Health and Social Care Professionals Bill 2004: Committee Stage.

Any minor amendments such as spelling mistakes can be dealt with here.

Sections 1 to 3, inclusive, agreed to.
SECTION 4.

Amendments Nos. 1, 2, 5, 18 and 19 have been grouped together for the purposes of discussion.

I move amendment No. 1:

In page 9, subsection (1), line 3, to delete paragraph (a).

This amendment has been grouped with an amendment of Deputy McManus's dealing with podiatrists. Deputies will be aware that under the legislation, one title is protected for each profession and that provision is made for the protection of variants by a regulation under section 95(3). This is the legal advice available to the Tánaiste and Minister for Health and Children, Deputy Harney. It will be an offence for an unregistered practitioner to use a protected title or to misrepresent himself or herself as being a registered practitioner.

There has been considerable debate within the chiropody-podiatry profession on the most appropriate title for the profession within the primary legislation. The title "chiropodist" has been used within the Bill because it reflects the title by which the profession is generally known to the public but varying views are entertained by the relevant professional bodies on the subject. Some expressed a preference for the title "podiatrist". To deal with the issue the relevant professional bodies sought to have both titles included in the primary legislation but this is not consistent with our legal advice and the approach taken in the Bill to other professions. In this context, the professional bodies have now come to the view that if only one title is to be protected under the legislation, the preferred title is "podiatrist" and the amendments tabled by the Minister for Health and Children reflect this.

There is an argument to be made for the use of either term, one of which is that the term "chiropodist" is in use by the public. The other is used in other jurisdictions and educational courses for the profession. On balance and in the light of the final views reached by the professional bodies in the matter, it was considered that it would be appropriate to bring forward amendments to change the title in the Bill from "chiropodist" to "podiatrist". The amendments, therefore, provide for a change in the title used, from "chiropodist" to "podiatrist", in section 4 which designates the professions for the purposes of the legislation and in section 26 which provides for the establishment of a podiatrists' registration board.

Deputy McManus's amendment would entail protecting two titles in the primary legislation. This would run contrary to our drafting advice.

I thank the Minister of State for that information. I will make two points only. Although the amendment marks an improvement, it does not meet the requirements of my amendment No. 2 which would include both titles. "Chiropody" is the term used by the public. Many of those who avail of such services are elderly and it will be confusing for them to deal with a new unfamiliar title which, in my experience, has been used in America and other countries, but certainly not in Ireland. I find it hard to understand why legislation, rather than mystifying, cannot facilitate the public. I would have thought my amendment was acceptable.

The Minister of State stated he had received drafting advice but that does not mean a great deal to me. He receives advice from all quarters but that does not mean he must accept it. It is a little vague to state it is drafting advice and that, therefore, he must abide by it. He need not do so. My concern is that the issue of physiotherapists and physical therapy arises subsequently in the section. If the Minister of State is stating there can be only one title because somehow that is the law of nature, obviously it will create difficulties subsequently when we come to the other issue to which I refer, a big issue among physiotherapists and physical therapists.

I will not press my amendment because the Minister of State's amendment probably offers a better solution than the one he proposed originally. I would make the point, however, that it is not right that legislation creates difficulties for the public. In this instance, there will be confusion, which is a pity.

The idea behind the Bill is to protect the public and patients using the services of the professions covered. In some respects, it is a little like the issue surrounding pharmacies. Pharmacists are qualified as such but call themselves chemists and are listed as such in theGolden Pages because that is what the public understands, even though the term “chemist” covers a much wider variety of occupations. If such a person begins referring to himself or herself as a pharmacist in the telephone book and in general, many members the public will not understand the term.

This boils down to much the same thing. The public understands the term "chiropodist" but it certainly might not understand the term "podiatrist". If we stick to this term completely, there is nothing to stop others with no qualifications using the term "chiropodist" as there is no protection provided in the Bill for the public. Such persons could operate easily and the public would be under the impression that this was a profession covered by the Bill. The Minister of State is merely making a straightforward legal argument about legislation but the amendment fails in protecting the patient.

While valid points have been made by Deputies Twomey and McManus, I draw their attention to section 95(3) which provides:

After consulting the registration board of any profession designated insection 4(1), the Minister may, by regulation, prescribe one or more than one title that is a variant of the title specified in that section for the profession and that, in addition to the title specified in that section, may be used by registrants of that profession.

The purpose of the provision is to address the issue raised by Deputy Twomey, that the public must be protected. Were unqualified persons to establish themselves, for example, under the description of chiropodist, under this legislation it would be open to the registration board for the profession to draw the attention of the Minister to that circumstance and address it under the subsection. Therefore, the Minister can protect a variant in the interests of a profession under section 95(3).

I will ask the Department to look at the matter and to see whether, on Report Stage, we can firm up the subsection somewhat. It is an important provision in the legislation to deal with the issue of multiple use. I am not sure, for example, that the pharmaceutical profession referred to by Deputy Twomey would seek to be protected much in the description of chemist, but I can see why it might well want to protect itself against persons acting under the name and description of chiropodist. I certainly will seek the views of the Department and convey them to members of the committee on Report Stage. Thankfully, we are at an early point on Committee Stage. I will revisit the amendment which raises an important issue on Report Stage. However, I would also like Deputies in considering the issue to take account of the provision in section 95(3).

Will the Minister of State clarify if under the section he has quoted it will be possible for the registration body, if it so wishes, to make an application to the Minister to have certain titles designated?

Yes. However, I do not want to anticipate a discussion we may have on another amendment to be discussed later this morning. In this context, I am speaking about chiropodists who will be covered by the provision in section 95(3) without, at this stage, any apparent legal difficulty. I would appreciate if Deputies again raised the issue of chiropodists on Report Stage, at which time I hope to be in a position to give a firmer answer. It is hoped the Minister or I will be in a position to state it is the intention that chiropodists will be protected by the legislation. However, one does not like to pre-empt legislation, given that the board has yet to be established. I would like to be in a position on Report Stage to give the House my firm assurance that chiropodists will be covered under section 95(3).

Pharmacists will be seeking separate legislation by way of the pharmacy Bill.

We have a lot of ground to cover and must move on.

Amendment agreed to.
Amendment No. 2 not moved.

I move amendment No. 3:

In page 9, subsection (1), between lines 3 and 4, to insert the following: "(b) chiropractor;”.

I am conscious that in drawing up the list the Minister cannot include all professions and that trying to add a particular discipline at this stage could create difficulties. However, it is important to make the point that there is a broad range of services outside those listed in the Bill that will have to be taken into consideration at some stage. I am requesting that chiropractors be included as they have become part and parcel of the broader health service. One can now obtain health insurance cover for visits to a chiropractor and be referred to one by a general practitioner. It is an established field, the standards for which are set by various international federations and should be recognised at some point.

I do not expect the Minister of State to accept my amendment. I am merely putting down a marker that consideration will have to be given to particular disciplines outside the context and framework of this legislation which are part and parcel of the broader health service. I am aware of the dangers in disregarding disciplines in the complementary health sector and giving recognition to the full range of such disciplines, and do not argue for this. I am seeking that the long established service provided by chiropractors be included in the legislation, given its stated development both here and abroad.

I agree with Deputy McManus and must declare an interest as I have found the chiropractor service very useful. I am sure, however, that Deputy Twomey will disagree with me and say the service is more complementary in terms of the scope of services rendered.

Section 4 makes provision for the inclusion by regulation of additional professions in the proposed system of statutory registration. Under the section, the Minister must examine the degree of risk to the health, safety and welfare of the public from incompetent, unethical or impaired practice of any given profession, the extent to which the profession has a designed code of practice and applies a distinct body of knowledge and the extent to which it has established itself, including whether there is at least one professional body representing a significant proportion of practitioners. If chiropractors can meet these requirements, the Minister is open to considering an application under the appropriate subsection on enactment of the legislation.

While I accept the Minister of State's point, I do not agree with the introduction of primary legislation which provides for great change by way of regulations which are not open to the same degree of public scrutiny as legislation. If we continue to make changes by way of regulation, public scrutiny will be greatly curtailed. I do not like this as a principle. However, I will withdraw the amendment.

I take it that what the Deputy is saying is that the process of enactment of a regulation is not as transparent as the process of enactment of primary legislation. A point in defence of this is that the legislation sets the general template which must be applied to the particular profession dealt with by the regulation. The Minister's hands are tied substantially by the framework set in the primary Act.

Amendment, by leave, withdrawn.

For the record, amendment. No. 4 in the name of Deputy Twomey is also in the name of Deputy McManus whose amendment, although submitted to the Bills Office some time ago, was not received before publication.

I move amendment No. 4:

In page 9, subsection (1)(g), line 9, after “physiotherapist”, to insert “or physical therapist”.

Two main concerns were raised during the Second Stage debate on this legislation. They relate to the position of those not covered by the legislation who believe the inclusion of their profession would ensure the safety of their patients and the reference to "physical therapist", an issue on which I have received more correspondence than any other in the context of of this legislation. Physiotherapists are anxious that the term "physical therapist" be included in respect of that profession, given that it has been using it worldwide for a number of years.

The physiotherapy profession has been in existence in Ireland since 1905, while physical therapists, a separate entry, have been in existence for only 20 years. While I sympathise with physical therapists who wish to protect their title — I have had numerous discussions with them in that regard — the terms "physiotherapist" and "physical therapist" are interchangeable across the European Union. In terms of legislation, Ireland will have to conform at some stage with what is happening in Great Britain and elsewhere in Europe. We will encounter problems in the future if we do not protect the two titles under one profession. Physical therapists have put their case well. However, we, as legislators, could run into enormous problems if we do address this issue now. I am sure the Minister of State is aware of the problem. The use of the two titles is the one major issue with which I have had to deal since the Bill was published and I am surprised no decision was made on the matter prior to Committee Stage. Can the Minister of State give the committee some indication of how the Government intends to address this significant problem?

I sympathise with physical therapists who have provided services under that title. However, since 1980 physiotherapists have been trying to have this matter addressed by the Department of Health and Children. It is only now in 2005 that we are providing the legislative framework for the use of these titles by various professions. I am aware physiotherapists have raised valid points on the issue. We need to consider the present position post the British-Irish Agreement. There is an onus on us to ensure there are no longer any discrepancies between the jurisdictions, North and South. Health is seen as one of the areas for North-South co-operation. The North-South ministerial body has considered the procedures to ensure there is no difficulty in registering professionals. We could be creating a difficulty in ensuring there are no unnecessary barriers between North and South. It may seem this is not central to the needs of the two organisations representing these professions but, as legislators, we have a duty to live up to the commitments we made to North-South co-operation. I would be more comfortable if we were to amend the Bill to ensure the compatibility of the professional register, North and South.

For once I am in agreement with Deputies Twomey and McManus. This issue was highlighted repeatedly on Second Stage. My approach is similar to that of the previous two speakers, but irrespective of the rights of either profession, our primary concern is the protection of the public. In this regard, the titles "physiotherapist" and "physical therapist" are interchangeable and synonymous in 92 countries. In Northern Ireland "physiotherapist" and "physical therapist" mean the same and with the increasing traffic North and South, we will leave ourselves open to the situation where somebody availing of a service will think the therapist has such a qualification when he or she does not. I understand the Department may have fears that if it does not make these titles interchangeable, a legal action may be taken against it for loss of livelihood. However, in 2001 the then Attorney General, in reply to a query from the Department of Health and Children, categorically stated the right to earn a livelihood was not an unlimited constitutional right and that the State was entitled to place reasonable restrictions on it, in accordance with the common good. I understand also there is a very comprehensive opinion from a senior counsel which states any such litigation would be unlikely to succeed. I urge the Minister of State to accept the amendment from Deputies Twomey and McManus at this juncture.

I am in complete agreement too with Deputy McManus, which is a rare occurrence. The points have been made. In drafting legislation it is our duty to ensure there is no ambiguity. I agree with Deputy Devins's point that the way in which professions are described in Europe must be the overriding issue in order that we are clear and in line with European practice. We should honour the arrangements made in the British-Irish Agreement. For these reasons I urge that the amendment be accepted.

As there is such a level of agreement, I will play devil's advocate in this instance. What will happen to the 150 people who, having undertaken a three year course in physical therapy, have qualified and joined the profession of physical therapists and the 200 students studying for this qualification? If we ask whether the profession of physical therapist is being confused with that of physiotherapist, the position is that health insurers, with the exception of VIVAS, do not provide cover for physical therapy. No claims have been submitted for such treatment, even if the public is confused between the services offered by physical therapists and physiotherapists. I am in the unusual position of having to make a point when surrounded by members with medical expertise. I understand a recommendation was made a number of years ago that hospitals should recruit physical therapists because of the shortage of physiotherapists. If the amendment is accepted, what will happen to those who qualify as physical therapists?

Having listened to both sides of the argument, I see the merit of both. However, we must protect the public. Most think physical therapy and physiotherapy are synonymous. I, too, received submissions pointing out the difference between them. If we accept the amendment and decide that the terms "physiotherapist" and "physical therapist" will apply to one profession, what will those with the qualification of physical therapist be called and what will happen to them?

The Bill provides for the protection of the title of "physiotherapist" for use by those professionals who register with the Physiotherapist Registration Board. The Irish Society of Chartered Physiotherapists is seeking the protection of the title "physical therapist" for use by those professionals registered with the envisaged board. The society considers both titles to be interchangeable in an international context, a point echoed by many Deputies this morning. The society believes there is a risk of confusion among the public if the title "physical therapist" is not protected for use by physiotherapists. On the other hand, members of the Irish Association of Physical Therapists who train with the Institute of Physical Therapy and who currently use this title and have used it for some time in this country want to retain it for their own use. The Department of Health and Children has met both the Irish Society of Chartered Physiotherapists and the Irish Association of Physical Therapists before and since the publication of the Bill with a view to encouraging both organisations to develop an agreed solution to the issue of the protection of title which takes account of the issues involved. There are complex legal, competition and public interest issues involved in resolving this matter and I regret to say a final solution has not yet been found. The matter remains under consideration in the Department.

I would like to be able to report more progress on this issue when the House revisits it on Report Stage. I accept the points made by many Deputies that the issue must be resolved. These are difficult matters and the Minister has looked at her position under section 95, where she, the Minister, after consulting the registration board, "may, by regulation, prescribe one or more than one title that is a variant...". I do not want to pre-empt what she may say about chiropodists on Report Stage, but that would seem to be a far more clear-cut case than this one. The significant problem in this case is the existence of two defined groups of persons. Deputy Devins referred to a legal opinion. Certainly, the Department would be much obliged to have sight of it as it might be of assistance. The staff in the Department are still awaiting definitive advice from the Attorney General on this question. I know the Minister is anxious to bring it to a satisfactory conclusion.

On the specific amendment tabled by Deputy Twomey, the mantra is that there is only one title and one profession but the machinery for variant titles is provided for in section 95. While the Minister is anxious to keep this as the policy of the legislation, she is also anxious to be in a position to be more definitive to the Houses of the Oireachtas before the enactment of the legislation.

I will make one point before we finish. This issue has been discussed at length on Second Stage in the Dáil and in the Seanad but we have never heard about the discussion on it in the Department. There have not been any discussions with the Department. Is there any possibility of getting more information on what the Department is discussing? We have tabled these amendments and there has been discussion in the Department. The Minister of State said he had spoken to both groups. This is primarily about protecting patients' interests, but if there are conflicts between two organisations in the health service and we are introducing legislation to deal with both organisations, we should be privy to a certain amount of information in the Department. We do not want to table amendments and then discover that the Department has progressed in a certain direction without letting us know. That would be a waste of time, particularly as it would have helped our case had we known about it. I will not press my amendment but will table it again on Report Stage. We should be told what is going on. We do not want to receive representations from both organisations when they are already in advanced negotiations with the Department on the same issue.

I wish they were as advanced as the Deputy seems to think. There has not been any progress in the negotiations, which is why little information has been given to the House about them. We were trying to establish in the negotiations if there was any common ground in relation to the scope of the practice of each group, if there was any question of common qualification and whether we could make progress on these subjects. That would have assisted us, but we have not been able to make progress to date in the discussions. I thank Deputy Twomey for withdrawing the amendment on the basis that the Minister is anxious to have a more definitive position by Report Stage.

I will do my best to ensure the Department has that legal opinion before Report Stage.

We need it as soon as possible.

Amendment, by leave, withdrawn.

I move amendment No. 5:

In page 9, subsection (1), between lines 9 and 10, to insert the following:

"(h) podiatrist;”.

Amendment agreed to.

I move amendment No. 6:

In page 9, subsection (2), line 17, after "(l),” to insert the following:

"and in particular shall, within the period of 12 months from the passing of this Act, so designate the profession of counsellor or therapist,".

This amendment seeks to have the profession of counsellor or psychotherapist considered for inclusion in the Bill. The growth of psychotherapy and counselling has been phenomenal. We should recognise the huge variation in the skills, training and expertise of the people concerned. Some are excellent, while others are totally untrained in what they are doing. However, in each case the potential for affecting people's lives is significant. I have listened to psychotherapists arguing for inclusion in some form of regulation. It is of concern to those who practise in the profession that some type of registration system is put in place. We should not underestimate the impact an untrained or poorly trained counsellor can have in someone's life, particularly at a time when they may be vulnerable. The Minister of State should consider this amendment.

I support Deputy McManus. I have been concerned for some time about the lack of regulation of counsellors and therapists, not only in the psychotherapy area, but also in relation to marriage and family counselling. Anyone can put a professional plate on an office to advertise his or her services as a counsellor and get a fee without any training. There is a lot of concern about alternative medicine, an area in which there are difficulties, as the Minister of State is aware. However, we do not know what the difficulties are in the areas of counselling and psychotherapy, in which the damage caused is often not identified or admitted. There are no psychological autopsies on those who take their lives to see if the problems arose because of a lack of advice or the wrong advice being given. Professional psychotherapists and counsellors identified the need to regulate this area some time ago and discussed the matter with us. We are also aware of the need for psychotherapy and counselling. It must be tempting for people to fill that gap, regardless of their qualifications, particularly when they realise they can earn €60 or €70 per session. I understand psychotherapy and counselling, including marriage, family and occupational counselling which is important in terms of the holistic approach to psychiatric illness, are not covered by a medical card.

My health board has appointed professional bereavement counsellors who have a medical, nursing or psychiatric background. Medical card patients are able to see them.

Some psychologists in the articles I have read have stated there are no clear guidelines. Is it regulated nationally? If someone needs a psychiatrist, a doctor or prescriptive medicine, that is covered by a medical card. What regulations cover the areas of psychotherapy and counselling?

I agree with previous speakers. The area of counselling has undergone a huge explosion. While there are many excellent counsellors, unfortunately, the area is not regulated. As it must be regulated, I support the amendment tabled by Deputy McManus.

There is no doubt this is a huge growth area, as Deputies have said. The first issue the Minister would have to address, if she was to include it in the legislation, is which precise occupation should be included, psychotherapy or counselling. The cognate regulation would have to be used to cover counsellors. Counselling has grown so much that we could be in danger of regulating ourselves in our constituency advice centres. I am not treating this matter with levity.

I am talking about people who accept a fee for their services and say they have skills to intervene in a crisis. I am not saying I should not advise people.

I only mentioned that to draw attention to the fact that the scope of the counselling area has extended enormously in recent years. We all see it in our daily work. While there has been huge growth in this area, there is no precision.

Deputy Neville asked about the entitlements of patients under the general medical scheme. My understanding is that when a psychiatrist refers someone to a designated counsellor to assist him or her, that is paid for by the health service. The position is more ambiguous when a person directly seeks the assistance of a counsellor. We can ask the HSE to look at this. I imagine there are differences between areas.

I appreciate why Deputy McManus tabled this amendment. There is no doubt there has been a huge explosion in counselling and psychotherapy services within the public health service. There has also been significant growth in the private sector. A working group was established by the former health board chief executive officer group to examine the role of psychotherapy in the health service and assess requirements for the future. That report has now been finalised. The next step will be for an action plan to be put in place to progress the issues identified, including a further exploration of issues relating to the development of an appropriate model of service. The outcome of this work will form an integral part of the formal process that will be required as set out in the Bill to determine whether statutory registration is warranted and appropriate in line with the Bill's provisions for the designation of further professions. There is a need for the various professional groups to prepare for statutory registration by strengthening their voluntary regulation arrangements and reaching a common understanding on baseline qualifications. In other words, there is much work to be done within the profession and on the official side before this can happen. In the circumstances, it seems more appropriate to use the machinery of the legislation now provided for in section 4 whereby the Minister can recognise a further profession than to insert a reference to a body which has not yet arrived at a stage of evolution where it can receive clear-cut statutory recognition.

I will withdraw the amendment on the basis that I may introduce it on Report Stage.

The amendment is well tabled as it draws attention to an issue that requires professionalism.

It is so good we will see it twice.

Is the report of the working group available?

It is not yet available.

Will the Minister of State make it available? I would like to see it as I am working and doing some reading in the area.

I will arrange to have a copy furnished to the Deputy.

I would appreciate that.

Amendment, by leave, withdrawn.
Sitting suspended at 11.35 p.m. and resumed at 11.55 p.m.
Section 4, as amended, agreed to.
Section 5 agreed to.
SECTION 6.

Is it agreed to discuss amendments Nos. 7 and 75 together? Agreed.

I move amendment No. 7:

In page 11, subsection (1), line 3, after "as" to insert the following:

"Comhairle um Ghairmithe Sláinte agus Cúraim Shóisialaigh or in the English language as".

This is self-explanatory. Perhaps the Minister might consider accepting it.

Glacaim leis an leasú seo in ainm an Teachta. I accept the amendment tabled.

Go raibh maith agat.

Amendment agreed to.
Section 6, as amended, agreed to.
Section 7 agreed to.
SECTION 8.

I move amendment No. 8:

In page 11, subsection (2), between lines 33 and 34, to insert the following:

"(e) make professional awards at certificate level of qualifications for health and social care professionals,”.

I presume the Minister has received representations from social workers and from the academics who train them regarding the issue of the professional award which is unique to social workers. This is an enabling amendment to allow a professional award to be granted to health and social care professionals. It gets over the difficulty social workers experience. They have had the national qualification in social work. It seems logical that we should be able to transpose into this new system a provision for a professional award.

In this amendment the Deputy proposes to add to the functions and powers of the council to cover the specific difficulty in respect of social work professionals. However, in training and education terms, it is the registration boards which have responsibility for approving education and training programmes and monitoring their suitability. I am bringing forward an amendment to section 27 of the Bill which provides for the object, functions and powers of the registration boards. It is a similar section to the one with which we are dealing but relates to the registration boards. My proposal will include the giving of guidance and support to registrants concerning continuing professional development. This will be in addition to the existing function in regard to guidance and support concerning the practice of the designated profession.

The council has over-arching responsibility for setting standards and enforcing standards of practice. It also has responsibility for overseeing and co-ordinating the activities of registration boards. The making of professional awards at certificate level for individuals would not be appropriate or consistent with the overall functions of the council in section 8. Therefore, I am not in a position to accept the Deputy's amendment to that section. We may be able to——

Is the Minister of State saying it could be granted elsewhere in the Bill?

I propose to amend section 27 to give powers to the registration boards which operate under the council to give guidance and support concerning continuing professional development.

Which amendment is that?

Amendment No. 23.

Does the Minister of State reckon that will cover the matter?

It will address some of the concerns raised. There is also in section 91 a transitional provision relating to existing qualifications. Again, it gives the registration board powers in this respect.

That only covers the transitional period.

I would like to reintroduce my amendment on Report Stage, which will give the Minister of State the opportunity to re-examine the issue.

That would be a good idea because the amendment, as tabled, is in abstract form. I do not think we quite understood the point being addressed. That has been my difficulty in responding today.

I thought it was crystal clear.

Is it agreed we will return to the amendment on Report Stage? Agreed.

Amendment, by leave, withdrawn.
Section 8 agreed to.
SECTION 9.

Amendments Nos. 9 and 30 are related and will be discussed together.

I move amendment No. 9:

In page 12, subsection (1), line 20, after "section" to insert the following:

"provided that the Minister shall take such steps and give such directions as are required to ensure that not less than 40 per cent of the members of the Council are men and not less than 40 per cent are women".

I hope the Minister of State will accept this amendment. How long must the women of Ireland wait? I have heard the Minister for Defence, Deputy O'Dea, laud the principle of gender balance and have no doubt that the Minister of State is fully behind the progress of Irish women towards equality in their struggle for their rights. I plead with him to accept the amendment.

The Minister fully supports the thinking behind the amendments as they are consistent with overall Government policy. Her reason for not accepting them is some members of the council and the registration boards are appointed by the Minister on their election by registrars. Given that individuals may vote as they see fit, it may not be possible to achieve the balance proposed by the Deputy but the Minister assures her that in the making of appointments to bodies she will take close cognisance of Government policy with regard to the need for a gender balance.

As the Minister of State knows well, that is the greatest load of rubbish. There is nothing to stop a directive being given. We make laws and the Minister is in charge. There is nothing to stop her giving a directive that when selecting a representative, a gender balance must be maintained. I will reintroduce this amendment on Report Stage because many promises are made, but nothing ever changes.

The ultimate conclusion to the Deputy's argument is that we should direct the electorate to elect females in a Dáil election to a ratio of 50%.

We are not talking about electoral reform, but about a Bill, about which we could do something. However, the Minister of State will not do it.

The registration boards elect members of the council. The Minister's hands are tied with regard to those appointments.

The Minister can ensure that when the elections are held, there will be a recognition that this country is 50% female. It is about time this 50% were represented in places of authority. Otherwise, women will continue forever as a tiny minority when decisions are made. That is what this is about. It is time to change.

I will draw the Deputy's views to the attention of the Minister.

I propose to reintroduce the amendment on Report Stage.

Amendment, by leave, withdrawn.

I welcome the Minister of State at the Department of Health and Children, Deputy Tim O'Malley.

I move amendment No. 10:

In page 13, subsection (4), line 3, to delete "may" and substitute "shall".

This amendment places emphasis on the need for consultation. Rather than suggest consultation "may" be facilitated, the word "shall" places a different emphasis. Use of the word "shall" changes the way a decision can be made. It would be a pity to miss out on the opportunity to copperfasten this in the legislation.

The Deputy does not require the Minister to consult any particular organisation. It is the intention that the Minister will consult, as appropriate, before making any appointments to the council. This is explicitly provided for in the Bill. Consequently, I do not intend to accept the amendment.

With due respect to the Minister of State, there is no reason to include this subsection in the Bill because it states the Minister "may" consult. The Minister may consult anybody she wishes, without the necessity for it to be written into law. If we say the Minister "shall" consult, there will be a requirement on her to do so. The choice would be hers as to how widely she should consult. We do not need to include the word "may" because she may consult anybody she wishes at any time. This is just window dressing. If we use the word "shall" and leave the choice to the Minister as to how many or how few organisations she should consult, the decision made will be an informed one. This subsection is so broad that the Minister may not consult any organisation. We do not need a subsection that just refers to consultation. As written, it is meaningless. It is, therefore, silly to include it in the Bill.

I will accept the amendment.

Amendment agreed to.

Amendments Nos. 11 to 14, inclusive, are related and will be discussed together.

I move amendment No. 11:

In page 13, subsection (6), line 10, to delete "in" where it secondly occurs.

These are technical drafting amendments. Consideration is being given to the overall composition of the council and a substantive amendment to section 9 will be brought forward on Report Stage. Considerable thought has already gone into the Bill's provisions for council membership. The guiding principle has been to facilitate the best balance of professional expertise, health sector knowledge and public interest. While the provisions, as they stand, support this principle, it is considered that they could be enhanced. On that basis, I propose to introduce an amendment on Report Stage to facilitate the council further in meeting its objectives. Subject to consultation with the Office of the Chief Parliamentary Counsel, it is envisaged that the amendment will provide for the appointment to the council of persons who have qualifications, interests and experience which, in the opinion of the Minister, would be of value to the council in the performance of its functions. It is not anticipated that any changes will be made to the overall number of members, or the overall balance of practitioner and lay member.

Amendment agreed to.

I move amendment No. 12:

In page 13, subsection (6)(a), line 11, before “the” to insert “in”.

Amendment agreed to.

I move amendment No. 13:

In page 13, subsection (6)(b), line 12, before “the” where it firstly occurs to insert “in”.

Amendment agreed to.

I move amendment No. 14:

In page 13, subsection (6)(c), line 14, before “the” to insert “as a member of that profession, in”.

Amendment agreed to.
Section 9, as amended, agreed to.
SECTION 10.

I move amendment No. 15:

In page 13, between lines 24 and 25, to insert the following subsection:

"(2) In addition to any allowances payable undersubsection (1), the chairperson may be paid by the Council, out of funds at its disposal, such remuneration for performing the functions of his or her office as may be determined by the Council with the approval of the Minister given with the consent of the Minister for Finance.”.

Section 10 currently includes a standard provision for the payment of travelling and subsistence expenses incurred in respect of a council member's attendance at a meeting of the council or committee, or otherwise in connection with the affairs of the council, as the Minister for Health and Children may determine, with the consent of the Minister for Finance. The new provision proposed in this amendment provides that the chairperson of the council may be paid such 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.

Amendment agreed to.
Section 10, as amended, agreed to.
Sections 11 to 21, inclusive, agreed to.
SECTION 22.

I move amendment No. 16:

In page 19, subsection (3)(a), line 11, to delete “is” where it firstly occurs and substitute “it”.

This amendment corrects a typographical error in section 22(3)(a) in order that it refers to “a draft of any rule that it proposes to make” rather than “a draft of any rule that is proposes to make”.

Amendment agreed to.

As amendments Nos. 17 and 32 are related, they may be discussed together.

I move amendment No. 17:

In page 19, subsection (6), line 26, after "determine" to insert the following:

"and laid before both Houses of the Oireachtas, and if a resolution of either such House is passed within the next 21 sitting days annulling such rules, the rules shall stand annulled, but without prejudice to anything previously done thereunder".

I ask the Minister of State to consider accepting this amendment which attempts to ensure there would be democratic scrutiny of any new rules made by the proposed health and social care professionals council. Section 22(6) of the Bill currently provides that a new rule will be "published in such manner as the Council may determine". It does not seem that the current version of this section provides in an appropriate way for the publication of decisions which might have wide-ranging impacts, not only on those working in professional areas but also on the patients they treat. I recommend strongly that we ensure the principle of democratic scrutiny applies to all our legislation. It was difficult for a long time to ensure regulations were incorporated in a way that was open to scrutiny, but that practice has improved considerably in recent years. In this instance, I recommend strongly that we include a mechanism in the Bill to ensure accountability.

Amendments Nos. 17 and 32 relate to the laying before the House of the council's rules and the registration boards' by-laws. Extensive redrafting of the relevant sections took place during the passage of the Bill through the Seanad. The processes which need to be followed when the council's rules are being published in draft form have been well defined with a view to ensuring the council's openness and transparency. By providing that the proposed council must publish a draft rule and invite comments from the general public, we have ensured the public, including members of professional bodies and other interested parties, will have an opportunity to contribute to the content of the rules made by the council.

Some provisions relating to the making of by-laws by registration boards were also redrafted during the Seanad debate. For example, a registration board must publish a draft by-law and invite comments from the general public before it makes a by-law. That provision will ensure the public, including members of professional bodies and other interested parties, will have an opportunity to contribute to the content of by-laws made by a registration board. After the date for the receipt of comments on a registration board's draft by-law has passed, the board must consider any comments received. It may amend the draft by-law if it considers it appropriate to do so.

If the by-law relates to the adoption or revision of a code of professional conduct or ethics, the registration board is obliged to submit the draft version of the by-law to the Competition Authority which will then provide its opinion on whether any provision of the draft by-law is likely to result in competition being prevented, restricted or distorted. The registration board will set down the timeframe within which the Competition Authority should submit its opinion. If, within the timeframe set down, the board receives an opinion from the authority that competition is likely to be prevented, restricted or distorted if the by-law is made, the board can accept the opinion and change the by-law accordingly before submitting it to the council for approval, or it can submit the draft by-law to the council without alteration, accompanied by a written statement of the reasons it has not taken the authority's opinion into account.

The amended version of this section obliges a registration board to publish a by-law, in whatever manner it considers appropriate, as soon as possible after it is made. The section enhances the openness and transparency of the boards. I consider that the overall process is sufficient to ensure a good level of transparency and public oversight. Therefore, I do not propose to accept Deputy McManus's amendments.

I regret that very much and intend to reintroduce my proposal on Report Stage. It is incredible that it is not considered appropriate for such information to be provided for the national Parliament and that the Government does not propose to institute a mechanism of a kind that is normal in cases of regulation. I am not sure the Minister of State is really conscious that the health service is a closed system, thanks to the Government. There is practically no accountability left in the system. Agencies are referred to other agencies. The public is left completely outside the loop. Nobody knows about some of the decisions made. Health boards no longer exist. The media do not know what is going on. It is often the case that parliamentary questions do not receive a reply. When replies are given, they are no longer put on the record in many cases. The system currently in place is dangerously unaccountable.

The process described by the Minister of State which relates to the drafting of rules and by-laws is perfectly acceptable — nobody has a difficulty with it. However, the final decisions on rules and by-laws will lie with the proposed health and social care professionals council which will determine how its decisions will be transmitted to the public. That is not how democracy works. It is quite shameful that the Minister of State is unwilling to accept the amendment. I have proposed a mechanism whereby the Parliament of the people would be able to access information proper to it. Such information is necessary to ensure there is proper scrutiny of any body established by the Oireachtas. The Government seems to be absolutely determined to ensure information on the health service is closed off. It wants to make sure that it is very difficult to get the most basic information on the health system. While I am delighted that it has initiated the process of establishing a health and social care professionals council, it is not acceptable that the council — the body which will be actually making the rules — will be able to choose the level of information it wants to release. I certainly intend to reintroduce the amendment on Report Stage. It does not do the Minister of State any credit to refuse to accept it.

I support Deputy McManus in that regard. There is growing frustration within the Dáil and Seanad in obtaining information in many areas. Health is the most recent example in respect of which previously we had reasonable access to information through parliamentary questions and otherwise. In fairness, we have been promised greater access which we await but it is at the discretion — without any parameters — of either the Minister or the Health Service Executive, HSE.

On 10 May I asked the Tánaiste and Minister for Health and Children for information on this year's budget for suicide prevention measures. As the Minister of State may recall, I raised the matter with him on Second Stage when he stated he would do his best for me, and I believe he did. I spoke to the Minister of State, Deputy Seán Power, outside the Dáil and I presume he also did his best for me. I spoke to the Tánaiste and Minister for Health and Children at a meeting of this committee and I received the information for which I had asked at the end of August. It took from 10 May to the end of August to get basic information pertinent to public debate on what is an important issue. Prior to the establishment of the HSE, I would receive information in four days in reply to of parliamentary questions, as I did every other year. That is merely one example — there are others — but that has been the trend.

We have written off discussions on national roads, as the Minister of State will be aware. In the Dáil we no longer discuss national roads, a key infrastructural issue, because the matter now comes within the remit of the National Roads Authority, it is no longer a question for those of us who are under pressure from our constituents to ensure action is taken. I imagine I speak for all sides of the House because we all come under pressure in this regard. While I appreciate it is not a subject for discussion today, on the issue of openness, I support Deputy McManus because in the short time the HSE has been in existence we have experienced a gigantic shift in the availability of information.

It is my understanding that at this committee some weeks ago the Tánaiste and Minister for Health and Children indicated that there would be a special unit in the HSE to deal with parliamentary questions.

She spoke about it last October.

Does the Minister of State know whether it has been established?

It is now in place.

I hope so. I could concur with the Deputy's request.

There is a real difficulty, as we all know. The replies to parliamentary questions are recorded in the Official Report. They are accessible to the public and the media but a private letter from the HSE to a particular Deputy forms part of a closed system of information. That is the big problem. First, there is no time limit on the provision of a reply and, second, it is not open to public scrutiny. The entire system is closed and I am amazed more people are not complaining.

Amendment, by leave, withdrawn.
Section 22, as amended, agreed to.
Sections 23 to 25, inclusive, agreed to.
SECTION 26.

I move amendment No. 18:

In page 20, subsection (1), line 36, to delete paragraph (a).

Amendment agreed to.

I move amendment No. 19:

In page 21, subsection (1), between lines 1 and 2, to insert the following:

"(h) Podiatrists Registration Board;”.

Amendment agreed to.
Section 26, as amended, agreed to.
SECTION 27.

Amendment No. 20 is in the name of Deputy Twomey. Amendments Nos. 37 and 38 are related. Amendment No. 38 is an alternative to amendment No. 37. Therefore, amendments Nos. 20, 37 and 38 will be discussed together.

I move amendment No. 20:

In page 21, subsection (3)(a), line 29, after “profession” to insert the following:

"and each register shall be available for inspection by members of the public".

This is a simple amendment which speaks for itself, that where the functions of the registration board of a designated profession are to establish and maintain the register of members of the designated profession, the amendment would make the register available for inspection by members of the public. Considering our earlier discussion about the need for professionalism and to ensure qualified and unqualified persons are identified and known, by introducing this amendment it would be easy for the public to check the register to see if somebody offering services was registered with his or her designated professional body.

Concerning complaints, the maintenance of a comprehensive, accurate and up-to-date register of practitioners is a main function of each registration board and 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 deals with the issue of access to registers. Subsection (1)(a) states a registration board shall make its register available for inspection by members of the public at all reasonable times. This meets the Deputy’s requirements. The section currently provides that the register can be published by electronic means or otherwise. This means that it will be open to a registration board to publish its register via the Internet but it is not restricted to this means alone. Deputy McManus has tabled an amendment which would provide for the publishing of a register electronically and otherwise. I fully agree that this approach would improve the provisions of section 46 generally. Having consulted the Office of the Parliamentary Counsel on drafting matters, I am tabling an amendment to the effect that a registration board shall publish its register by electronic means and not less than one other means. On this basis, I am not accepting the Deputies’ amendments.

It is my interpretation that the Minister of State is accepting the spirit of the amendment. I appreciate he has a drafting responsibility and withdraw the amendment on that basis, subject to reintroducing it on Report Stage if Deputy Twomey sees fit.

Amendment, by leave, withdrawn.

I move amendment No. 21:

In page 21, subsection (3), between lines 30 and 31, to insert the following:

"(c) to make or forward complaints to the Council under section 51,”.

This amendment relates to a registration board bringing complaints to the council. Under section 52(3), a complaint to the council may be made on behalf of any person or by a registration board. On that basis, the substantive issue in the Deputy's amendment is already provided for under the Bill. Therefore, I do not propose to accept the amendment.

Having checked section 52(3), I will withdraw the amendment, although Deputy Twomey may wish to reintroduce it on Report Stage.

Amendment, by leave, withdrawn.

Amendment No. 22 is in the name of Deputy McManus. Amendment No. 23 is related. We will discuss both together.

I move amendment No. 22:

In page 21, subsection (3), between lines 30 and 31, to insert the following:

"(c) accredit and inspect providers of education for members of a designated profession,

(d) ensure a system of continuing professional development for members of a designated profession,

(e) carry on research to monitor trends and performance in health services,”.

I welcome the tabling by the Minister of an amendment to include a reference to continuing professional development. As my amendment is more comprehensive, I ask the Minister of State to consider accepting it. The two are completely compatible.

This issue has been raised by the four universities providing social work education and training. Their concern is that there is a danger all of the aspects developed under the current system such as the concentration on standards and professional training, accreditation and inspection may not be continued in the new form. I hope the Minister of State will accept my amendment as being more specific and detailed. However, I welcome that he has tabled an amendment in recognition of the need to deal with the issue.

Section 49(1)(a) empowers the registration board to satisfy itself as to the suitability of the education, training, assessment and examination provided by any educational programme approved by the board and, in subsection (b), the clinical training and experience provided in any education and training programme approved by the board. The accreditation refers to the education and training of candidates for registration in its register under section 48(1)(a) which deals with courses leading to a qualification for inclusion in the register. While the providers of courses are not accredited, the courses are.

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 the practise of their profession. Guidance on continuing professional development is an important element in regard to professional competency. I am, therefore, introducing an amendment that places it appropriately within the functions of registration boards. It might also be noted that section 31(1)(h) already provides for the making of by-laws by registration boards relating to the continuing professional development of registrants. It is envisaged that the provision allowing the boards to make by-laws under section 31 will deal with continuing professional development and the accreditation issues in this regard.

The carrying out of research to monitor trends and performance was seen to be more proper to other bodies such as the Health Service Executive and it would not be appropriate to charge registration boards or the council with this function. I do not, therefore, intend to accept the Deputy's amendment and ask that members support amendment No. 23 in regard to continuing professional development.

Amendment, by leave, withdrawn.

I move amendment No. 23:

In page 21, subsection (3)(c), line 33, after “profession” to insert “and continuing professional development”.

Amendment agreed to.
Section 27, as amended, agreed to.
SECTION 28.

Amendments Nos. 24, 25, 27 and 28 are related and will be discussed together.

I move amendment No. 24:

In page 22, subsection (1)(a)(ii), line 15, after “engaged” to insert “, as members of that profession,”.

These are technical drafting amendments consistent with those made under section 9 in regard to council membership.

Amendment agreed to.

I move amendment No. 25:

In page 22, subsection (1)(a)(ii), line 16, to delete “that profession” and substitute “it”.

Amendment agreed to.

I move amendment No. 26:

In page 22, subsection (1)(a)(iii), line 17, to delete “one” and substitute “3”.

This amendment deals with an issue in the context of social work departments. The existing NSWQB which will be abolished includes three educators on its board. I imagine social work is the biggest discipline with which the legislation will deal, although I may be wrong. I ask the Minister of State to consider accepting the amendment which was suggested by the educators.

The Deputy must be conscious of the significance of the registration board's role in accrediting training courses. It is essential that the board has the proper expertise to carry out its functions. It is open to a registration board, under section 33, to establish a committee to assist it in regard to education and training issues. This committee may include members who are not members of the board. On that basis and given the board's overall responsibilities and the need to maintain a workmanlike number of members, it is considered that the number of board members who are registrants and engaged in education and training should remain at one, rather than being increased to three.

Amendment, by leave, withdrawn.

I move amendment No. 27:

In page 23, subsection (4)(b), line 1, after “engaged” to insert “, as members of the designated profession,”.

Amendment agreed to.

I move amendment No. 28:

In page 23, subsection (4)(b), line 2, to delete “the designated profession” and substitute “it”.

Amendment agreed to.

I move amendment No. 29:

In page 23, subsection (5)(b), line 12, to delete “subsection” and substitute “subsections”.

This amendment corrects a typographical error.

Amendment agreed to.
Amendment No. 30 not moved.
Section 28, as amended, agreed to.
Sections 29 and 30 agreed to.
SECTION 31

I move amendment No. 31:

In page 24, subsection (1)(e), line 12, before “qualifications” to insert “and (4)”.

This is a technical amendment. 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 it. Under section 31(e), by-laws made may relate to procedures for the assessing of qualifications awarded or training or professional experience acquired outside the State. However, the current provision refers only to section 38(3) which relates to qualifications awarded in member states of the European Union to persons who are nationals of a European Union member state. The proposed amendment broadens section 31(e) to encompass the making of by-laws relating to procedures for the assessing of qualifications awarded in offshore states, that is, states other than members, to their nationals. The making of by-laws in this regard will enhance the transparency and openness of the system of statutory registration.

Amendment agreed to.
Section 31, as amended, agreed to.
Amendment No. 32 not moved.
Section 32 agreed to.
SECTION 33.

Amendments Nos. 33 and 34 are related and will be discussed together.

I move amendment No. 33:

In page 26, subsection (1), line 4, after "Part" to insert ",Part 4”.

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 and that are assigned by the board to a committee. Parts 3 and 5 of the Bill currently provide for the establishment of committees to perform functions or exercise powers of a registration board. Part 3 deals with registration boards, while Part 5 deals with the approval and monitoring of education and training programmes.

The proposed amendment to section 33 will extend the ability to establish a committee to perform functions of a registration board under Part 4. This will be a useful facility for a registration board as Part 4 deals with registration arrangements and, under section 38, the approval by boards of national and non-national qualifications held by applicants for registration as attesting to the standard of proficiency required. Section 33 allows a registration 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 interests of the general public. Section 33(5) currently provides that the acts of a committee are subject to confirmation by the registration board unless the board dispenses with the necessity for confirmation. The proposed amendment provides that 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.

Amendment agreed to.

I move amendment No. 34:

In page 26, subsection (5), line 18, after "unless" to insert the following:

", in the case of a committee established under this Part orPart 5,”.

Amendment agreed to.
Section 33, as amended, agreed to.
Sections 34 to 37, inclusive, agreed to.
SECTION 38.

I move amendment No. 35:

In page 28, subsection (4), line 18, to delete "the" and substitute "an".

A further amendment will have to be made on Report Stage. Section 38 provides for registration in a register of a designated profession and, as I mentioned earlier, the approval by boards of national and non-national qualifications held by applicants for registration as attesting to the standards of proficiency required. Section 38(4) deals with a person who is a national of an offshore state and has undergone training in that state. The amendment I am proposing will broaden the scope of section 38(4) to encompass training undergone by a person who is a national of an offshore state in his or her own and any other offshore state. I believe this amendment improves section 38. I should also state that further improvements are being considered to section 38 and appropriate amendments will be tabled on Report Stage. Section 38, as it stands, encompasses nationals of European Union member states who have been awarded qualifications in a European Union member state. It does not specifically encompass EU nationals who gained their qualification in an offshore state. At present section 38 also encompasses a national of an offshore state who gained his or her qualifications in the offshore state. However, it does not specifically encompass a national of an offshore state who was awarded his or her qualifications in a European Union member state. This has been considered and, as I have said, appropriate amendments will be tabled on Report Stage.

I can see the reason for it. It will apply to a person born in one country who obtains his or her professional qualifications in another country. If the present arrangement were to apply the non-national must be awarded his or her qualifications in the state where he or she was born. It is interesting that the Minister of State mentioned the European Union. Why confine this provision to those who qualified in a European Union member state and not broaden it to encompass qualification from other states which would be recognised and have the same status as a European Union qualification, for example, those who qualify in the United States?

It does not comply with European Union directives.

Amendment agreed to.
Section 38, as amended, agreed to.
SECTION 39.

I move amendment No. 36:

In page 29, subsection (2), between lines 23 and 24, to insert the following:

"(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,".

This concerns the re-registration of a person who has had a considerable period of absence from practising in the profession. In this amendment there is no restriction on the time period a person has been off the register at his or her own request. If a person has been off the register for a period of 24 months or more, the amendment provides that he or she must provide evidence of upgraded training or that he or she satisfies the current criteria. As members are aware, one must keep abreast of developments in the profession such as new diagnostic systems and new approaches arising from research. Under the provisions of this amendment a person who did not practise in his or her profession for six or seven years, could return, without having to satisfy the professional body that he or she has a competency equal to his or her peers.

Section 39 (2)(c) provides that a registration board shall restore the name of a person to the register if the person meets the criteria established by by-law for restoration to the register. I envisage the amendment proposed by the Deputy would be covered by the by-laws of a registration board and therefore I do not propose to accept it

This is a very important area.

I accept what the Deputy states about its importance, but if the by-laws cover it, there is no need for the amendment.

The Minister of State states "if the by-laws cover it" .

I am sorry, the by-laws cover it.

Not necessarily, the registration board will accept a person who has not been registered for less than ten years. What I propose is that the Oireachtas should state that a person who has not been on the register for a period of 24 months or more must satisfy the criteria required by the profession of their peers. We do not know whether changes to the period stated in the by-laws may be introduced. I believe the Oireachtas should determine that a set period be laid down so that somebody who has not been on a register must satisfy clear criteria, as set out in my amendment.

I agree with the Deputy but the by-laws cover the restoration of a person's name on the register. It is a matter for the registration board to decide on the standards.

What that means is the Minister will leave it to the registration boards to do so. Should the Oireachtas not lay down the criteria for registration with the registration board?

Standards can change and, as the Deputy rightly stated, one must keep abreast of the changes in the profession. It is more applicable to the registration board to change by by-laws the criteria for registration rather than providing for it in legislation.

Under the terms of the amendment it would be up to the registration board to restore the name of a person who previously has been registered within the preceding 24 months. However, after a period of 24 months, we believe there should be an obligation on the person to provide evidence of having attended and successfully completed in the past three months relevant, accredited refresher training. Will the Minister of State reconsider this amendment and bring it back on Report Stage.

Yes, I will do that.

Amendment, by leave, withdrawn.

Section 39 agreed to.
Sections 40 to 45, inclusive, agreed to.
SECTION 46.

Amendments Nos. 37 and 38 have already been discussed with amendment No. 20.

I move amendment No. 37:

In page 32, subsection (1)(b), line 11, to delete “means or otherwise” and substitute “and not less than one other means”.

Amendment agreed to.

I move amendment No. 38:

In page 32, subsection (1)(b), line 11, to delete “or” and substitute “and”.

Amendment, by leave, withdrawn.
Section 46, as amended, agreed to.
Sections 47 to 50, inclusive, agreed to.
Amendments Nos. 39 and 40 not moved.
Section 51 agreed to.
SECTION 52.

I move amendment No. 41:

In page 36, subsection (1)(c) line 13, after “ailment” to insert the following:

"which cannot be addressed by reasonable accommodation by any present or future employer of the registrant".

This amendment is tabled to ensure the protection of people with disabilities. There is a danger with the way the legislation is framed that a person with a disability could be discriminated against. We are proposing a cautious amendment that would allow for reasonable accommodation by any present or future employer. Something wonderful is happening in that people with disabilities are moving into areas in which they have not traditionally worked. It would be a pity if we failed to provide some safeguard to ensure disability does not become an obstacle for them. Under this legislation, a complaint could be made that someone with a disability was not being reasonably accommodated and he or she could end up in great difficulty.

The Deputy's amendment would result in a complainant being able to make a complaint on grounds of impairment of their registrant's ability to practise due to a physical or mental ailment only in circumstances that could not be addressed by reasonable accommodation by an employer. A complainant may not know whether the circumstances could be reasonably addressed by an employer. It should remain open to a complainant, based on his or her experience of care by the registrant, to make the complaint. It would be a matter for the committee to come to a conclusion in regard to the future practice of the registrant and set conditions in that respect. The amendment might lead to inequality of treatment between self-employed registrants and those who are employed. Therefore, I do not propose to accept the amendment.

I will reintroduce it on Report Stage.

Amendment, by leave, withdrawn.

Amendments Nos. 42 and 43 are related and will be discussed together.

I move amendment No. 42:

In page 36, subsection (1)(g), line 21, to delete “triable” and substitute “tried”.

Will the Minister of State examine this issue as it seems harsh to use the term "triable", according to the legal advice I have been given. It is very broad in that a large number of offences are triable, namely, they are capable of being tried as opposed to actually being tried on indictment. The example that is always used is that stealing a Mars bar is an indictable offence. There is such a broad range that it is hard to justify it. Using the term "tried" instead would narrow the range in a reasonable way to protect the public. I ask the Minister of State to examine this issue.

The phrase "triable on indictment" is used in a similar context in other legislation such as section 84 of the Veterinary Practice Act 2005, sections 32(3) and 42(1) of the Dentists Act 1985, section 42(1) of the Nurses Act 1985 and sections 33 and 49 of the Medical Practitioners Act 1978. The phrase describes an offence that could, at the election of the Director of Public Prosecutions, be tried either summarily or on indictment. The proposed amendment seeks to ensure a registrant would not be disciplined for an offence that, though triable by indictment, was, in fact, tried summarily. This seems to cut off the possibility of discipline when discipline would be appropriate. I would also be unhappy regarding amendment No. 43. The council is unlikely to be in a position to determine whether the act or omission constituting the offence in the other jurisdiction has been done or made in the State. The Director of Public Prosecutions would have been likely to proceed by indictment. For these reasons, I do not propose to accept the amendments.

Amendment, by leave, withdrawn.
Amendment No. 43 not moved.

Amendments Nos. 44 and 45 are related and will be discussed together.

I move amendment No. 44:

In page 36, subsection (4), line 34, after "complaint" to insert the following:

"and the complaints are processed as soon as reasonably practicable".

Amendment agreed to.
Amendment No. 45 not moved.
Section 52, as amended, agreed to.
NEW SECTION.

I move amendment No. 46:

In page 36, before section 53, to insert the following new section:

53.—The Council may, if it appears to it desirable in the public interest to do so, irrespective of whether or not it has received a complaint, investigate any matter that appears to it to indicate that a registrant may have—

(a) committed an offence, or

(b) behaved in a manner that would contravene the grounds set out in section 52(1).”.

This is an amendment to give the power to the council to initiate investigations. As section 52 stands, a complaint may be made to the council concerning a registrant on the grounds set out. This amendment would give the council power to investigate a matter in the public interest, irrespective of whether it had received a complaint. It is important that the council has such powers. A situation may arise where it becomes aware of a contravention of professional conduct but because the powers are not explicitly given, it may not be in a position to initiate an investigation. One might say it could suggest to somebody to initiate the process but it would be unprofessional of such a body to use an alternative route to investigate a matter, of which it has become aware.

As Deputies will be aware, given the potential implications for a practitioner's livelihood, all decisions of the council in the area of discipline are subject either to appeal or confirmation by the High Court. In this respect, it is clearly essential 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 to dictate an appropriate sanction based on the recommendation 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 the Deputy would circumvent the detailed fitness to practice system and run the risk of rendering the disciplinary committee superfluous or, at least, confer on it a lower order of importance. It might also undermine the objective of the Bill to develop a more modern approach to the investigation of fitness to practice 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 where an investigation could be commenced in the absence of a complaint being made. The requirement for there to be scope for the regulatory system to initiate a complaint against a registered practitioner is reflected in section 52(3) of the Bill which allows a registration board to make a complaint to the council. The proposed amendment is, therefore, not accepted.

I thought I made a very simple and logical case regarding an obvious need to take a sensible approach if the council believes something is wrong. Who wrote the Minister of State's reply for him?

It answers the Deputy's question.

We would have to read what the Minister of State said very carefully and interpret everything. I will withdraw the amendment and reintroduce it later.

Deputy Twomey would understand.

Amendment, by leave, withdrawn.
SECTION 53.

I move amendment No. 47:

In page 37, between lines 19 and 20, to insert the following 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.".

This is straightforward. If there is a complaint against someone on the council, that person should not sit in on any deliberations pertaining to it.

I agree with the Deputy that a registrant who is a member of the council and becomes the subject of an inquiry should absent him or herself from council discussions on the matter. I will consult the Office of the Parliamentary Council with regard to the drafting of an amendment to be brought forward on Report Stage.

Amendment, by leave, withdrawn.
Section 53 agreed to.
Sections 54 to 57, inclusive, agreed to.
Amendments Nos. 48 and 49 not moved.
Section 58 agreed to.
SECTION 59.
Amendments Nos. 50 and 51 not moved.

I move amendment No. 52:

In page 41, subsection (7), line 19, to delete "€2,500" and substitute "€3,000".

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 refuse to co-operate with a committee of inquiry. Subsection (7) currently specifies that a person found guilty of an offence under this section is liable on summary conviction to a fine not exceeding €2,500. The amendment to increase the fine to one not exceeding €3,000 will bring the fine into line with the fine set out in section 80 of the Bill which deals with offences.

Amendment agreed to.
Section 59, as amended, agreed to.
Amendment No. 53 not moved.
Section 60 agreed to.
Sections 61 to 78, inclusive, agreed to.
SECTION 79.

I move amendment No. 54:

In page 49, subsection (4), line 12, to delete "subsection” and substitute “subsections”.

Amendment agreed to.
Section 79, as amended, agreed to.
Amendment No. 55 not moved.
Section 80 agreed to.
Sections 81 to 89, inclusive, agreed to.
SECTION 90.

Amendments Nos. 56 and 57 are related and may be discussed together.

I move amendment No. 56:

In page 52, between lines 26 and 27, to insert the following:

"‘corresponding qualification' means a qualification that has been awarded in another member state and that, before or after the passing of this Act, has been recognised by or on behalf of the State pursuant to a directive or other relevant measure as corresponding to—

(a) in the case of a designated profession listed in the second column of Schedule 3, a qualification listed opposite that profession in the third column of that Schedule, and

(b) in the case of any other designated profession, a qualification standing at the time of application for registration prescribed under section 95 for that profession;

‘directive' and ‘member state' have the same meanings as insection 38;”.

Appropriate qualifications for registrants will be a matter for the relevant registration board under section 38. However, the Bill contains transitional arrangements for the registration of existing practitioners. The 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 in 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 to the Bill and linked to provisions for "grandparenting" of existing practitioners under section 91. As these are largely Irish-based qualifications, it is necessary to make provision for practitioners holding corresponding qualifications awarded in other European Union member states. The inclusion of these new definitions makes clear what is meant by corresponding qualifications and also that relevant measures have the same meaning as in section 38 which provides for the system.

Amendment agreed to.

I move amendment No. 57:

In page 52, between lines 29 and 30, to insert the following:

"‘relevant measure' has the same meaning as insection 38;”.

Amendment agreed to.
Section 90, as amended, agreed to.
SECTION 91.

As amendments Nos. 58 and 60 are related, they may be discussed together.

I move amendment No. 58:

In page 53, subsection (1)(c), to delete lines 1 and 2 and substitute the following:

"(i) holds—

(I) a qualification listed opposite that profession in the third column of that Schedule or a corresponding qualification, or

(II) a qualification that, in the opinion of the board, is sufficiently relevant to that profession and is of a standard not lower than a qualification listed opposite the profession in the third column of that Schedule,".

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 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 to 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.

This section also sets out similar "grandparenting" arrangements for professions that may be included in a system of statutory registration in the future. In granting registration to existing practitioners the amendments now proposed will allow a registration board to have regard to a qualification that in its opinion is sufficiently relevant to that profession and is of a standard not lower than a qualification listed opposite the profession in the third column of Schedule 3. This would be relevant to practitioners holding non-standard but comparable qualifications with those in the Schedule. A similar provision is proposed for registration boards and professions coming under the system of statutory registration in the future.

Amendment agreed to.

I move amendment No. 59:

In page 53, between lines 8 and 9, to insert the following subsections:

"(2) The Social Care Workers Registration Board shall grant registration to a person who, at any time during the period of 5 years ending on the relevant date, was engaged in the practice of the profession of social care worker and who—

(a) applies during the transitional period to that board for registration,

(b) meets the requirements of paragraphs (a), (b), (d) and (e) of subsection (1),

(c) has been engaged in the continuous practice of that profession for a period of not less than 2 years immediately preceding the date of application, and

(d) is, in the written opinion of the person’s employer, competent in the practice of that profession.

(3) An opinion is not valid for the purpose ofsubsection (2)(d) unless the employer concerned has, in forming that opinion, taken account of any assessment guidelines issued by the Council for that purpose.

(4) The function of the Social Care Workers Registration Board undersubsection (2) is in addition to, and not in substitution for, its function under subsection (1) in relation to applicants for registration.”.

Social care workers are employed in child care services and the intellectual disability sector. While the qualifications set out in section 3 of the Bill are long established, they were not an absolute requirement for practitioners. The provision set out in the proposed amendment is in addition to the other provisions in section 91 and designed to facilitate registration of competent practitioners in a timely manner. The standards to apply will be those in accordance with council guidelines.

What does that mean?

It means it will be up to the council to lay down the guidelines.

What is meant by subsection (c)?

It means competency must be established by the employer.

I am not referring to subsection (d) but to subsection (c).

The employer must know the person concerned.

I am speaking about subsection (c).

The employer must give a written opinion which proves he or she knew the person concerned and was aware of his or her competence.

The Minister is referring to subsection (d), while I am speaking about subsection (c).

What is the Deputy's question?

What is the position of a person who has been practising for a period of less than two years? Do such persons have a right to temporary registration?

They must have been in practice for two years.

They must be practising for two years before applying to be included in the register.

Amendment agreed to.

I move amendment No. 60:

In page 53, subsection (2)(c), to delete lines 20 and 21 and substitute the following:

"(i) holds—

(I) a qualification prescribed undersection 95 for that profession or a corresponding qualification, or

(II) a qualification that, in the opinion of the board, is sufficiently relevant to that profession and is of a standard not lower than a qualification prescribed undersection 95 for that profession, or”.

Amendment agreed to.
Section 91, as amended, agreed to.
Amendments Nos. 61 and 62 not moved.
Section 92 agreed to.
Sections 93 and 94 agreed to.
SECTION 95.

I move amendment No. 63:

In page 54, subsection (3), line 44, after "section 4(1)” to insert the following:

"and any organisations that he or she considers appropriate".

Having consulted 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. The amendment provides that the Minister may also consult any organisation he or she considers appropriate and, therefore, widens the consultative process.

Amendment agreed to.
Section 95, as amended, agreed to.
Section 96 agreed to.
SCHEDULE 1.

I move amendment No. 64:

In page 57, paragraph 9(4), line 42, to delete "chairperson," and substitute "chairperson".

This is a technical drafting amendment.

Amendment agreed to.
Schedule 1, as amended, agreed to.
SCHEDULE 2.

Amendments Nos. 65 to 67, inclusive, are related and may be discussed together.

I move amendment No. 65:

In page 59, paragraph 3(1), line 20, to delete "subparagraph (2)” and substitute “subparagraphs (2) and (4)”.

Amendments Nos. 65 and 66 relate to the term of office of registration boards. Amendment No. 66 relates to a standard provision in regard to the first board, while amendment No. 65 is a consequential drafting amendment.

Amendment agreed to.

I move amendment No. 66:

In page 59, paragraph 3, between lines 22 and 23, to insert the following:

"(2) One-half of the members of a registration board first constituted under this Act hold office for a term of 2 years from the date of their appointment.

(3) The members who are to hold office for a term of 2 years shall be decided by lot to be drawn in the manner that may be determined by the Minister.".

In regard to subsection (2), does that mean half the membership of the board will change after two years?

Yes, that is correct.

Amendment agreed to.

I move amendment No. 67:

In page 59, paragraph 3(4), line 31, before "is" to insert "or(4)”.

Amendment agreed to.
Schedule 2, as amended, agreed to.
SCHEDULE 3.

Amendments Nos. 68 to 74, inclusive, are related and may be discussed together.

I move amendment No. 68:

In page 63, to delete line 4.

Section 91 requires,inter alia, that a registration board must grant registration to persons engaged in the practice of the relevant health and social health profession at any time during the period of five years before the day the relevant register for the particular profession is opened, provided that he or she satisfies the board that he or she either holds a qualification prescribed in the Schedule 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. It is expected that many practitioners currently working in the public health service will be grandparented by virtue of possessing the qualifications listed in the Schedule. This list of qualifications is designed to mirror as best as possible qualifications declared under the Health Act 1970 for professionals working in the public health service. The proposed amendments correct typographical errors and reflect the existence of new educational training courses.

Amendment agreed to.

I move amendment No. 69:

In page 62, to delete lines 7 to 10 and substitute the following:

"

3.

Dietitians

Bachelor of Science (Honours) in Human Nutrition and Dietetics from the University of Dublin and Diploma in Human Nutrition and Dietetics from the Dublin Institute of Technology, orDiploma in Dietetics and Nutrition from the City of Dublin Vocational Education Committee awarded after 1976 and before 1987, orDiploma in Dietetics from the City of Dublin Vocational Education Committee awarded after 1951 and before 1977.

Amendment agreed to.

I move amendment No. 70:

In page 63, column 3, between lines 31 and 32, to insert the following:

"Master of Science in Occupational Therapy (Professional Qualification) from the University of Limerick, or".

Amendment agreed to.

I move amendment No. 71:

In page 63, column 3, between lines 42 and 43, to insert the following:

"Bachelor of Science in Physiotherapy from the Royal College of Surgeons in Ireland, or".

Amendment agreed to.

I move amendment No. 72:

In page 63, between lines 48 and 49, to insert the following:

"

8.

Podiatrists

Bachelor of Science in Podiatry.

Amendment agreed to.

I move amendment No. 73:

In page 64, column 3, line 37, to delete "Science" and substitute "Arts (Moderatorship)".

Amendment agreed to.

I move amendment No. 74:

In page 64, column 3, between lines 39 and 40, to insert the following:

"Bachelor of Arts (Remedial Linguistics) from the University of Dublin, or Master of Science in Speech and Language Therapy (Professional Qualification) from the University of Limerick, or".

Amendment agreed to.
Schedule 3, as amended, agreed to.
Amendment No. 75 not moved.
Title agreed to.

I thank the Minister, members and the committee secretariat for their work on the Bill.