Liam Twomey (Wexford, Fine Gael)

A great injustice was bestowed on the Minister of State to have to read through all that. I read through the legislation's memorandum as well as the Tánaiste's speech on the Bill in the Seanad and I had a sense of déjÀ vu every few minutes while listening to the Minister of State's speech. I am sure it must have been just as painful for him to read through 30 minutes of that as it was for me to listen to it.

As regards the Tánaiste's speech in the Seanad, she made a few important points. She said that this was the first of three Bills to reform the regulatory environment for health professionals, with legislation for medical practitioners and nurses to follow. It was pointed out that we have been waiting for this legislation for almost 20 years. I hope that, when the Tánaiste stated that this would be followed soon by new medical practitioners legislation and nurses legislation, it will be in our lifetime as politicians rather than in the lifetime of the Government.

It was pointed out that the 2001 health strategy was based on four key principles, namely, equality, people-centredness, quality and accountability. We must constantly focus on points such as those when talking about legislation. Legislation can often look very good on paper but, as happened recently, it can go badly wrong when tested in the High Court or the Supreme Court. The Tánaiste said that the vision adopted in the strategy for the future health system set great store on treating people with dignity and respect. She said the health strategy envisaged that action would be taken to strengthen the customer focus of service providers.

It is important to reiterate these points because there is an element of fine words having been spoken as regards the health service over the past couple of years, and the health strategy was very much the basis for many of these fine words. However, it is delivery and ensuring that people benefit from this so-called patient-centred approach from the health service that is important. I will expand more on that later. For the moment I am just putting forward the themes I intend to deal with.

My last quotation from the Tánaiste's Seanad speech is that strengthening and clarifying, accountability and measurement of excellence are the priorities. That basically is what this Bill is all about. It is about protecting the consumer or the patient using the legislation we pass in this House as legislators. Before we talk too much about this legislation, we should look at what is already in existence. The setting up of the council will be a dramatic initiative. We abolished 250 health board positions last December and we are establishing 186 regulatory bodies and councils under this legislation. It is not a case of self-regulation, as with the Medical Council. It is to be a statutory body, and obviously the Government will keep control of the regulations and the regulation of people in these professions.

There are some parallels, however, with the Medical Council. Many fine ideas are proposed, for example, about training, regulation and registration of people. Over the next couple of weeks a report will be published on one medical practitioner. It will focus very much on Dr. Michael Neary and what happened in Drogheda hospital. The report will be extremely critical of the medical profession and the Medical Council, the self-regulatory body of doctors. I do not seek to scapegoat the council but to make the point that, irrespective of good intentions, systems can dramatically fail patients. Although I have not read the report, having been involved in much of the debate on Dr. Neary, I know in my heart it will be extremely critical of the Medical Council and doctors, including many consultants outside Drogheda who were involved in dealing with the events at the hospital.

Whether one is a medical director or consultant colleague of a bad consultant, doctors are slow to report each other. The Garda Síochána is often accused of protecting its own out of self-interest. This accusation will also be levelled against doctors and there is no doubt a certain element of self-interest is evident in all professions with politicians being no exception. Deputy McManus will agree that this trait has been much in evidence in recent months in the Joint Committee on Health and Children at which certain Government Members have engaged in protecting their own, rather than pursuing responsibility and accountability to the House.

Sometimes the reason doctors refuse to make a complaint against a colleague is not to cover up issues but because no genuine protection is afforded to those who wish to do so. The Dr. Neary affair is a case in point. It exploded into the public arena because two student midwives who, to the best of my knowledge received much of their training in Northern Ireland where matters of this nature are dealt with under a different legislative framework, were horrified by what they saw taking place in Our Lady of Lourdes Hospital, Drogheda, and complained to their supervisor. The matter came to light when the supervisor took their complaints further.

Why are consultants, powerful individuals in the hospital system in their own right, afraid to report colleagues, even to the Medical Council? One of the main reasons is the fear of litigation. If one cannot prove an accusation one makes about a colleague, one may well find oneself in the High Court, even if the allegation is true. Hearsay and circumstantial evidence are not sufficient as one must be in a position to demonstrate that problems exist. If, for any reason, one is proved wrong, the accused person can sue one for defamation.

A further problem is the lack of political and, in some respects, administrative support. A case in point, which may not be crystal clear but with which the Minister of State, as a matter of interest, should familiarise himself, involves an orthopaedic surgeon in Cork, Mr. Maha Lingham, who has found himself without a job. Mr. Maha Lingham, who worked as a temporary consultant in Cork University Hospital for 12 years, was one of the most successful orthopaedic surgeons in the region and had a tremendous workload. He was also one of a few people carrying out extremely specialised orthopaedic surgery. I do not understand why he is without a job.

The Minister must address the absence of political and administrative support for consultants who wish to make a complaint and the fact that they may find themselves out on a limb as colleagues close ranks. Legislation on the medical profession, including this Bill, does not protect patients or doctors because it is ineffective when those at the top show weakness or lack of leadership. Fundamental changes are needed to make this type of legislation work. In this respect, I fully support my constituency colleague, Deputy Howlin, who has repeatedly called for the introduction of whistleblower legislation. The Bill is too reliant on people being genuine and well intentioned. We must bear in mind that if someone wishes to play the legal system or has ulterior motives or other agendas, the legislation will fail those it is meant to protect. For this reason, the Government should consider the introduction of whistleblower legislation.

It may transpire that a complaint made against a person is not completely true and many such cases have come before the Medical Council, which receives a large number of complaints about medical practitioners. Patients, for instance, complain about the manner in which they have been treated by a doctor. I have every sympathy for the doctors in question, many of whom I know to be caring and considerate and have been badly affected by complaints made against them. Such complaints are not all malicious as patients genuinely believe they have been badly treated. Even if it is shown by the Medical Council that a doctor was not negligent or incompetent and is declared innocent after 12 months or two years, he or she may still feel wronged.

We need whistleblower legislation to encourage people in senior positions, doctors and professionals, to act if they see bad practice. In the course of 12 years — 18 if one includes my medical training, a period when I had ample opportunity to see how other consultants work — I have seen a number of things I would not encourage. As junior doctors, we were under severe pressure not to take action and, as a result, we did nothing.

There is nothing in place to protect consultants who make a complaint, even if it is not substantiated in the long term. This is the case throughout the public service, including in the Garda Síochána, the teaching profession and the medical profession, from physiotherapists to chiropodists and all the professions to which the Minister of State referred, as well as those which, I hope, will seek registration on the new body. If we do not have a proper mechanism to enable people to make their views and concerns known without having to worry that if they put a concern in writing or make a complaint, a lily-white or weak-hearted administrator will release the information.

See this speech in context