Jimmy Devins (Sligo-Leitrim, Fianna Fail)

I thank the Leas-Cheann Comhairle for allowing me the time to speak on this important legislation, namely, the Health and Social Care Professionals Bill 2004. This legislation comes to the House from the Seanad where it was passed recently.

There has been much discussion both within the House and outside on health matters. The provision for the health service costs approximately €11 billion in the current year and I strongly believe that the service patients receive must be of the highest order. For that to happen it is essential that the staff delivering the service are well-trained in the first instance and, in the second, they are subject to a continuous statutory process of regulation during their professional lives. Members of the public must have faith in the professionals who treat them. They must be assured that they are suitably trained and fit to practice to the highest standards. If this does not occur, the public might have some doubts about the persons treating them being suitably qualified. That is the purpose of regulation — to ensure that members of the public know they are receiving a service from people who are competent and properly qualified to deliver it. That is why this Bill is important and timely.

At present only a handful of health care staff are subject to statutory regulation. These include nurses, dentists, doctors, opticians and pharmacists. However, many other professionals supply valuable services in health. This Bill aims to regulate 12 different health care professions: chiropodists, chemical biochemists, dieticians, medical scientists, occupational therapists, orthoptists, physiotherapists, psychologists, radiographers, social care workers, social workers and speech and language therapists. All these groups provide a vital and valuable role in the provision of health care. I strongly believe that the system of regulation, which must be done on a statutory basis, will ensure that members of the public will have people supplying their care that are competent and fit to do so.

I have no doubt that the 12 professions I have mentioned which are the subject of this Bill, provide excellent services and that their members are properly trained to do so. However, once the Bill becomes law, the protection afforded to the public will be greatly enhanced. In practice each profession will be regulated by a registration board comprising 13 members, six of which will be members of the respective profession, while the other seven — a majority — are from outside the profession and nominated by the Minister for Health and Children.

It is important that the seven nominated people include a member or members of the public so that the views of the users of the particular health service are represented. Only in this way may transparency be achieved. Once transparency and openness is present, trust will be delivered. For too long within health care and outside it, professions have operated within their own narrow structures of governance. By bringing in outside viewpoints, a greater degree of understanding of how a profession operates is achieved. The end result is of benefit both to the patient and the particular profession in question. This has already happened in medicine and I have no doubt that the Medical Council is now a much stronger and more effective body as a result of the contributions of its non-medical members. The views of the consumers of each service will be heard and acted upon, thereby ensuring that the profession as a whole is strengthened.

I also welcome the establishment of the overall health and social care professionals council, which will have 25 members, one each from the 12 disciplines I have mentioned, with the remaining 13 coming from outside. This council will ensure consistency and uniformity of practice among the 12 registration boards under its control. When a complaint is received by the council, I hope it will be dealt with in a logical manner. It will be reviewed first by a preliminary procedure committee which will decide if the complaint is sufficiently serious to warrant further action. In this way, frivolous complaints can be dealt with expeditiously, while genuine complaints will be more thoroughly investigated. In the interests of fairness and transparency, genuine complaints should be dealt with quickly and without delay. Having a complainant wait for years to have his or her case heard is wrong and would act as a deterrent to openness and transparency.

I also welcome the fact that most complaints will be heard in public. If it is believed that the case has been caused by a practitioner's ill health, either physical or emotional, it will be heard in private by a specific health committee. The list of sanctions which may be imposed on a practitioner if he or she is found guilty of misconduct is comprehensive and ranges from censure to erasure of the practitioner's name from the relevant register. By having such a wide ranging complaints procedure, members of the public can have confidence that the highest standards of behaviour from their respective practitioners are maintained.

I refer to Part 7, encompassing sections 78 to 80, inclusive, which deal with the protection of titles. It is important that there is no confusion among members of the public regarding the use of a title to describe a particular profession. Before I was elected to the House, I worked as a general practitioner and had contact in my work with members of all the professions I mentioned and which are the subject of the Bill. At all times, I was very impressed by the high standard of the professional work I encountered. All the professions, in their own respective ways, play a vital role in the workings and delivery of the health service.

However, a degree of confusion surrounds one profession, namely, with regard to the titles of physiotherapy and physical therapy. All over the world these titles are interchangeable, especially in the United Kingdom, Northern Ireland and the United States. I understand the professional qualifications and requirements are the same for both titles in 92 countries. Indeed, the world representative body is known as the World Confederation of Physical Therapists and has consultant status with the United Nations and an official relationship with the World Health Organisation.

Physiotherapy in Ireland is a four year degree course awarded by four universities, namely, Trinity College Dublin, University College Dublin, the College of Surgeons and the University of Limerick. Courses have been in existence for more than 100 years and the first school of physiotherapy was founded in 1905, exactly 100 years ago.

If physiotherapists all over the world are known as physical therapists, surely the same should apply here. Consumers, that is patients, should have a clear understanding of the qualifications and training of each professional they attend. The same position should apply in Ireland as applies all over the world. Perhaps this issue will be addressed when the Bill is referred to committee but there must be no confusion and no chance of confusion in the minds of members of the general public as to the qualifications of the profession they attend.

I wish to refer to a comment made by a previous speaker in regard to the workings of the Joint Committee on Health and Children, of which Deputy Neville is a prominent member. The speaker referred to the committee's recent prolonged deliberations on the Travers report. From the start of the joint committee's hearings on the report, it was obvious that certain members were determined to ensure there would be a political killing.

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