Róisín Shortall (Dublin North West, Social Democrats)
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I move amendment No. 6:

In page 7, between lines 6 and 7, to insert the following: “Report into the future of regulating health and social care professionals

6.The Minister shall, within 3 months of the passing of this Act, prepare and lay a report before both Houses of the Oireachtas, and the relevant committee, setting out the implications of introducing an established criteria for determining which health and social care professions to regulate into the future under the Act of 2005.”.

My amendment requests that the Minister shall with three months of the passing of this Act, prepare and lay a report before both Houses of the Oireachtas and the relevant committee, setting out the implications of introducing established criteria for determining which health and social care professions to regulate into the future under the Act of 2005.

I repeat the point I made a few minutes ago which is that there are serious questions about the operation of CORU. There are serious questions about the fact this is legislation from 2005 to regulate health and social care professions. It stipulated that CORU would regulate 17 professions. It opened registers on ten of those. This is 2005 legislation and CORU has only opened registers on ten of these with some preparatory work going on on the remaining ones. What happens all of those other professions that were not included in the original legislation and other professions that have evolved and developed since 2005? Medical science moves pretty quickly and there are many new areas, especially related to diagnostics, that should be included in the CORU professions but were not included. The idea with starting with setting out in legislation what the totality of the professions to be regulated should be was a flawed approach. It should have been possible to add to that list of professions as new professions evolved.

One would have to ask why progress has been so painfully slow in including all of the original 17 professions. Questions have to be asked about the appropriateness and the competence in such an important area in terms of regulating different health and social care professions. At the end of the day, this is about ensuring risk is minimised and that patient safety is the priority. How can the Minister give any kind of assurance that patient safety is a priority when patients are being treated by professionals who are not regulated? That is not to say for a moment that all health and social care professions have to be regulated. It is about assessing the risk and then identifying those professions that carry a high risk.

However, that has not been the approach taken in this country. It is the approach taken in other countries and we have something to learn from it. In the past while, I have had dealings with many different professional organisations, including the Irish Institute of Clinical Measurement Science. With the progress being made in diagnostics in particular, we have a very large number of clinical measurement physiologists. These are people who operate different diagnostic machines. Clinical measurement is carried out across five disciplines within clinical measurement science. These professionals are responsible for diagnostics and the monitoring of disease within cardiology, gastroenterology, neurophysiology and respiratory and vascular medicine. They are key people in medical science and medical care but their field is not regulated. They have been in touch with the Department on an ongoing basis to seek regulation but it has not happened. These are people who are crying out for regulation. It is a really important science and a really important profession. They could do so much more including, in many cases, replacing consultants. Croí gave a very good presentation on this last year. It showed how medical scientists can measure heart function in the same way that people previously had to be referred to a consultant and go on a waiting list to avail of. There are many new professions that can greatly improve the level of care people receive. They want to be regulated.

I will mention another profession, that of athletic therapists. For at least the last two years, the Minister has received representations from Dublin City University and also from South East Technological University, specifically from what was previously the Institute of Technology, Carlow. These institutions are providing very high level training courses in athletic therapy. Athletic therapists are people who deal with injuries in all areas of sport but who also deal with other recreational injuries and workplace accidents. They can manage a great deal of demand in that area as it relates to musculoskeletal injuries and yet there is no move to regulate their profession. Both of those universities have been appealing to the Minister for some time. They are saying that the absence of appropriate recognition is unfair to those who have qualified in this discipline as it precludes them from taking up roles in a number of areas, including in HSE facilities throughout the country. There is terrific capacity there but these therapists are excluded because of the absence of regulation. They do very high quality training courses and are really well qualified people. They should be fully utilised. The universities are also concerned that the absence of appropriate recognition has the potential to increase patient risk. These are two key areas the Minister should be concerned about: availing of as much capacity in the health service as possible and ensuring that patient risk is reduced.

These are two major areas that are crying out for regulation and there does not seem to be any plan to regulate them. Equally, as members of the committee, we all received correspondence from the Irish Dental Association yesterday. That association proposed amendments to this legislation. It is looking for regulation as well. It is seeking statutory continuing professional development training for dentists to be recognised. It says that there are a number of gaps in the Dentists Act 1985 and, again, that there is the potential for serious risk. The association wrote to the Department in 2021. It is looking for inclusion by way of amendment to this legislation.

In a reply I got from the Minister, he referred to 20 different professional groups that are not included in the CORU legislation. It is not clear what approach the Minister is taking to these groups. There is an argument for going through each one and adding them in a Schedule to the Bill but one has to ask whether there is sufficient capacity within CORU. If it could not deal with the original 17 going back over all the years since 2005, how could it have the capacity to deal with another 20? This is a very urgent matter. I recognise that the Minister asked the Health Research Board to take a look at the matter and see what has happened in other countries. It is saying that regulation should be proportionate to the level of risk posed by health and social care professionals. I accept that fully. Some pose a lower risk and not all need high level regulation. However, what is the Minister doing about it? As I have said, there have been very strong appeals from very important categories of health and social care staff and from their training bodies but there is no indication of what the Minister intends to do to address the very concerning shortcomings within CORU and the legislation underpinning it not being fit for purpose. With this legislation, he is amending the Act to only a very minor degree when there is major work to be done as regards amending that original legislation.

My amendment seeks action on this matter within a reasonable period. It requests that the Minister bring forward a report in three months setting out how he intends to proceed with regard to the major gaps in regulation which exist in this country in respect of health and social care professionals. I appeal very strongly to the Minister and to other members of the committee to support the amendment. It is reasonable and proportionate. We need to recognise the significant gaps that exist and see some progress.