Liam Twomey (Wexford, Fine Gael)

We cannot trust that information will not be leaked. We have seen how a junior Minister released information which, in some respects, should have been considered confidential. We need to protect people from this kind of practice by offering substantial support and protection.

The legislation is the way forward and is, therefore, welcome. There is far too much ad hoc regulation of the health care professions. Nevertheless, two major concerns arise. Some professionals believe they have been left out of the legislation, for example, some titles are not specifically mentioned. One of the most important issues to arise since the introduction of the legislation — the Minister of State will have heard about it — is the title of "physical therapists". Every Member of the House has received correspondence from physiotherapists and physical therapists on the matter. This issue must be addressed on Committee Stage. If it is not resolved before the legislation is enacted, the title of "physical therapist" will remain outside its scope, thus creating more problems in the future. The Government should take the bull by the horns and deal with the issue now as it will crop up in future.

A number of other organisations have been omitted from the scope of the Bill. With the complexity of medicine and the many qualifications available, we will see many other bodies seeking to be included under this legislation. In the same way the Medical Council has given status to the medical profession, patients will want to see all health care providers covered by governing councils. The public will think those who are not included under the legislation are alternative or unqualified practitioners. That will have a detrimental effect on many people who hold qualifications who feel they should be included under the legislation. Eventually someone will take a test case to the High Court on the issue. To serve the public interest we must reduce ambiguity and at some stage a Government will have to legislate for alternative practitioners. It is becoming so complex that people do not know where they are going.

Psychologists are included in the legislation but some people call themselves both psychologists and counsellors. We must make the qualifications needed crystal clear. People qualify as psychologists having studied for a long time at a third level institution that is not a university. They may well be left out under the legislation even though we would currently consider them to be psychotherapists. Others who do not have a qualification will also be left out — perhaps the legislation could make that differentiation because patients and doctors do not know how qualified many of those described as counsellors and psychotherapists are.

If a profession other than the 12 mentioned in the legislation feels it should be included, are there any means to consider that? If it established itself and fulfilled the rules and regulations, could the Minister issue a regulation to include such a group in the legislation? It would have to set up a regulatory body with 13 members. Where would that fit in with the council? Would it be difficult to nominate a member to the council?

The majority of the 12 organisations mentioned participate in the public service so perhaps the Minister is thinking that once they are covered, the public service remit has been fulfilled. Does he intend to look after the other bodies that might not have a role in the public service?

What is a medical scientist? Is someone working in a pharmaceutical company, in a laboratory in a hospital or a science graduate doing research at university, perhaps controversially on embryos, a medical scientist? We have not teased this out. We must always keep in mind factors external to those we are addressing. If someone is carrying out stem cell or embryo research, would he or she come under this legislation and would he or she break the law if doing something that this House had not approved?

Has the Minister named the representative bodies for the 12 professions mentioned in the legislation? Physiotherapists are represented by two organisations. Which will be nominated as responsible for looking after physiotherapists? Many of the bodies have at least two representative organisations and there could be conflict if one is chosen above another. We should examine this on Committee stage because the Bill is unclear at present on the matter.

All of the organisations named in the Minister of State's speech are involved in either the health or social welfare services. Why, then, are the ministerial nominees for these bodies named by the Minister for Enterprise, Trade and Employment? That is strange. Why is the Minister for Health and Children not nominating them? Perhaps I have a problem with the Minister for Enterprise, Trade and Employment, Deputy Martin, nominating people because his nominations to the board of the Irish Blood Transfusion Service left lingering problems that the Tánaiste might still have to address before the next election.

The sections on registration, education and training, complaints, inquiries and disciplinary procedures are mostly fine; they follow the criteria used by the Irish Medical Council on making complaints. The council, however, is moving towards all professional conduct committee hearings being heard in public. That has created anxiety for members of the medical profession because if there is a committee hearing in public, it can be reported in the media. If the committee finds all charges baseless, however, the media is not concerned about reporting that. Many of the professions will find themselves in a unique position when complaints are made about them. It is difficult for patients to get a hearing and many of the professionals will be in for a surprise when this legislation is enacted. At least the health committees will be held in private because they cover emotional subjects for everyone involved.

Under section 58, there is provision that each committee of inquiry has the powers, rights and privilege vested in the High Court or a judge of the High Court relating to enforcing the attendance of witnesses, examining witnesses on oath and compelling the production of records. In the discussions by the Joint Committee on Health and Children on illegal nursing home charges, attempts were made to ascertain Deputy Martin's responsibilities as Minister for Health and Children and those of the Ministers of State and special advisers. We hit a stone wall as nothing had been committed in writing. When we sought legal opinion during the course of our inquiries, we were referred to the case of the Abbeylara incident sub-committee and whether Members can make judgments on people that have a negative outcome.

Has this been explored in how the Medical Council works or how this committee will work given that it is not part of the Judiciary? Are there aspects of the Abbeylara incident sub-committee case where negative findings cannot be made on an individual? Has this been cleared with the Attorney General? The Medical Council is the only one that functions to any significant degree. However, the Bill will see the establishment of 12 more similar bodies. Has legal opinion been sought as to whether these committees can operate on this basis and make negative findings?

Section 61 states: "A committee of inquiry may, at any time after a complaint is referred to it, request the registrant concerned to do one or more of the following ... consent to being admonished or censured by the Council." I will ask for this provision to be clarified on Committee Stage. It is almost saying that one must consent to whatever punishment is meted out by the committee before the opportunity is given to hear what the complaint is or make a defence case. An individual should be allowed to wait to hear the full facts of the case against him or her before consenting to being censured by the council looking after his or her professional interests.

While my points are to ensure the legislation works, it is welcome. There is no point in going through all this rigmarole, establishing one council and 12 regulatory bodies with 189 people being taken on in the administrative set-up, if it will not work properly. The Government must examine whistleblowers legislation as it will make this Bill work in protecting patients in the legal environment. While much of the legislation passed by the House never finds its way into public discussion, it is still our role to ensure legislation protects people.

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