Simon Coveney (Cork South Central, Fine Gael)

I am pleased to have an opportunity to say a few words on this Bill. The Fine Gael Party welcomes the thinking and purpose behind it. It provides for the establishment of a system of statutory registration for certain health and social care professionals as well as ongoing regulation. The Bill is not before time. It is quite extraordinary that the Government or previous Ministers under various Governments did not see fit to introduce such legislation before now. It is surely a vital responsibility of legislators to ensure that those professionals who provide health and social care to citizens are adequately and independently regulated by a suitable system.

I am pleased to hear the Bill is the first of three which form part of the reform process of the health provision regulatory environment. The Minister made it clear in the Seanad that this Bill is the first of three steps to improve legislation in this area. Legislative measures to cover medical practitioners and nurses are to follow. I urge the Minister to introduce these as soon as possible. Perhaps the Minister of State, Deputy Brian Lenihan, will indicate when they are likely to be introduced.

This Bill covers statutory registration for chiropodists, clinical biochemists, dietitians, medical scientists, occupational therapists, orthoptists, physiotherapists, psychologists, radiographers, social care workers, social workers and speech and language therapists. A broad range of vital health services is covered by these professions. Members who have worked on health boards, as I have done, will be aware of the importance of the combination of skills such professionals possess.

We must ensure the consumer is provided with a constant standard of care throughout the country. When a child needs specialist care, for example, its guardian or parent has no way of assessing accurately whether the available specialist, if there is one in the area, operates to an acceptable standard or has an acceptable skill level. Parents need to rely on the State and professional bodies to ensure a common standard of excellence is applied. That is the essence of this Bill and the reason it must be welcomed. The State is responding, albeit belatedly, to put a system in place to ensure that when parents take a young child to an occupational therapist or speech and language therapist, whether he or she is in Cork, Galway, Limerick or Mayo, they can be sure of a certain standard of skill or care.

The national health strategy has many themes but the most important may be that of so-called patient-centred approaches to health care policy. This Bill represents a step forward in strengthening the regulatory environment pertaining to health professionals.

It is tempting to refer to some of the many areas where the Government's so-called patient-centred approach would be considered a joke if it were not so serious, but I will try to confine my remarks to the content and purpose of the Bill. First, let me consider the issue of the statutory registration of professionals. The proposed structure seems sensible enough. A registration board for each of the 12 professions listed will be set up and each board will have 13 members. Six of the 13 will be from the relevant participating profession and seven, appointed by the Minister, will be from outside the profession, thus ensuring independence and balance. While I agree entirely that there should be a majority from outside the relevant medical profession, I believe some difficulties might arise over how members of a board are chosen. In some cases, the professions concerned are represented by a number of bodies, as has been pointed out by various speakers. Perhaps the Minister of State will address this issue when he has the opportunity to do so. I will be interested to see the Minister's assessment criteria for deciding who should be on the boards.

Consider the recognition of qualifications and assessment procedures. Having had the benefit of being involved in European politics for the past year, I believe it is essential to have automatic recognition of the qualifications of professionals from all 25 member states. A very interesting debate is taking place in the European Parliament at present on the services directive in term of whether health care should be part thereof and whether we should have absolute recognition of skills and qualifications of professionals from all 25 member states in all other countries. Will this Bill take into account the services directive if it includes health care provision?

I seek clarity on the recognition of qualifications of professionals from non-EU countries. I recently dealt with a very good example of the problem to which I refer. A dentist from Russia, who is married to an Irish person and is an Irish citizen, received her qualifications from a recognised university in Russia, yet she is having great difficulty having her dentistry degree recognised in Ireland. If she had received her qualifications in Latvia, she would have no problem. We need to streamline a system for recognising qualifications of medical practitioners, especially those from countries that border the European Union. Although the example I cited concerns a dentist, whose profession is not covered by this legislation, the principle is the same.

The principles of this legislation are welcome because we are ensuring a common standard, but when one reads the list of professions covered by the Bill, one realises that, in the majority of cases, there are not enough professionals in Ireland to provide adequate services. A parent looking for an occupational therapist or speech and language therapist for a child, or a physiotherapist for an elderly person, will note a shortage of staff. If one talks to social workers, they will tell one they are over-worked. Although we need to ensure a common standard, we also need to ensure that when we bring in health and social care professionals from outside the European Union, as we will have to do, we will adopt a streamlined approach to recognising their qualifications.

On registration, there is a need to add further professions to those covered by the Bill. Other speakers have referred to this. An osteopath visited my office recently and spoke about UK legislation, dating from 1993, which created a new registrar for qualified professionals, run by the General Osteopathic Council. Nine organisations representing osteopaths were amalgamated into a single registrar. We have no such registrar in Ireland. Regardless of whether legislation is required in its own right to address this issue or whether it can be addressed through this Bill, we must consider it.

Deputy Neville referred to the difference between physical therapists and physiotherapists. More clarity is required in this area and I hope the issue will be explored on Committee Stage.

If the Minister of State chooses to add another profession to the list of 12, the Dáil and Seanad should be consulted. I am unclear how this can be done, or whether a Minister can do it of his or her own accord.

After registration issues, one must consider the ongoing regulatory procedures dealt with in the Bill. Complaints of malpractice will be dealt by the health and social care professional council which is comprised of 25 people. Is it necessary to have so many? This number, however, was chosen in a bid to represent the 12 sectors concerned with the Bill together with 13 other individuals nominated by the Minister to ensure a majority of non-health care people.

We should consider Deputy Twomey's point with regard to this matter. There is a need for whistleblower legislation in health care, as well as across a range of other sectors. Deputy Rabbitte raised the issue this morning and it has been promised time and again. Such legislation needs to be brought forward as a priority so that people who need to make a complaint can do so without fear of intimidation or potentially losing their job because of internal medical politics or downright bullying.

Junior doctors may feel they should report something resulting from the work of a more senior consultant doctor in a hospital. Systems should be put in place to ensure that if somebody makes a complaint, whether they are a member of the public or, more importantly, another health care worker, they and their job are protected and they will not be discriminated against.

This Bill moves regulation in health care in the right direction and, most importantly, protects the public. We should not expect parents or people who are ill to attempt to assess the doctor or professional they attend. That must be a given. Those people must be sure that the State has provided the necessary structures to ensure they can go to a health professional in the knowledge that the person is of an acceptable standard for them, their child, parent or family member.

The Bill protects the integrity of the health professional's title. People deserve recognition if they go to the trouble of educating themselves, sometimes over a period of ten years, to obtain a qualification. Others who take shortcuts and set themselves up as so-called health experts without the necessary qualifications must be exposed. This is not happening to a sufficient extent at present. The protection of professional titles is extremely important in health care because it also ensures that titles and professions are associated with excellence by rooting out people who are not suitable or capable of being health care professionals, doctors, social workers, physiotherapists etc.

The Bill also protects the State. In years to come, people may well ask why we did not introduce the legislation earlier. There is a State responsibility if people have suffered as a result of malpractice and this legislation provides for necessary protection in the future.

Perhaps the Minister of State would outline when we are likely to see similar legislation for nursing and medical doctors, so that we in Opposition can add our support when it comes forward. This is a move in the right direction. It is only a very small sector within the overall health portfolio. However, positive decisions such as this should be recognised.

See this speech in context