Catherine Murphy (Kildare North, Independent)

Generally I welcome the Bill. Much discussion has taken place in the public arena about regulation and the term "nanny State" has been used. Clearly that has to do with regulation of personal behaviour. If anything there has been under-regulation of professions, organisations and institutions. There is much catching up to be done and this Bill attempts to do that.

I have been contacted about this matter by physiotherapists. While I do not wish to repeat the points made by previous speakers, there is a substantial difference between the two disciplines. It is obvious they have co-existed, albeit in different areas of specialty. A four-year degree course is required for one discipline while for the other discipline, according to the documentation, the course ranges from a part-time 40 weekend course to short distance learning without any clinical practice. Clearly there is a difference in the level of qualification required and what they do is quite different.

The Bill is intended to protect the public. The area about which I would be concerned is the confusion among the public in regard to the service they are getting. One in two in the over 65 age group said they did not know the difference between the two disciplines. That is a gigantic level of confusion and it cannot be ignored. In the younger age group the level of confusion is one in three. Very often these are people who are vulnerable. Often those over 55 take a professional qualification as an absolute guarantee of the service in which they are engaging. It is important the Bill regulates that area. That issue needs to be addressed during other Stages of the Bill.

The Bill draws attention to the fact that this is not the only area that requires regulation. Some ten or 12 areas are listed as requiring regulation while others are not listed — almost everyone can think of areas that are not listed. Given that it has taken a long time for the Bill to get to this stage it is fair to say the list is not complete. The longer the timeframe without regulation the more professions appear to emerge.

It is in the interest of the profession to maintain good professional standards but I am not certain that self-enforcement achieves that aim. One would imagine there would be a vested interest in maintaining good standards. There are plenty of examples where good standards have not resulted from self-enforcement. I will be interested to see what happens on Committee Stage in terms of adding to the Bill.

There are others who operate in the social care area who are not included in the Bill but should be included. The public is entitled to and has an expectation that it will be protected. There is much in the Bill that is good from that point of view. For example, the Bill makes it an offence to use the title of any registered practitioner as set out in the Act or as prescribed by regulation, and that is worthwhile. The problem is that if some professions are excluded it almost makes it worse for them. That is the reason the list needs to be complete as it provides some comfort and protection to the public. It is important also that standards are not just set but maintained. I would welcome the inclusion of education and training and discipline, albeit with the proviso that I am not an absolute fan of the mechanism of self-enforcement.

A plethora of people practise in the health care area in complementary and alternative medicine, some of whom provide services which people swear by and consider them wonderful. There are others who are chancers and prey on the vulnerable. It is important that issue is addressed and obviously regulation and legislation is needed. Sometimes people turn to complementary medicine and they need protection.

I am concerned about the perception of legislation such as this, worthwhile as it is. There is a perception that if one regulates for something, the service is there to be regulated. In many of the areas that will be regulated there will be those who will work in private practice. Similarly, there will be those who work for agencies such as the Health Service Executive. The expectation is that if one regulates for speech therapists, there are speech therapists. I can speak only of the experience in Kildare and I am fortunate that it will be readily understood by the Minister of State at the Department of Health and Children, Deputy Seán Power, who is present, given that we share the same region in terms of the Health Service Executive. The reality is that there are no speech therapists in the Kildare area, particularly for people with intellectual disabilities, even though that area was part of the old Eastern Regional Health Authority. The position is different in Dublin which is within the same Health Service Executive region.

It is fair for the public to ask if this regulation is an academic exercise and what use are regulations if a person has a child who requires speech therapy at a critical time and the service is not available, irrespective of whether it is regulated. A number of other professions are listed which fall within the same category. While the Bill is important it will create a perception that there will be movement on the services provided. There could be disappointment that this is an academic exercise for many who cannot avail of those services that are being regulated. I avail of this opportunity to make that point and use Kildare as the example.

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