Dr. Tony Holohan:

They are not part of the formal healthcare system. We have good and detailed policy understanding, since I mentioned physiotherapy in this context, of the role the physiotherapist can play. That is why I can talk in the terms that I am about development of services. To answer the Deputy honestly, I have thankfully never had such recourse.

Senator Colm Burke asked, if there has not been any evidence that radiologists have been called to give evidence of harm, whether that would be a sufficient basis for us. That would not be a sufficient basis for us to take a step or sufficient grounds for us to incorporate this. We are not in the business of excluding anybody. The purpose of this directive is to identify and empower appropriate professionals as either referrers or practitioners, which is what we are doing, and then to empower various competent authorities with the means to be able to ensure that, from the point of view of the protection of the public, the people who are empowered to operate the legislation are the ones operating the legislation and that nobody else is operating it as if they were empowered. That is the intention. It is not about any individual grouping or the naming and exclusion of any individual grouping. It is the empowering of named and identified professionals. There is also an important point for me to address relating to the Senator's question on referral. We have an ordinary use of referral, in the way we talk, in that people do get referred. One person can be referred to another person. Referral under the Act carries with it privileges that are set out in the legislation. Referral in the meaning of the directive is not the same in the sense of if, for example, a chiropractor referred a patient to a GP for an opinion.

That could be regarded as a referral in terms of its common meaning but it is not a referral under the legislation. It is important not to conflate those interpretations. I do not suggest the Deputy is doing so but it has been done in some public discussion on the issue.

A commitment of which I have seen documentary evidence was made in 2002. I do not understand the reasons for it not moving forward and am not aware of the discussions in that regard. Now, a substantial number of years later, any such question must be considered in the context of the directive and a strengthened set of arrangements from Europe that seek in broad terms to tighten up the arrangements that already exist in respect of the use of radiation for the purposes of protecting patients and the wider public from exposure.

As to the wider question asked by the Chair, there has been no commitment to set up a body for the purpose of regulating chiropractors or others. That has never been expressly considered. That is not to say that it would not be given positive consideration but, rather, it has never been considered.