David Stanton (Cork East, Fine Gael)

I am pleased to have the opportunity to speak on this quite important legislation. At the outset I wish to declare a possible interest in that I am a counsellor. I am not sure how I would fit into the required qualifications for a psychologist, who according to the Bill should have "A recognised university degree or diploma obtained with first or second class honours in which psychology was taken as a major subject and honours obtained in that subject".

The professions listed can have a major impact on the lives of ordinary people when they seek help. It is important that people should have confidence when seeking such help. I am very concerned that anybody can put his or her name on a plate and declare himself or herself a counsellor. We are talking about the areas of psychology, psychotherapy etc. Significant damage can be caused by going to a person who is not trained in the particular area. Often serious deep emotional issues can be brought to the surface. If the counsellor, psychotherapist or psychologist is not adequately trained to help, support and treat, considerable damage can be caused. I suggest that counselling be examined in this light.

Some podiatrists have brought to my attention their concern that the professional title of podiatry is not recognised in the Bill. They argue that this has been an accepted international term for many years. They seek to protect the public by enshrining continual professional development in the wording of the Bill. Those who have been in contact with me maintain that the Bill as drafted would result in the unsatisfactory position whereby a podiatrist could fail to practise for nearly five years and return to work without any retraining or update, or could be registered year-after-year without having to demonstrate any commitment to continual professional development. That could be the case in other areas and the Minister should examine it. They maintain that it is unacceptable and at variance with the Government claim to be developing a quality health service.

The professionals that wish to register are required to have a bachelor of science degree in podiatry. They maintain that it would be anomalous to maintain the title of chiropodist only. Both titles have been in use for over 20 years and this degree qualification succeeded the diploma since the early 1980s. They argued that the name of podiatry is not so well known in Ireland and this is because there is no school of podiatry in the country. Deputy Seán Ryan of the Labour Party already alluded to that. Those wishing to study podiatry do so at one of the universities in the UK. They put forward the argument that recent legislation in the UK has protected both titles and they claim that we risk losing Irish graduates in podiatry to the UK if the title of podiatry is not protected under Irish legislation.

Is it possible that persons could be registered in two professions? They claim that this does not pose a problem if persons have recognised qualifications in both. However, there is a possibility of registering persons via transitional arrangements in one profession while they have qualifications and are registered in another profession, such as An Bord Altranais and so on. They also state that the legislation should be amended to give assurances on competence. It is essential to keep up with current practice and recent evidence in health care. They claim that continuing professional development is an essential element of clinical governance and should be enshrined in the Bill. They also state that continuing education is a quality issue and that the health strategy is undermined by the principles of quality and fairness.

Section 6 of the Bill deals with complaints. My reading of it is that the council cannot act unless it receives a complaint. I stand to be corrected, but it seems to me that the section is complaint driven. Irish people are slow to make complaints. We do not want the hassle and we let the issue go. Where medicine and the health professions are concerned, Irish people are slower to make complaints because they are afraid. A friend of mine called me this morning. His wife is in hospital, an operation went wrong and she is now seriously ill. He is very concerned about the quality of care she is receiving, but he does not know where to go because there is no mechanism to make a complaint. I suggest to the Minister of State that we allow feedback in all our hospitals. If one is in a hotel, one is given an feedback form to determine whether service was satisfactory. If patients leaving our hospitals were to do something similar, that could be taken on board. This legislation should also include provisions to allow for feedback.

It would also be useful if the Minister included some form of a whistleblower mechanism. If someone rings the council and makes an informal complaint, the council should send an inspector to the clinic involved. If it is not up to standard, the council could take action. Such a provision would be very useful and it should be in the Bill.

Some of these professions find it difficult to source clinical placements. I praise the Government for bringing forward 75 badly needed new places for occupational therapy. However, many occupational therapists cannot find clinical placement. The Government needs to make it easier for them, so that they can get the experience they require.

The objective of the council is to protect the public by promoting high standards of professional conduct and professional education, training and competence among the registrants of the designated professions. I welcome the fact that each of the designated professions will be represented on the council, along with representatives of the public, voluntary and third level sectors as well as the general public. Given that the initial council will have 12 members from the professions and 12 members from the other sectors, there will be a healthy balance within the council. Will this balance be affected when additional professions come into the registration system? How long will members of the council hold office? Can members be re-appointed? If so, for how many terms?

Part 7 makes it an offence to use the title of any registered practitioner unless entitled to do so. I welcome the protection for both the public and the registered professions. We possibly need to go further. People put advertisements in the newspapers claiming to improve health by providing this or that therapy. We need to control that and it is related to what is happening in the Bill.

We know of doctors who claim to be able to cure cancer. I know people whose children had cancer and who visited these doctors, who paid out huge sums of money, who got medication and physically suffered in getting this medication. At the end of it all, the child died. This has happened more than once. The State needs to step in and take hold of this situation. People at their most vulnerable will grasp at any straw. It is dreadful that people will raise the hopes of parents of children who are terminally ill and take advantage of their vulnerability knowing that it is pure quackery. The State has a duty to ensure that this does not happen in any of the professions. This Bill provides a statutory basis for protecting members of the public who may be very vulnerable against exploitation.

I note the Minister has retained the power to extend and add to the list of occupations in the Bill, which is welcome. I hope over time occupations which are not mentioned will be included. There will be an opportunity on Committee Stage when amendments are being discussed for Members to make suggestions to include other professions.

I welcome this important Bill. The wider issues involving complaints, especially in the context of hospitals, must be taken on board by the Government. It would help if a feedback mechanism were made available as people have nowhere to go at the moment. While I do not wish to cast aspersions on doctors and nurses who, in the main, work extremely hard under a great deal of pressure, if something goes wrong or a patient is dissatisfied, it would be useful for hospital management to have access to feedback to enable them to put matters right. A mechanism to address the gap would be an innovation for the Minister of State to take on board to make a name for himself. He is well known, of course, as it is.

I commend the Bill and wish the Minister good luck with it.

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