Health and Social Care Professionals (Amendment) Bill 2017: Second Stage

Question proposed: "That the Bill be now read a Second Time."

I welcome the Minister of State, Deputy Finian McGrath.

I am pleased to have the opportunity to address the House on the Health and Social Care Professionals (Amendment) Bill 2017. This is a short Bill, containing only nine sections, that amends the provisions of the Health and Social Care Professionals Act 2005 in three main areas. First, the Bill will address the gaps that have been identified in the Act’s provisions relating to the appointment of professional members to the Health and Social Care Professionals Council and the registration boards. Second, it will permit a registration board to apply criteria or conditions in respect of further education, training and experience to applicants for registration who, although qualified, have not yet practised their profession. Third, the Bill will make necessary amendments to the Act in advance of draft regulations to protect the title of "physical therapist" being brought forward. The 2005 Act already provides for the protection of the title of "physiotherapist" for the exclusive use of those granted registration by the Physiotherapists Registration Board.

Before explaining the Bill's provisions in more detail, I will provide some background to the Health and Social Care Professionals Act 2005 - which the Bill seeks to amend - and with a brief update on its implementation to date. The Act currently provides for the statutory regulation of 14 designated health and social care professions. Regulation under the Act is primarily by way of the statutory protection of professional titles by confining their use solely to persons granted registration. The structure of the system of statutory regulation comprises the registration boards, a committee structure to deal with disciplinary matters and the Health and Social Care Professionals Council, which has overall responsibility for the regulatory system. These bodies are collectively known as CORU and they are responsible for protecting the public by regulating health and social care professionals in Ireland. CORU is also charged with the promotion of high standards of professional conduct and professional education, training and competence among the registrants. The Act provides for a transitional period of two years during which existing practitioners may register on the basis of specified qualifications. After this period, only registrants of a registration board who are subject to the Act’s regulatory regime or those who applied during the transitional period and whose applications are still being determined or are under appeal will be entitled to use the relevant protected title or titles. Title protection is the key to public protection under the Act and is central to the Bill’s provisions relating to the physiotherapists registers. I will provide more detail on this aspect later.

To date, the registration boards of 11 of the designated professions have been established. The professional titles of seven of these professions are now fully protected under law. The physiotherapists register was established in September of last year and the registration boards for the professions of social care worker, medical scientist and psychologist are working hard towards establishing their registers. Registration boards for the remaining professions will follow close behind and it is expected that the boards for all 14 professions will be operating by the end of 2018.

From a public protection viewpoint, a crucial milestone in the regulation of the Act's designated professions was the introduction of the its fitness-to-practise regime two years ago. This involved the commencement of Part 6 of the Act to allow complaints about the conduct or competence of registrants to be investigated. Disciplinary sanctions, where complaints are substantiated, up to and including cancellation of registration, may be imposed. The regime is similar to that applicable to medical practitioners, nurses and midwives. While a number of complaints have so far been investigated by CORU's preliminary proceedings committees, none has yet been referred for full investigation.

I would also like to take this opportunity to update the House on the proposals to regulate counsellors and psychotherapists.

The Act provides that the Minister for Health may designate health or social care professions not currently designated if he or she considers it is in the public interest to do so and if the specified criteria have been met. Towards the end of last year, following consultations with the Health and Social Care Professionals Council, the Minister undertook a detailed public consultation on the question of regulating counsellors and psychotherapists. The consultation process yielded information that has been of considerable assistance to the Minister and officials. The 80 submissions received showed majority support for statutory regulation of the professions and for it to be undertaken in the context of the Health and Social Care Professionals Act 2005.

Having considered the submissions carefully, I decided last May to proceed with the designation of two distinct professions under the Act, that of counsellor and psychotherapist. Each will have its own register under one registration board. This decision was communicated to the council, the relevant professional bodies and all the respondents to the public consultation process. The regulations to designate the professions and to establish their registration board have now been drafted by the Office of the Parliamentary Counsel and have recently been submitted to this House and to Dáil Éireann for their approval. Subject to the approval of the regulations by the Houses, the next step will be the appointment of the 13-member registration board.

Following the submission of suitable candidates for my consideration, 12 members will be selected by the Public Appointments Service; the 13th will be nominated by the Minister for Education and Skills. I expect the registration board will be in a position early next year to begin its workload. It will be tasked with advising me and the Health and Social Care Professionals Council on some of the outstanding issues to be decided. These include the professional titles to be protected by regulation under the Act and the qualifications that ought to be required of existing practitioners in order to register.

In tandem, the registration board will begin the process of drafting the various by-laws needed to establish its registers and to commence each register’s two-year transitional period. Title protection will come into effect after these transitional periods when only those granted registration by the board will be entitled to use the protected professional titles.

I am aware of other professions seeking designation under the Act. Creative arts therapists, play therapists and audiologists, for example, have been making a case for regulation for some time. The immediate priority, however, is to establish the regulatory process for the 14 professions already designated and to make progress on the regulation of counsellors and psychotherapists. Next year, when all the registration boards have been established and the professions of counsellor and psychotherapist have been designated under the Act, the Department will turn its attention to the question of how best to treat the unregulated professions. As a first step, I will ask CORU to prepare a risk assessment, in terms of public protection, of the principal health and social care professions seeking designation and to make recommendations concerning options for their possible future regulation.

I now propose to outline the main provisions of the Bill in more detail. The Bill has nine sections. Section 1 provides for definitions. Sections 2, 3 and 4 of the Bill deal with appointments to the Health and Social Care Professionals Council and to registration boards. These three sections address gaps that have been identified in the Act relating to the appointment of professional members to these State boards.

Section 2 amends the Act to allow the Minister for Health to make the initial appointment of a professional member to the council when a new profession is designated by amendment of the Act. At present, the Act provides for such appointments only when a profession is designated by regulation. The professions of optometrist and dispensing optician were designated when the Act was amended by the Health (Miscellaneous Provisions) Act 2014. Representatives of these two professions are currently attending the council in an observer capacity. This amendment will allow me to formally appoint these professional members. This section also permits the Minister to appoint professional members to the council to fill casual vacancies where the relevant registration board has not yet established its register or has not conducted an election and is therefore not in a position to nominate elected members for appointment to the council.

Sections 3 and 4 will allow the Minister to appoint professional members to a registration board during the transitional period of the profession concerned when the boards do not have sufficient registrants to hold elections for these positions.

Section 5 of the Bill will permit a registration board to make by-laws to apply criteria or conditions on further education, training and experience to applicants for registration who, though qualified for a specified period of time, have never practised their profession. It will apply to all the designated professions. The Act already has such provisions in respect of applicants who wish to resume the practice of their profession.

Section 6 amends section 38 of the Act to provide for an amendment consequential to section 5. It also provides for the registration in the register of physiotherapists, on a once-off basis and for a limited period ending on 31 December 2019, of recent graduates of the Institute of Physical Therapy and Applied Science, Dublin, and of current students of the institute’s programme who will graduate in 2019 with the relevant qualifications.

Section 7 provides for the registration in the register of physiotherapists, on a once-off basis and for a limited one-year period, of existing users of the title of physical therapist who hold specified qualifications awarded by the institute or equivalent qualifications or who successfully complete an assessment of professional competence set by the physiotherapists registration board.

Section 8 provides for an amendment to the Act consequential to section 7. Section 9 provides for the Short Title of the Bill and for the commencement of its provisions.

I will now give the House some background to the amending provisions in the Bill relating to the register of physiotherapists. In other English-speaking countries, physiotherapists often use the title of physical therapist interchangeably with that of physiotherapist. In Ireland, however, for the past 25 years or so and in the absence of regulation and title protection, the title of physical therapist has been used by other providers of musculoskeletal therapies practising in the private sector. Those currently using the title of physical therapist are predominately the members of the Irish Association of Physical Therapists. They number about 300 and most of them are degree level graduates of the Institute of Physical Therapy and Applied Science in Dublin. These practitioners and physiotherapists, mostly the 3,000 members of the Irish Society of Chartered Physiotherapists, all provide musculoskeletal therapies. Physiotherapists, however, are also trained to provide cardiorespiratory and neurological therapies. The profession of physiotherapist is a designated profession under the Health and Social Care Professionals Act 2005.

Three years ago, in June 2014, the newly established Physiotherapists Registration Board held its first meeting. One of the first items on its agenda was the protection of the title and how best to address the question of protecting the title of physical therapist. Early last year, the then Minister for Health, Deputy Leo Varadkar, concluded extensive consultations with the registration board and other relevant organisations. He came to the conclusion that protecting the title of physical therapist under the Act as a variant of the title of physiotherapist would be the best way to eliminate the risk of title confusion and the consequent risks to public safety. Protection of variant titles is done by regulations that require the prior approval of both Houses of the Oireachtas. The effect of prescribing the title of physical therapist as a variant of the title of physiotherapist will be to protect both titles under the Act by confining their use solely to registrants of the profession of physiotherapist.

It was also decided to allow certain practitioners who are users of the title of physical therapist, and who hold qualifications of a certain standard, to continue to use the title. This requires the amendments to the Act, proposed in this Bill, to allow such practitioners to apply on a once-off basis and for a limited period to register in the physiotherapists register. These decisions took into account, appropriately and subject to ensuring public protection, the legitimate concerns of all the practitioners involved and of the other parties that will be affected by the regulations to protect the title of physical therapy.

The decisions were welcomed by the two main professional bodies, the Irish Society of Chartered Physiotherapists and the Irish Association of Physical Therapists. Specifically, the Bill will permit the registration in the register of physiotherapists, on a one-off basis and for a limited period, of qualified existing practitioner-users of the title physical therapist by recent graduates of the Institute of Physical Therapy and Applied Science, Dublin, and of current students that graduate from the institute's final programme which commenced in 2016 and will end in 2019. It is intended that the regulations to protect the title of physical therapist will be made during the 12-month period provided for in the Bill.

As I mentioned earlier, the Physiotherapist Registration Board established its register on 30 September 2016. This means that all legislation necessary to protect the title of physiotherapist is now in place. When the register's two-year transitional period ends in September 2018, entitlement to use of that title will be confined to the members of that register. While the register has been open for receipt of applications since last September I am disappointed to hear that the rate of application has been slower than for other professions. It is important that CORU be given the opportunity to process as many applications as possible before the 30 September 2018 deadline, otherwise if the existing practitioners leave it to the last minute to apply for registration it is likely that a number of non-registrants will still be using the protected title of physiotherapist after that date and until such time as their applications are processed. This would be far from ideal from a public safety perspective.

I am keen to ensure that the Bill proceeds through this House as quickly as possible. As stated, the Bill will provide for the necessary amendments to the Health and Social Care Professionals Act 2005 to allow me to bring forward regulations to protect the title of physical therapist alongside that of physiotherapist and to make other technical amendments to the Act to enable the Health and Social Care Professionals Council to continue to fulfil its objective, which is to protect the public by promoting high standards of professional conduct and professional education, training and competence among registrants of the designated professions.

I commend the Bill to the House.

Fianna Fáil will be supporting this Bill which makes minor technical amendments to the relevant Act and will facilitate the implementation of the decision to protect the title of physical therapist. These decisions were taken following a consultation process and were welcomed by the professional bodies involved. The Bill originally introduced in the Dáil proposed to protect both titles under one protected title, physiotherapist, in order to eliminate the ongoing risk of title confusion and the consequent risks to public safety. It also proposed certain qualifying criteria to enable physical therapists to register as physiotherapists. As the Oireachtas Bills digest on this legislation points out, there are obvious similarities in the titles of physiotherapist and physical therapist and both professions closely overlap in practice.

The Physiotherapists Registration Board estimates that there are over 3,000 people practising physiotherapy in Ireland and approximately 300 people practising as physical therapists. However, as we know, these are not identical professions. Physiotherapists primarily work in the public sector and are trained to provide musculoskeletal therapies, cardio-respiratory therapies and neurological therapies. In Ireland, physical therapists mostly work in the private sector and are trained to provide musculoskeletal therapies solely.

In a letter to the Irish Society of Chartered Physiotherapists in January 2016 then Minister for Health, Deputy Varadkar, in undertaking to legislate on the matter, stated "new registrants will be required to confine their practise to musculoskeletal therapy."

Similarly, in October 2016, the Minister, Deputy Harris, told the Dáil:

New grandparenting provisions will allow such practitioners to apply on a once-off basis and for a limited period to register in the physiotherapists register, confining their practice to musculoskeletal therapies. Preparation of the necessary legislation to give effect to these decisions is now at an advanced stage.

However, the Bill as initially published by Government did not make it explicit that physical therapists will be confining their practice to musculoskeletal therapies. Consequently, the Irish Society of Chartered Physiotherapists raised grave concerns about the Bill.

Fianna Fáil tabled an amendment in the Dáil which served to make good on the commitments made by the former Minister for Health and current Taoiseach, Deputy Varadkar, and the current Minister for Health, Deputy Harris. On Committee Stage, the Minister said that the Department of Health would, before Report Stage, engage further with the two professional bodies involved, the Irish Society of Chartered Physiotherapists, ISCP, and the Irish Association of Physical Therapists, IAPT, on the provisions that were of particular concern to them. On that basis Fianna Fáil withheld its amendments. Over the summer recess, and following meetings and correspondence between Department officials and representatives of the ISCP and IAPT, it was agreed that the outstanding concerns of the two professional bodies would be adequately addressed by amendments in two areas. I am happy that both groups are now fully supportive of the Bill as it stands and that it can progress further.

There is another group, however, whose concerns have not been addressed in any way. Athletic Rehabilitation Therapy Ireland, ARTI, which is an important cohort of professionals, was formed in 2009 to act as the governing body of Certified and Athletic Rehabilitation Therapists in Ireland who have graduated from accredited honours degree programmes. These are a group of professionals who have spent four years studying in one of the three State-funded programmes delivered in Dublin City University, the Institute of Technology, Carlow, and Athlone Institute of Technology. ARTI has become a leading organisation in Ireland in the area of musculoskeletal and sports medicine. As a result of following best international practice in terms of programme accreditation, independent certification and membership requirements, ARTI is the only European body to have earned a mutual recognition agreement with sports medicine bodies in the USA and Canada. Many of these professionals work hand-in-hand with consultant colleagues of mine around the country who specialise in sports medicines. They are a vital cohort of professionals and they are seeking recognition and regulation. While it may not be possible to do this in the Bill before us today, this matter needs to be addressed. Will the Minister of State give a commitment today that he will look at this issue not with regard to this Bill but in the near future? I would be willing to introduce legislation in this regard. As I said, this is an important cohort of professionals that have been ignored.

On behalf of the Independent group, I welcome the Health and Social Care Professionals (Amendment) Bill 2017. The Bill proposes to amend certain provisions of the Health and Social Care Professionals Act 2005. This is a procedural and technical Bill which seeks to address gaps in the 2005 Act, which is designed to regulate 14 different professions, including psychologists, biochemists, care workers and radiographers. I do not propose to discuss each of the nine sections and the amendments in detail but I would like to comment on the purpose of this legislation and how it will enhance the 2005 Act.

The 2005 Act provided for the establishment of registration boards in health and social care professional councils in respect of a number of professions. Broadly speaking, the board and the professional council, which is composed of the various people practising in the professions they seek to regulate, provide for the registration and disciplining of the professions they were created to regulate. The board and, in particular, the professional council deal with issues of complaint and the professional development of the professions. The council promotes high standards of professional conduct, education, training and competence among the professional body it represents. The council also carries out practical functions, including receiving applications from members seeking to register with the profession and establishes committees of inquiry into complaints made in respect of its members.

The amendments, in particular to section 2 of the Bill, will allow the Minister for Health to make the initial appointment of a professional member to the council when a new profession is designated and will allow him to fill casual vacancies among professional members where the relevant registration board has not yet established a register. The Bill will also allow the Minister to appoint professional members directly to the registration boards during the transitional period of the professions concerned.

The Bill, in particular section 5, will also amend the Act to permit a registration board to make by-laws to apply conditions in respect of education and training for applicants for registration who are qualified for a specified period but who have never practised their profession. Section 5 contains a broad discretion for the registration board to set the criteria by which those who have been "out of practice" for some time should be estimated as professionally fit to resume their professions, including their education and training and any matter which, in the eyes of the registration board, is necessary or desirable for the protection of the public. That is what we are trying to get at. We are trying to protect the public.

One of the most significant amendments the Bill proposes relates to the introduction of the profession of physical therapist as a variant of the physiotherapist profession. The Bill will specifically amend the Act to permit the registration in the register of physiotherapists on a once-off basis of physical therapists who have graduated since 2013. This has been done, I understand, in consultation with the various professions on foot of concerns they raised and is subject to a number of qualifying criteria. It is clear from the proposed section 7 that any physical therapist who registers in the register of physiotherapists must hold specified qualifications awarded by the Institute of Physical Therapy and Applied Science, Dublin. The purpose of making a distinction between both professions - those of physical therapist and physiotherapist - is that no confusion can arise between the professions. This will, I hope, address concerns raised by those practising in each profession.

Overall, the amendment is practical and gives significant powers to enhance regulation of both registration boards and the Health and Social Care Professionals Council. It serves to fill gaps identified in the 2005 Act and allows the Minister to implement decisions taken last year that will result in the protection of the title of physical therapist for the exclusive use of those granted registration by the Physiotherapists Registration Board. I understand that this change of policy was taken following a consultation process and the amendments were welcomed by the professional bodies concerned. Naturally, the Government should always be guided by the experience of those professions in the manner in which regulation should take place.

I would like briefly to encourage the Minister, Deputy Harris, to continue his good work on the regulation of counsellors and psychotherapists by reference to the powers already granted to him under the 2005 Act. The Minister spoke briefly about this in the Dáil last week and said plans were under way for the creation of a 13-member registration board tasked with carrying out regulation of counsellors and psychotherapists, which is not too far from my own background. There has been ongoing public concern with the regulation of these professions and the extraordinary power they have when giving advice to vulnerable people. It is most important they are regulated by registration boards. I trust that the ongoing efforts to regulate these practices in a way that gives best protection to those who engage their services will continue.

I welcome the Minister of State to the House. I very much welcome the Bill. It sets out a number of amendments to the principal Act, namely, to sections 9, 28, 28A, 31, 38, 91 and 91A. It sets out a number of amendments that are required, and we are talking about 14 different professions here. My understanding is, as the Minister of State said, that for 11 of the professions the boards are up and running. The Bill deals with a broad range of people across the health care sector. This is important because normally when we talk about the health care sector, we tend to focus on doctors and nurses, but a huge range of people provide very well-developed services. It is important, therefore, that they too are regulated to ensure standards are maintained in those services.

The Minister of State has already set out in quite some detail the reasons for the amendments and the introduction of the Bill. In fairness, much work has been done by all the people involved in these professions to ensure we get broad agreement. I know the issue regarding physiotherapists and physical therapists has taken quite some time to resolve, but agreement has been reached, which is a welcome development. The provision of health care without regulation is an issue I have raised in this House previously. I refer to people offering to provide medical scans without any regulation. I am not clear whether many of those providing that service have adequate insurance.

When it comes to medical care, there is a need to protect the public. It is interesting how we have allowed certain things to develop over the years without regulation. For instance, it was 2012 when I introduced a Private Members' Bill into this House in this regard. One cannot drive a car without insurance, and I could not practise as a solicitor without insurance, but there was no legal requirement for one's local GP to have professional indemnity insurance. A Bill similar to mine had been introduced in 2009 by Senator James Reilly, who was then the Opposition spokesperson on health, and it is only in the past few weeks that such a regulation, the requirement for all medical practitioners to have professional indemnity insurance, has been in place. Like that area, much of the area relating to this Bill has been left unregulated in real terms for a long period. It is important there is proper regulation and adjudication in ensuring that the general public who are getting services are getting them from people who are qualified and have the training and skills to provide the care they need. The structure we are now setting up ensures there are not only standards, an education process and a qualification process, but also a supervisory process, which is extremely important.

As I said, quite an extensive area is covered by 14 professions. It is fantastic that we have now made progress on this and it is important that the Bill goes through to the next Stage and all of the procedures we need to put in place are put in place at an early date and there is proper regulation so that if a member of the public feels he or she did not get the service he or she sought, there is a mechanism for dealing with that, which is extremely important as well. Again, I thank the Minister of State for bringing forward the Bill and for coming to an agreement with the physical therapists and physiotherapists. I thank all the people involved, including the Department officials, for the work done and I look forward to seeing the Bill pass into law in a very short period.

The Health and Social Care Professionals (Amendment) Bill has been robustly debated and scrutinised in the other House. I know there were differences among those affected by the Bill, specifically physiotherapists and physical therapists, about some aspects of it and some of the amendments tabled on Committee Stage. We liaised with the representative bodies, the Irish Society of Chartered Physiotherapists and the Irish Association of Physical Therapists, and were made aware of certain difficulties presented by the Bill. On Committee Stage, my colleague, Deputy Louise O'Reilly, suggested that both bodies take a period over the summer to resolve the outstanding issues. Thankfully, the Minister for Health and those from all parties and none agreed to the Department of Health overseeing the mediation talks between physiotherapists and physical therapists, and today we have a Bill, as amended by the Dáil, which suits the needs of all parties involved.

The Bill amends the Health and Social Care Professionals Act 2005, which provides for the statutory regulation of the 14 professions currently designated under the Act. The main aim of the legislation before us today is to ensure greater patient care and tie all those professions under one registration body, the Health and Social Care Professionals Council, known as CORU. Regulation is primarily by way of the statutory protection of professional titles by confining their use solely to persons granted registration under the principal Act. The new provisions are essential to ensure only those who are properly qualified and subject to statutory regulations will be allowed to practise the various disciplines outlined in the Bill. There is no doubt that we need this statutory protection and guidance in order to enable people to be confident that those from whom they receive treatment are fully competent and accountable within their professions.

Having been a registered member of An Bord Altranais agus Cnáimhseachais na hÉireann, also known as the Nursing and Midwifery Board of Ireland, I was always fully aware of my responsibility and accountability in safeguarding public safety and protecting my patients to the utmost of my ability. The measures put forward following the consultation with and between physiotherapists and physical therapists will protect the public interest without putting at risk the livelihoods and practices of either profession and the skills developed over years of diligent and professional effort. The legislation will finally see physiotherapy and physical therapy coming together under one title, thereby bringing Ireland into line with other countries around the world where the two titles are interchangeable.

I commend the diligent efforts of all involved in advancing these proposals, including the members of the Select Committee on Health, the departmental officials who mediated on these issues and the Minister, who facilitated the suggestion of a mediation process. I thank the Irish Society of Chartered Physiotherapists and the Irish Association of Physical Therapists for their ability and willingness to work together positively to agree changes and amendments that will address the problematic elements of the existing system. I support the legislation and echo Senator Freeman's sentiment in welcoming the future establishment of a registration board for counsellors and psychotherapists. Every person providing health and social care services to the public must be accountable and responsible in the conduct of their role.

I was privileged to be a member of the Physiotherapists Registration Board from its establishment until, some years later, I began busying myself in this House. As such, I am familiar with the yin and yang and the ins and outs of the issues we are discussing today. More specifically, I am very familiar with the treble skill set of the physiotherapist. One soon ceases to be surprised when something that presents as a problem with a shoulder or knee turns out to have its roots somewhere else entirely.

There are three organisations that have been particularly active on this issue, namely, the Irish Association of Physical Therapists, the Irish Society of Chartered Physiotherapists and Athletic Rehabilitation Therapy Ireland. These organisations undoubtedly have skin in the game but, when everything is worked through, those with the greatest interest in this being done right are the ordinary members of the public. This is a public health and public protection issue. I would never seek to minimise the work done by fellow physiotherapists and physical therapists, all of whom have invested years of their lives and made many sacrifices to become qualified. They, quite rightly, have great pride in their profession. Ultimately, however, our most important function is to ensure the public is protected.

There are several ways of ensuring that protection is in place. One way is to stipulate that where there is a contravention of the rules, there will be repercussions. This is what I refer to as rear-view protection in that it arises only after the damage and hurt have already been done. Although it is an important part of any regulatory regime, the most important element is the need to ensure people are properly informed before the event, that is, before they access any treatment. I do not expect the average person to know the difference between a physical therapist and a physiotherapist; it is up to us to ensure the necessary information and protections are provided. The Minister and CORU must both be strong on this point. If I go to a physical therapist, it is important that it be there in lights, so to speak, that this person has a particular, clearly defined, skill set, which would include the three elements. The core point here is the importance of ensuring people receive advance notice and understanding as to the precise qualifications and skills of the person whose expertise they are accessing. Something might be done in this regard via an awareness campaigns, but more will be required. We cannot expect people to be able to divine the difference between a physical therapist and a physiotherapist.

The third group of professionals involved here is the athletic rehabilitation people. My view, which is echoed by others, is that a lot of work has been done to get us to where we are and we should hold steady now at the point at which things are currently resting. The registration of these particular practitioners is important, but their skills should not be confused at this point with the other two skill sets.

To reiterate, I hope we will see an expectation imposed on both physiotherapists and physical therapists of providing before-the-event information and protections. There should be an onus on both practitioners to say what they are as well as what they do. This is part of the process of people learning and engaging as they go on. I know from my own involvement over the past three and a half years that there has been a lot of water under the bridge and a great deal of engagement. It is time now to move matters on and deal with these registration matters.

I welcome the Minister of State, Deputy Finian McGrath, to the House. As colleagues have noted, these amendments to the 2005 Act provide a welcome strengthening of existing provisions. Following on from what Senator Dolan said, the key element here is the clarity that is now provided regarding the distinction between physical therapy and physiotherapy. It is not to diminish the role of either profession to point out there are distinct differences between the two. It is very important that the public, as Senator Dolan so clearly stated, is very much aware of those differences. It is vital, therefore, that the Irish Society of Chartered Physiotherapists, the Irish Association of Physical Therapists, the Department, and all the relevant stakeholders do their best to communicate those distinctions to the public. The ultimate aim is to protect people and ensure we have high standards for the delivery of services.

It has been helpful in recent months to have constructive consultation with the various stakeholder organisations in seeking to find a better solution. CORU, in particular, has an important role to play in ensuring we have proper regulation in place.

Yes, we have a distance to travel in terms of ensuring more professions are accountable. Senator Colm Burke made a very important point regarding the number of allied health professionals who are engaged in the health sector and how important it is that proper standards and expectations regarding continuous professional development are in place and health care professionals delivering services are equipped with the appropriate skills, knowledge, attitudes and training. The amendments to this Bill will strengthen this. I very much welcome these changes. Our ultimate aim is to promote high standards and good professional conduct. This Bill attempts to do that. I thank the Minister of State for his time today.

I think this is my first time addressing the Minister of State in this House.

Senator Craughwell, without interruption.

I welcome the Minister of State to the House and compliment him on his work for the disabled in Ireland. He has done a tremendous job and is a great champion.

I am delighted to welcome this long-awaited Bill to the House. Not only will it address the gaps in the 2005 Act regarding appointments to the State bodies established under the Act but it will also insert new provisions for applicants for registration who have not yet practised their profession. I particularly welcome the fact that the Bill will provide further conditions for registration of physiotherapists and physical therapists in the register of physical therapists in advance of regulations to protect the title of physical therapists.

In a Commencement debate in January 2016, almost two years ago, I asked the then Minister for Health and current Taoiseach, Deputy Varadkar, to legally define the difference between a chartered physiotherapist and a physical therapist. I stressed that in the interests of patient safety, the titles of physiotherapist and physical therapist should be protected in one register for use by the physiotherapist profession. It is extremely important. People have set themselves up in gymnasiums and various other places and regulation is becoming extremely important in this area. I know the Irish Society of Chartered Physiotherapists, members of which are here in the public Gallery today, has been campaigning for this for many years and has been part of a full and comprehensive consultation in the Bill. I am also aware that amendments to the Bill were introduced in the Dáil on Report Stage and that the Bill was passed without opposition.

I congratulate the Minister of State, his officials, the Office of the Parliamentary Counsel and bodies such as the Irish Society of Chartered Physiotherapists and the Irish Association of Physical Therapists for their considered and practical approach to the Bill. I believe the public and users of the services of physiotherapists and-or physical therapists will be deeply assured that the registration board's code of professional conduct and ethics will ensure that those registered under the Bill act within the limits of their knowledge, experience and competence, which is an important point, and that in the case of physical therapists, this will confine their practices to musculoskeletal therapies.

I thank the Minister of State for his hard work on this and for bringing the Bill to this House. Like Senator Dolan, I hope this Bill will pass through the House quickly and be brought into law. I thank the Minister of State for coming here today and for taking the time to listen to us.

I thank the Senators for their contributions and note the broad support for this Bill. I also thank the officials from the Department of Health who have done excellent work on this legislation. As I indicated earlier, the main purpose of this mainly technical Bill is to address identified gaps in the provisions relating to the appointment of professional members to CORU and registration boards and to permit a registration board to apply conditions relating to training, education and experience to applicants for registration who have not yet practised their profession. The third aim of the Bill is to provide further conditions for registration in a register of physiotherapists in advance of making regulations to protect the title of physical therapist.

I thank the Senators for all their constructive contributions during the debate. I will respond briefly to a few points. Issues raised during this debate will inform preparations for Committee Stage. A number of Senators raised the issue of athletic rehabilitation therapists. I know the Minister and his officials have met with athletic rehabilitation therapists on a number of previous occasions. The Minister's position is that while he acknowledges the quality of the DCU honours degree-level education and training which specialises in musculoskeletal therapy in the sports sector, athletic rehabilitation therapists constitute a separate profession to that of physiotherapist and physical therapists. Athletic Rehabilitation Therapy Ireland, ARTI, does not use the title, and is not seeking to practice under the title of physical therapist. There is no risk of confusion in the public mind regarding the services of those practising under the title of athletic rehabilitation therapist. The Minister has assured ARTI on a number of occasions that once work concludes in late 2018 approximately on the regulation of the professions currently designated under the Health and Social Care Professionals Act 2005, CORU will be requested to undertake a risk assessment on a number of other professions seeking regulation by CORU, including athletic rehabilitation therapists, and to make recommendations to him in this regard so that issue will be dealt with.

I thank Senators for their contributions to Second Stage and look forward to constructive examination of the Bill on Committee Stage. I commend this Bill to the House.

Question put and agreed to.

When is it proposed to take Committee Stage?

Committee Stage ordered for Tuesday, 28 November 2017.

When is it proposed to sit again?

Tomorrow morning at 10.30 a.m.

The Seanad adjourned at 6.20 p.m. until 10.30 a.m. on Wednesday, 22 November 2017.