Health and Social Care Professionals Bill 2004 [Seanad Bill amended by the Dáil]: Report and Final Stages.

This is a Seanad Bill which has been amended by the Dáil. In accordance with Standing Order 103 it is deemed to have passed its First, Second and Third Stages in the Seanad and is placed on the Order Paper for Report Stage. On the question "That the Bill be received for final consideration", the Minister may explain the purpose of the amendments made by the Dáil. This is looked upon as the report of the Dáil amendments to the Seanad. For the convenience of Senators I have arranged for the printing and circulation to them of those amendments. The Minister will deal separately with the subject matter of each related group of amendments. I have also circulated in the House the proposed grouping of amendments. Senators may contribute once on each grouping. I remind Senators that the only matter that may be discussed is the amendments made by the Dáil. I welcome the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, to the House.

Question proposed: "That the Bill be received for final consideration."

These amendments deal with changing the title "chiropody" to "podiatry" in the Bill. The sections amended are section 4, designated professions, section 26, the establishment of registration boards, and Schedule 3, qualifications required by existing practitioners. In line with the legal advice given by the Parliamentary Counsel, one title is protected for each profession under the primary legislation while provision is made for the protection of variance by regulation under section 95(3) of the Bill. It will be an offence for an unregistered practitioner to use a protected title or to falsely represent himself or herself as being a registered practitioner.

As Senators will recall, there was considerable debate on Committee and Report Stages in this House and also within the chiropody and podiatry profession on the most appropriate title for that profession in the primary legislation — chiropodist or podiatrist. During the debate in this House, the title "chiropodist" was used in the Bill because that reflects the title by which the profession is currently better known to the public in this country.

As Senators will be aware, however, varying views were held by the relevant professional bodies on this matter. Some groups expressed a preference for the title"podiatrist". While the relevant professional bodies had sought to include both titles in the primary legislation to deal with the issue, that would not have been consistent with the legal advice available and the approach taken in the Bill for other professions. Against that background, following the debate in this House the professional bodies agreed that if only one title is to be protected under the primary legislation, the preferred title is "podiatrist". Variance can be protected by regulation.

There is an argument to be made for the use of either "chiropodist" or "podiatrist". One is a title currently more in use by the Irish public while the other reflects the title used in some other countries and in educational courses for the profession. On balance, and in light of the final view reached by the professional bodies in this matter, amendments were made to change the title in the Bill from "chiropodist" to "podiatrist". These amendments are largely technical in nature and provide for the change in title used, from "chiropodist" to "podiatrist", in section 4, which designates the professions for the purpose of the legislation, and in section 26, which provides for the establishment of a podiatrists registration board instead of a chiropodists registration board. The amendments also provide for the necessary consequential technical changes to Schedule 3 of the Bill.

I thank the Minister of State for explaining these amendments. If professional bodies agree that "podiatrist" is the term that should be used in the event of disagreement, we would support the amendment.

As the Minister of State can imagine, I am delighted with this amendment having spent a great deal of time arguing that "podiatrist" should be the terminology used in the Bill. I thank him very much for the change. The change is important because a degree in podiatry will be recognised; that is covered in Schedule 3. If we are to recognise a degree in podiatry we are obliged to have that description in the Bill. I am glad this sensible amendment is being made.

A concern I have is that we do not yet have a school of podiatry in this country and, unfortunately, as the Minister of State will be aware from his professional background, we do not need one school but several because with people living longer and the huge increase in the incidence of diabetes, many more people badly need the care of podiatrists from a medical point of view. That is not just to keep them on their legs but to ensure they are not overtaken by complications of illness, which require them to be admitted to hospital in some cases, whereas if they had access to a qualified podiatrist on a regular basis, all would be well. The school of podiatry must be established as soon as possible.

That is also important from the point of view of the establishment of the board to regulate podiatrists because a member of that board must be someone qualified in podiatry in this country. The fact that we do not have such a person is a complication. I suggested during the passage of the Bill through this House that we should take someone with a qualification from outside the country until a school of podiatry is established here. We need someone with experience to become a member of the board but that is not covered in the Bill. When replying, will the Minister of State explain how that will be dealt with? Will someone from an academic institution with a qualification in podiatry be available to go on the board or will it be someone who is working in a school of podiatry here? We may not be able to acquire someone like that for quite some time and I would not wish to see any delay in the setting up of the board for podiatrists.

Níl a fhios agam cad a tharla le grúpa a haon but they are only minor matters. I am delighted that the wisdom of Senator Henry and Seanad Éireann in particular was finally acknowledged. To paraphrase Churchill's wonderful quote, never was so much of the time of so many people devoted to one word.

I am glad that the process of parliamentary scrutiny has produced what I believe is a far more significant amendment than the one word suggests, and I welcome it.

Before I call Senator Feeney I would like to welcome a former Member of the House, Willie Farrell, to the Gallery.

I, too, welcome the former Senator. Willie Farrell is a very good friend of mine and I am delighted to see him looking so well this morning.

I welcome the amendment also after what seemed like hours of debate on Committee Stage.

It was hours.

I take my hat off to Senator Henry who was like a dog with a bone on this issue. She was not going to let it go; it was going to stay on the agenda. The amendment is most welcome. As Senator Maurice Hayes said, the professionals called for the change although as the Minister of State said, the general public will probably continue to call it chiropody. I thank the Minister of State for being most accommodating in terms of the amendments on all Stages and in getting help from his officials.

Regarding Senator Henry's comments about a school of podiatry, I understand consultations are already taking place on that matter with the Department of Education and Science. I hope we will be able to progress that matter.

On Senator Henry's last question, the registration board can bring in outside expertise with appropriate qualifications. In cases where there are no suitably qualified persons, the provisions of subsections (5)(a) and (5)(b) of section 28 will apply. This provides a mechanism to get over those situations where the expertise is not available for a particular profession.

I ask the Minister of State to deal with the third group, which consists of amendments Nos. 5 to 14, inclusive.

These amendments relate to section 9, which deals with membership of the health and social care professionals council. The council will have a pivotal role in the system of statutory registration established under the Bill. Its object is to protect the public by promoting high standards of professional conduct, education, training and competence among registrants of the dedicated professions.

The council will have responsibility for overseeing and co-ordinating the activities of the registration boards. It will also enforce standards of practice for registrants, including the code of professional conduct and ethics adopted by their registration board. Moreover, the council has responsibility for establishing committees of inquiry into complaints against registrants of the designated professions and making decisions relating to the imposition of disciplinary sanctions on registrants.

When providing membership arrangements for the council, it is therefore essential to strike a balance between professional expertise, knowledge of the health service and the public interest, to ensure the council is in the best position to carry out its responsibilities.

Amendment No. 7 provides for the inclusion of three people among the council membership who have such qualifications, interests and experience as in the opinion of the Minister will be of value to the council in performing its functions. This will ensure the council has a wide mix of members and a continued strong level of involvement by those representing the interests of the public. The number of members has not changed, nor has the overall balance of practitioners and lay members. Amendments Nos. 5 and 6 are technical amendments consequent to amendment No. 7.

Amendments Nos. 8 and 9 require the Minister to consult as appropriate in regard to council appointments. Amendment No. 14 provides that the chairperson of the council may be paid certain remuneration for performing the functions of his or her office as may be determined by the council with the approval of the Minister for Health and Children, with the consent of the Minister for Finance. This is an enabling provision in keeping with similar provisions in other legislation. Amendments Nos. 10 to 13, inclusive, are technical drafting amendments.

These amendments seem reasonable. However, I again have concerns in regard to the situation of podiatrists. Section 9(3)(b)(iii) provides that one of the members of the council will be “representative of third level educational establishments involved in the education and training of persons with respect to the practice of the designated professions and is nominated by the Minister for Education and Science”. Will the Minister of State explain how we can get around this provision in regard to podiatry, given that there is no relevant third level institution? Must we wait until such is established? I am otherwise in agreement with the amendments.

My question may be more relevant to the previous group of amendments. Section 4(2) provides that after consulting the council, "the Minister may, by regulation, designate for the purposes of his Act any health or social care profession not already designated undersubsection (1)”. A profession not included in section 4(1), and therefore not “designated” under the provisions of this Bill, is that of the rehabilitation engineer. Given that a medical device directive has come from the EU and that such engineers are involved in the development and modification of these types of devices, it seems remiss that they will not be governed by the health and social care professionals council because they are not a recognised profession under this legislation. It is unacceptable that the EU should be setting standards for these people while they are excluded from this legislation and, thus, from the governance of the council.

For occupational therapists and speech therapists working in rehabilitative situations, it is generally the rehabilitation engineer who is the prominent professional with overriding responsibility. Unlike the professionals working under his or her direction, however, the rehabilitation engineer is not governed by the council in his or her work. What is the timeframe envisaged in section 4(2) during which the Minister may designate other professions not included within section 4(1)? With advances in assistive and rehabilitative technology, rehabilitation engineers have a major role to play, particularly in the disability sector, and should be covered by the provisions of this Bill.

I support Senator Kett in highlighting the situation in which rehabilitation engineers find themselves. As the Senator rightly observed, this legislation provides no regulatory body for them. They are, however, the dominant player in terms of their dealings with some of the other disciplines accommodated in the Bill. If we do not examine this issue, patients may suffer in the long term because of a breakdown in communication. We might have highlighted this area at an earlier date if it had come to our attention but it is better late than never. This profession should be included and its interest noted on the council.

On the issue raised by Senators Kett and Feeney in regard to rehabilitation engineers, I am not aware it has been raised in any discussions I have had on the Bill in either House. That does not matter, however, as the legislation can accommodate more professions than are currently included. It was agreed that only 12 professionals should be included because they were better organised than many other professions.

As regards the timeframe for the inclusion of other professions, I am interested in those professions that are necessary to be registered and in cases where there can be agreement among the professions themselves. In the mental health area, for example, there is a major requirement for counsellors and psychotherapists. The reason they are not included in this Bill is that we cannot get agreement on basic criteria for registration, expertise, qualifications and competence. In all these areas, there must be a baseline agreement in regard to the competence of the profession. As I have told counsellors, psychotherapists and others, they should try to determine a baseline qualification. It may already be there. They may be prepared to work with us in respect of forming a registration board. Some but not all of these groups have registration bodies of their own.

Irish groups.

Irish or voluntary registration.

They have recognised bodies.

That is fine. If they have much of the work done, the timeframe should not be long. I would welcome a conversation with the Senator. However, it is impossible in the present Bill as we have agreed on 12 professions that have done much work.

I ask the Minister of State to deal with the amendments in grouping No. 4, amendments Nos. 15 to 17, inclusive, and No. 28 on the publication of by-laws.

These amendments to sections 22 and 32 deal with the rules made by the health and social care professionals council and the by-laws made by registration boards. Amendment No. 15 corrects a typographical error. Amendments Nos. 16, 17 and 28 provide for the laying of rules and by-laws before each House of the Oireachtas.

Senators will recall that the Bill was extensively amended in the Seanad to strengthen and enhance the transparency of arrangements for the making of by-laws by registration boards and rules by the council. On Committee Stage in Dáil Éireann, Deputies sought amendments requiring by-laws and rules to be laid before the Houses. Amendment No. 16 provides for the health and social care professionals council to publish its rules and submit them to the Minister for laying before the Houses.

Section 95 deals with the Minister's power to make regulations and amendment No. 17 provides that section 95, subsections (4) to (6), inclusive, apply with the necessary modifications to rules of the council submitted to the Minister in accordance with the section as if they were regulations made by the Minister.

Section 32 provides for the publication and other requirements relating to draft and other by-laws made by registration boards. Amendment No. 28 amends this section to provide for registration boards to publish by-laws and submit them to the Minister for laying before each House. Sections 95(4) to 95(6) will apply with the necessary modifications to the by-laws of registration boards submitted to the Minister in accordance with the section as if they were regulations made by the Minister. These provisions will further enhance the transparency and credibility of the regulatory system.

I welcome the amendments as they clarify matters. I also welcome other groups approaching various Senators and the Minister of State in order to be placed on statutory registers. We needed to go ahead with the then best organised groups as we could otherwise be waiting to get everyone moving forward in an organised way.

One matter the groups are not clear on is that the various registration boards, once they make everything transparent, have a good level of autonomy. Other Senators and I have received considerable amounts of correspondence from psychologists. I can tell by those nodding that they have received correspondence also. These psychologists believed that the qualification for psychology outlined in Schedule 3 was insufficient to be on their registers. I was assured in the House, as were we all, that these registration boards could increase the required qualifications. I would welcome the Minister of State's clarification of this matter for the benefit of those outside the House.

I was sure that I was right on this issue but the psychologists believe that a recognised psychology degree or diploma attained with first or second class honours is not enough, which I can understand. They believe people should have specialist training in the different branches of psychology. On reading the Bill again, especially in light of the amendments, all that boards must do is be transparent in what they do and bring it before the Houses.

I agree with Senator Henry's comments. On examination of the areas of psychology at third level and first or second class honours degrees, people must do postgraduate studies in order to secure employment. No one will look at them when they come out of universities with primary degrees. We all spoke at length on Second Stage about the types of psychologists. Someone after six weeks of training can call himself or herself a psychologist. While what the Minister of State is saying is clear to me, we should perhaps send out a clearer message.

I welcome the amendments. As has been stated, they clarify matters. I agree with Senators Henry and Feeney regarding registration boards in that, according to the Bill, it is within their remit to amend and change their rules as necessary. The matter should be better clarified.

I will do my best to explain the situation. I understand where the psychologists are coming from and there is very little disagreement between us. This happens when one registers a profession in order to have the optimum standards. No one questions that psychologists have extremely high standards as they have both primary degrees with first or second class honours and postgraduate training. All of the psychologists working in the public sector have these standards but there are some psychologists who have degrees and no postgraduate experience, many of whom have been practising for years in the public sector. It would be impossible in initiating legislation in this House to discriminate between members of a profession working in the public and private sectors.

There is a timeframe in this legislation as these arrangements will apply for a period of two years from the establishment of a register and include the provision that practitioners who hold a stated qualification and have been in practice at any time during a period of five years before the establishment of a register should be granted registration. A practitioner must also satisfy the registration board, which is the key issue, that he or she is a fit and proper person to engage in the practise of that profession.

The new registration board will determine the criteria. I can understand fears on this issue but it had to be introduced for this reason. One cannot introduce legislation that would immediately discriminate against some excellent people working in the private sector. I do not suggest for one moment that the Psychological Society of Ireland wanted to do that, as I understand its fears, but we managed that issue in a way that does, and will, satisfy its requirements.

The subject of the amendments in grouping No. 5 is the registration board which is the subject matter of amendments Nos. 20 to 25, inclusive, 29 to 30, inclusive, 34 to 36, inclusive, and 45 to 47, inclusive.

These issues relate to the registration board and sections, 27, 28, 33, 46, 52, 59. These amendments relate to the work of registration boards generally and also refer to issues concerning complaints against practitioners. The object of the registration board of a designated profession is to protect the public by fostering high standards of professional conduct and professional education, training and competence among registrants of that profession. Its functions include giving guidance to registrants concerning ethical conduct and giving them guidance and support concerning the practice of their profession. Guidance on continuing professional development is an important element overall in regard to professional competency.

Senators will know that section 31(1)(h) already provides for the making of by-laws for registration boards relating to continuing professional development of registrants. Amendment No. 20, which amends section 27 on the object of functions and powers of registration boards, explicitly places continuing professional development appropriately within the functions of registration boards.

Section 28 provides for membership of registration boards and amendments Nos. 21 to 25, inclusive, are technical drafting amendments to this section. Amendments Nos. 29 and 30 amend section 33 which provides for committees of a registration board. With the council's approval and in keeping with any council rules and registration board by-laws, a registration board may establish committees to perform any of its functions or exercise any of its powers that may be better or more conveniently performed by a committee that are assigned by the board to a committee. During the debate in this House, the Bill provided for the establishment of committees to perform functions or exercise powers of a registration board under Part 3 or Part 5 of the Bill. Part 3 deals with registration boards, while Part 5 deals with the approval and monitoring of education and training programmes.

Amendment No. 29 extends the ability to establish a committee to perform functions of a registration board under Part 4 of the Bill, which deals with registration. This will be a useful facility for a registration board as it may be appropriate or valuable for a registration board to establish a committee to undertake the complex task of assessing national and non-national qualifications held by applicants for registration as attesting to the standard of proficiency required.

Section 33(5) provided that the acts of a committee are subject to confirmation by the registration board, unless the board dispenses with the necessity for confirmation. Under amendment No. 30, a registration board will not be able to dispense with the necessity for confirmation of the acts of a committee performing the board's functions or exercising its powers under Part 4. I should point out that section 33 allows a board to appoint people who are not members of the board to a committee and also makes it clear that a registration board should have regard to the necessity of including as members of the committee an appropriate number of persons representative of the interest of the general public.

Amendment No. 34 amends section 46 of the Bill which deals with the issue of access to registers. 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 registration board. Registrants also have important responsibilities to keep the relevant registration board informed of any changes in their registration details. Section 46(1)(a) states that a registration board shall make its register available for inspection by members of the public at all reasonable times. Section 46(1)(b) provides that the register can be published by electronic means or otherwise which means that it is open to a registration board to publish its register via the Internet but it is not restricted to this means alone. Amendment No. 34 further strengthens this provision by requiring a registration board to publish its register by electronic means and not less than one other means.

Turning to complaints issues, section 52 of the Bill deals with complaints about conduct or competence of registrants and amendment No. 35 places an obligation on the council to process complaints in a timely manner. Section 59 provides for powers and protection relating to witnesses and evidence in regard to complaints committees. It is an offence to fail to comply with a summons or to refuse to co-operate with a committee of inquiry. Section 59(7) specifies that a person found guilty of an offence under this section would be liable on summary conviction to a fine not exceeding €2,500. The amendment to increase the fine to not exceeding €3,000 brings the fine in line with the fine set out in section 80 of the Bill which deals with offences and which was itself amended by Seanad Éireann.

Amendments Nos. 45 to 47, inclusive, relate to the arrangements for the term of office for registration boards as set out in Schedule 2 of the Bill. Amendment No. 46 is a standard provision in regard to the first board which mirrors the approach taken for the first members of the council and amendments Nos. 45 and 47 are consequential technical drafting amendments.

These amendments are to be welcomed. I have some anxiety to ensure that the general public will be made very aware of which professions are on a statutory register. One will see advertisements for "registered osteopath" but what register is being referred to? We must ensure it is well known which people are on a statutory register. I am sure these osteopaths are perfectly fine people and are doing a very good job but it should be ensured that the general public knows which professions have registers. All too sadly, there have been grim cases where people have become involved from a medical point of view with people who are not subject to any rules or regulations. It is bad enough when professions are subject to rules and regulations but at least there is some form of redress when problems arise. It is important that the public are made aware of which professions are registered on a statutory basis.

I welcome these amendments. The reason for the Health and Social Care Professionals Bill 2004 was the protection of the public as well as to regulate the professions. The public is being protected by the provision of continuous professional development. At least the public will know these practitioners have bought in to continued professional development. This is essential to give that feel-good feeling to the general public.

I am delighted to hear the Minister of State refer to the ability of the registration boards to establish their own committees. Now that they have been given the tools, I hope they will take this further and perhaps develop competence assurance committees or consider peer review. I acknowledge that a clinical audit would be further down the road but they are only a short step away. It could be suggested to them when they have settled in. This will bring better protection for the public. I am delighted they will be allowed draft in expertise from without as this will introduce fresh air and let out the stale air. There will be no progress if they spend the whole time talking to themselves. I welcome the amendments.

I welcome the amendments as they will improve the Bill. As has been stated, the protection of the public is of paramount important in this regard. I hope it will receive the publicity it deserves. I also hope it will also frighten the public away from these cowboys, who are at every crossroads claiming that they can cure cancer and various other ailments and who should be banished. It is important that the public knows who is registered and that there is a proper registration board in place for these professions. I welcome the proposed amendments.

On some of the comments made by the three Senators, first, the publication of the various professions which have registers, and which have been dealt with in the Bill, will be done and I am sure the professions will let it be known. To allay Senator Henry's fears about the protected titles, once the Bill is enacted these titles are protected in law and a person will not be able to put on a plate that he or she is a registered physiotherapist or a registered speech and language therapist if the person is not on the register. There is no duplicity about which register is concerned. They cannot be alluding to a made-up register. This will get over that difficulty in so far as one can. As Senator Henry stated, we encounter problems from time to time within professions that are already registered. Admittedly, this occurs infrequently but that, I suppose, is human nature. I am not excusing or condoning it, but it will happen in all professions.

Senator Feeney commented on continuous education, which has always been important and will become more important as time goes, for all professions. Unfortunately, in previous times once somebody qualified in a profession he or she was not obliged to continue education. There has been evidence in the past of professions not keeping abreast of up-to-date practice and, unfortunately, causing damage. I am sure that continuous education will be a criteria of the registration board. It is essential. We all know that now. In every profession, their qualifications are nearly out of date within five years of qualifying. It is imperative that they will continue education and I am sure the new boards will insist that it happens.

Grouping No. 6, on qualifications, is the subject matter of amendments Nos. 26, 27, 31, 32 and 33. I remind the Minister of State and Senators that debate on the Bill is due to conclude at 1 p.m.

That is disappointing. We are just getting into the matters.

It was agreed on the Order of Business. The House decided.

If the Leader was here, she would give us an extension.

Section 38 provides for the granting of registration to applicants who comply with general requirements and who hold a qualification approved by the registration board of a designated profession as attesting to the standard of proficiency required for registration. It also provides for a registration board to take account of qualifications awarded in another EU member state and those awarded in states outside the EU.

Amendment 31 arose from concern that section 38 as it stood did not encompass some circumstances. Section 38 encompassed nationals of EU member states who have been awarded qualifications in a EU member state but did not specifically encompass EU nationals who gained their qualifications outside the EU.

While section 38 also took account of those who are not EU nationals and who gained their qualifications outside the EU, it did not specifically encompass people who are not EU nationals and who have been awarded qualifications in a EU member state. Amendment No. 31 therefore amends section 38(2), 38(3) and 38(4) to fully take into account qualifications approved by the registration board whether such qualifications are awarded in this country, in another European country or outside the EU. It also takes into account both EU nationals and non-EU nationals.

In some cases a qualification held by an applicant for registration may be below the standard required for registration. It may, in other words, be a lesser qualification. However, the applicant may have undergone additional training or acquired experience which satisfies the registration board, following a test of competence that it may require the person to take, that he or she has the requisite standard of proficiency for registration. The amendment takes account of this.

Amendment No. 32 is a technical amendment defining what is meant by a lesser qualification. Amendment No. 33 is also a technical amendment deleting a previous definition which is no longer required in the context of the substantive amendment to sections 38(2), 38(3) and 38(4).

Amendments Nos. 26 and 27 amend section 31. Section 31 provides for the making of by-laws by the registration board of a designated profession with the approval of the council and in accordance with any guidelines issued by the council. Amendment No. 26 is a technical amendment required on foot of the changes to section 38. Amendment No. 27 broadens section 31(e), which provides for the making of by-laws relating to procedures for the assessing of qualifications awarded, or training or professional experience acquired outside the State. This broadening of the scope of section 31(e) will further serve to enhance the transparency and openness of the system of statutory registration.

This House considered aspects of the issue regarding EU nationals who would get qualifications outside the European Union, but I am glad to see that we left something for the Dáil to do. These are important amendments.

I wish to mention one of my disappointments with the Bill. I understand the way it was decided to protect just one name only for each profession and I want to return to that of physiotherapist and the problem arising with physiotherapist and physical therapist. While we are correctly bringing in these other EU qualifications, the Minister of State will be aware that the United Kingdom legislation protects physical therapist with physiotherapist. Therefore, there is some conflict in this section. There is protection for titles being given but at the same time there is no protection of physical therapists in Schedule 3 and earlier in the Bill.

As the Minister of State will be aware, the chartered physiotherapists have stated for years that our legislation should protect the title "physical therapist" with "physiotherapist" because of the occasional confusion that can arise here on this issue and I am sorry that this has not happened. I fear we may run into trouble in these sections where the term "physical therapist" may be used to describe someone who we would call a physiotherapist and to acquire those qualifications.

Apart from that, I welcome the changes the Minister of State has made here. In view of the fact that the Belfast Agreement stated that we should try to ensure that the various qualifications in all parts of the island are in line with each other, I regret the fact that in this instance we will provide for a situation where in Northern Ireland physical therapist and physiotherapist are protected and in the Republic of Ireland only physiotherapist will be protected. I was one of those enthusiastic about the fact that we, particularly in the medical area, should try to get as much agreement as possible within the legislation.

I echo the sentiments expressed of my colleague, Senator Henry. This took more debate than the area pertaining to podiatrists. We were all strong in our view that the title "physical therapist" should have been introduced just for the protection of physiotherapists. I understand Senator Henry's point, coming from a medical background as she does. One fears that people will visit a physical therapist thinking they are visiting a physiotherapist and not realise the difference.

The Minister of State was very accommodating on this issue. He reconsidered it and tried to reach agreement between the Irish Association of Physical Therapists and the Irish Society of Chartered Physiotherapists but there was no budging on the part of one of those bodies. I am sorry that body could not see its way to accommodating the issue.

I support what was said on Second and Committee Stages, on which I spoke. The Minister of State and his officials have done a great job with regard to the Bill and I know of his effort and enthusiasm to solve this problem. The problem left unsolved is a danger. Senator Henry referred to the fact that in other parts of the world the use of the term "physical therapist" is understood to be the same as "physiotherapist". Therefore, we must be particularly careful that customers and patients are not misled.

I know the Minister of State's heart is in the right place and that he has done his best. While we have not yet found a solution, I urge the Minister of State and his team to ascertain whether it is possible to find a solution in the years ahead.

I thank the Senators who have raised this matter again. The question of the title "physical therapist" has consistently attracted attention during the passage of the Bill through the Oireachtas. For the physiotherapy profession, the title protected under the Bill is "physiotherapist". However, the Irish Society of Chartered Physiotherapists also wishes to have the title "physical therapist" protected for exclusive use by those professionals registered with the physiotherapists registration board established under the Bill. The society considers both titles to be interchangeable in an international context and believes there is a risk of confusion for the public if the title of physical therapist were not protected for use by physiotherapists. However, members of the Irish Association of Physical Therapists, who currently use the title in this country, have argued against such a protection and wish to retain the title for their own use.

As Senators have remarked, this is clearly a complex issue to which much attention has been given. The Tánaiste is of the view that matters must be resolved in a timely way. The way forward is to deal with protection of titles issues by regulation, as provided for in the Bill. In line with the provisions of section 95(3), the Tánaiste intends to consult with the physiotherapists registration board, on its establishment, and any organisations she considers appropriate in regard to prescribing the title of "physical therapist" for use by registrants of the physiotherapy profession. She would expect to make an early decision on the matter.

I understand the points made by Senators. It is not an easy issue. We were afraid competition problems would arise and that the Bill could lead to litigation, which no-one would want. The Tánaiste has considered the issue and feels this is the way forward.

I propose that we continue for a further five minutes to accommodate the debate.

Is that agreed? Agreed.

Amendments Nos. 37 and 44 are technical drafting amendments to correct typographical errors in section 79 and Schedule 1 of the Bill.

Determination of appropriate qualifications for registrants will be a matter for each registration board under section 38. However, the Bill contains transitional arrangements for the registration of existing practitioners. This system of grandparenting applies to those persons who are engaged in the practice of any one of the 12 professions covered by the Bill at the time of the introduction of statutory registration and who wish to be included on the relevant register. A similar arrangement will be available for professions that may be included in the system of statutory registration in the future. Section 90 defines terms used which relate to grandparenting provisions for existing practitioners. These provisions are in turn set out in section 91.

The qualifications required of current practitioners are set out in Schedule 3 of the Bill and are linked to provisions for grandparenting of existing practitioners under section 91. As these are largely Irish-based qualifications, provision needed to be made for practitioners holding corresponding qualifications awarded in other European Union member states. Amendment No. 38 therefore defines "corresponding qualification" while amendment number 39 defines "relevant measure" in line with a definition set out earlier in section 38.

Section 91 requires that a registration board must grant registration to persons who have been engaged in the practice of the relevant health and social care profession at any time during the period of five years before the day the register for the particular profession is opened, provided that the person satisfies the board that he or she either holds a qualification prescribed in Schedule 3 of the Bill or successfully completes an assessment of professional competence, and also satisfies the board that he or she is a fit and proper person to engage in the practice of that profession.

Amendment No. 43 amends section 95 which provides for the Minister's power to make regulations for the effective operation of the system of statutory registration. Section 95(3) provides that, after consulting with the relevant registration board, the Minister may, by regulation, prescribe one or more than one title that is a variant of the title specified under section 4(1) of the Bill. Amendment No. 43 provides that the Minister may also consult any organisations he or she considers appropriate and therefore widens the consultative process.

With regard to the importance of the Irish language, amendments Nos. 1 and 4, inclusive, were made to ensure that the Irish language title of the health and social care professionals council was included as appropriate, a point I omitted earlier.

Question put and agreed to.
Question proposed: "That the Bill do now pass."

I am sure the Minister of State can understand the gratitude, not only of those present, offered to him and his officials on the introduction of the Bill as it has been sought for almost 20 years. It is well that it is such good legislation because it is extremely important. It is important that the members of the professions covered by the Bill ensure publicity is used to show that they are the ones with statutory registration.

The working of the Bill will probably be quite simple. The matters which Senator Feeney brought forward, based on her experience on the Medical Council, are important. These include continuing education, which is of such importance nowadays, and competence assurance. As the Minister of State said, when people qualified years ago that was it, and no one had to do any more study.

I will just ask him to do one thing further, namely, try to get something done about the medical practitioners Act, which has been sought for 20 years as well. I told the House recently that I was assured six years ago, at this time of the year, that the Bill would be ready before Christmas. My mistake was not to ask which Christmas.

I compliment the Minister of State and his officials for bringing forward this very important legislation. I also thank him on behalf of the Fine Gael spokesman, Senator Browne, who is unavoidably absent this morning. The legislation deserves considerable publicity because it is in the public interest that people know about registered practitioners.

I, too, thank the Minister of State. He has been very accommodating, making this a simple Bill for the House to put through. He listened at all times and went back to amend the Bill in some way. I am glad it is back with us and that the House is giving it the green light. As Senators Henry and Cummins have noted, it is wonderful legislation. It is great for the general public and good for the professions. Well done to the Minister of State and his hard-working officials.

I wish to echo Senator Henry's words as regards the medical practitioners Bill. We are both like long-playing records or CDs. It is legislation that must be amended and updated for the protection of the public. It would be remiss of us to say it does not need to be done. I would dearly like to see it come before the House.

I thank all the Senators for their valuable contributions to this very important Bill during its passage through the Seanad. The Bill represents a major step forward, not alone for the professions, but more importantly, the public. The whole thrust of the Bill is to safeguard the public and ensure that quality health services are on offer from the various professions.

I was not aware that it was fiche bliain ag fás, that it took 20 years. Perhaps the fact that it is 20 years in gestation is the reason it is so good. Again I thank all the Senators for their contributions. I will try to find out about the medical practitioners Bill and expedite it, because I understand its importance.

Question put and agreed to.
Sitting suspended at 1.15 p.m. and resumed at 2 p.m.