Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

This Bill is welcome but long overdue. It has been recognised for some years that better regulation of a range of health and social care professions is necessary. It is essential for the professions themselves and will ensure that only those who are properly qualified and subject to statutory regulations are allowed to practise the various disciplines outlined in the Bill. The public needs this statutory protection and guidance to be confident that those from whom they receive treatment are fully competent and accountable within their respective professions.

Before addressing the Bill, it is appropriate to say something about the issues surrounding health and social care professionals in Ireland today. It must be recognised that care across a range of areas has improved, primarily as our knowledge has improved and led to a more detailed and specialised approach to all aspects of human health. This is welcome.

The issue of accessibility, however, to the skills, knowledge and care of these professions is central in our health and social services. Access to care for many citizens is very difficult and is often denied for two reasons.

Our two tier public and private health system means the higher a person's income, the more likely he is to avail of the care provided by the professions listed in this Bill. The Bill covers those who work in the public and private sectors and the self-employed but the trend of our times, encouraged by the Tánaiste and Minister for Health and Children, is for more and more of these professions to be sucked into the private sector. At the same time the public sector is starved of the professionals it desperately needs.

The second reason for the inequity in accessibility is due to the shortage of persons practising in many of these professions. This is clear to us across the range of services addressed in the Bill. One only has to look at the desperate need for more speech and language therapists to provide services for children with special educational needs. Not enough speech and language therapists are being trained. For some reason, young people are not choosing it as a career in sufficient numbers, yet the system is crying out for more therapists. There is also a shortage of radiographers which often prevents state-of-the-art hospital facilities from coming on stream. The planned roll-out by the autumn of 2007 of BreastCheck with its static centres in Galway and Cork and mobile units for the rest of the country will require a large intake of trained radiographers and others within the associated professions. Despite this, I do not believe this is achievable or that those positions required will be recruited from within the indigenous complement. As with many other areas of health care, BreastCheck will have to look overseas to fill some of these positions.

It would be interesting to conduct a survey of the professions covered in the Bill to assess the state of play of each regarding supply to learn whether numbers in the professions are inadequate. In areas where they were found to be inadequate, one would find the private system receiving a disproportionate number of those trained in those professions and the public system losing out once again.

A serious examination must be conducted into inequality in access to education. In wide sectors of society, young people do not aspire or have no expectation or possibility of ever being able to practice any of the professions covered in the Bill. We need to see greater activity on the part of the Department of Health and Children and the Government in informing second level schools to equip young people with the information to make informed career choices. I have no doubt many young people, owing to a variety of reasons, some of which I have alluded to, would never think of these real and live options for their career paths. As a result we are deprived of the talent of countless young people who could make an invaluable contribution to the health system.

One great disadvantage of the health system and a barrier to progress within it is the elitism among medical professionals. The former Minister for Health and Children, Deputy Martin, called the hospital consultants kings in their own domain. I absolutely agree. Without diminishing the central role played by consultants and the higher echelons of the health profession in the system and the work most of them do, it must be admitted that for decades they were subject to too little accountability and scrutiny. Only the very privileged minority secured contracts which hospital consultants still enjoy and which the Government has been attempting to renegotiate for years in an effort to ensure greater equity in hospital care for public patients. It appears the process is painfully slow.

To cite one instance, in the Neary case we saw the total inadequacy of the Medical Council as a regulatory body. For years the victims were ignored and when the council was finally forced to take action, its investigation also took years. The victims of this practitioner were vindicated but were alienated from the body supposedly in place to ensure public confidence in the medical profession. Sadly, they have yet to receive justice.

In his summing up, will the Minister of State explain where the medical profession fits into the picture? Where stands the promised medical practitioners Bill and the nursing Bill? These Bills are designed to provide for regulation in the same way as this Bill. Perhaps the Minister of State will elaborate on the promised Bills mirroring this one when Deputy Durkan has finished consulting him.

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