusive approach in order to bring practitioners under the supervision of a registration board. The effectiveness of the regulatory system established by this Bill will be optimised by maximising the number of professionals, subject to the rigours of the regulatory regime. A quality threshold of basic professional competence must be established in the grandparenting process, which then allows each registration board to monitor the professional conduct and competence of registrants as appropriate. If a registered practitioner does not demonstrate the standard of proficiency, competence and professional conduct expected of registered professionals, this will be grounds for a complaint and will be investigated under fitness to practise procedures.
It is considered a priority, working with the Minister for Education and Science, to establish a school of podiatry in Ireland. I understand that the professional bodies concerned are undertaking some preliminary work in this regard so that we will reach that point. Therefore, I do not propose to accept Senator Henry's amendment. The proposal of five years is better.
I suppose it is not unreasonable to leave it to the registration boards. However, people should have been in a practice for a minimum amount of time. They should not be allowed to apply at the last moment having just qualified and not engaged in any practice. The Minister of State could examine the issue further. The purpose of the provision is to ensure that the person is competent. If the Minister of State wants to leave the issue to the boards, that is fair enough as it is not vital to the Bill. However, the amendment might prevent people applying right at the last moment, having only been in practice for a few weeks five years previously.
They must prove their competence.
Amendment, by leave, withdrawn.
Section 90 agreed to.
Sections 91 to 93, inclusive, agreed to.
SECTION 94.
Question proposed: "That section 94 stand part of the Bill."
This is a very important section, particularly subsections (5) and (7), which allows the Minister of the day to add other parties to the list of registration boards. In that context, physical therapists in particular would ideally prefer to be designated separately and have their own registration board. Is it wise to provide for this at this stage? Given that it has taken 20 years for the Bill to reach this stage, is there any danger it will take another 20 for its provisions to be enforced? Does the Minister of State envisage adding any particular groups in the near future? If so, which will get priority and what timeframe is proposed — will it be before or after the next general election? Will the Minister of State also explain the steps involved for the groups which might wish to be added, for example, the podiatrists to whom Senator Henry referred?
I have been lobbied by several groups which are not among the 12 specified in the Bill. This is an enabling Bill and the Minister for Health and Children will give due consideration to the requirements of public safety as well as the fact that we lack therapists in certain areas who are needed to provide proper services to the public.
If the Bill is passed, the three groups about which we have spoken, namely, physical therapists, psychotherapists and podiatrists will be a priority. However, there could be several others and I do not want to limit their number. I cannot impose a timeframe on this process because discussion must take place on many issues. As Senators have pointed out, this Bill is primarily about safeguarding public health and we want to ensure that whatever we do is in the best interests of the public. The officials in my Department are holding discussions with all these groups.
Major discussions have taken place in the areas of counselling and psychotherapy. It will not be possible to satisfy everyone because different requirements and criteria apply to different professions and we must ensure a level of competence is established to which the public is entitled. That is the Department's responsibility and it is engaged in pursuing it with the professions. There are three or four professions which I am keen to include. I badly need many more physical therapists, podiatrists, counsellors and psychotherapists in my area. In that context, we will try to bring forward legislation as soon as possible but I do not want to put a date on it. Nevertheless, I assure the Senator that the Department regards this issue as a matter of urgency.
Along with the Minister of State, Senator Browne and other Senators, I have been lobbied. Psychotherapists are a particularly important group with which to deal as rapidly as possible. There is an idea that, because one is not doing something physical with a person, it is not possible to do them any damage. However, people who set themselves up as some sort of psychotherapists without training — which is quite possible at present — can cause a great deal of damage. We cannot please everyone. The Department must decide when it meets with the Irish Council of Psychotherapists what criteria it will use in respect of their qualifications, training and experience. The Department should just go with it now because we can add other groups later if necessary. It would be better to do so than to allow matters to drift. I acknowledge that dealing with all these groups is terribly hard work but this is a very important and worthwhile Bill.
I am satisfied by the Minister of State's assertion that Senators' concerns will be addressed. Any group which is not included in the specified 12 and which has its house in order — of which there are a number, to which the Minister of State referred — does not have anything to worry about. All such a group has to do is prove its members have the level of expertise, proficiency, training and qualifications which merit their benefiting under section 4 of this Bill. This Bill took a long time to come forward but it is never too late to do the right thing. We are on the right road so let us drive forward.
Question put and agreed to.
Section 95 agreed to.
Schedules 1 and 2 agreed to.
SCHEDULE 3.
Amendment No. 28 not moved.
Question proposed: "That Schedule 3 be Schedule 3 to the Bill."
Good definitions of qualifications have been included in Schedule 3. However, I was asked by the clinical biochemists to point out that a degree in biochemistry, where it was just taken as the final subject, would be a minimum requirement for becoming a clinical biochemist. Clinical biochemists must have postgraduate degrees in this area because they will be in charge of hospital and other laboratories. I discussed with the Minister's officials whether I should table an amendment to include the higher degrees that must be taken but if this is what is required for existing practitioners, it might be superfluous.
However, Senators should be aware that any clinical biochemist dealing with them in this country will have a considerable amount of postgraduate qualifications and not just simple training in biochemistry or in some science subjects where biochemistry is among the subjects taken in the finals.
I am aware of the views of the Association of Clinical Biochemists in Ireland on the desirability of postgraduate qualifications for all biochemists and its advocacy of extensive related changes to the biochemist grading structure. However, Schedule 3 must continue to take account of current stated arrangements to accommodate the registration of existing practitioners within the time frame set out in the Bill.
Under section 37 it will be a matter for the clinical biochemists registration board, once established, to determine the baseline qualification for entry onto the register of clinical biochemists. In addition, there is scope under sections 22 and 35 for the division of registers into specified divisions for different categories of registrants.
Question put and agreed to.
Title agreed to.
Bill reported without amendment.
When is it proposed to take Report Stage?
Next week, subject to the agreement of the Whips.
Report Stage ordered for Tuesday, 30 November 2004.
