Seán Ó Fearghaíl (Kildare South, Fianna Fail)

I am delighted to have this opportunity to contribute, albeit briefly, on this vital legislation which has been described by the Minister, echoed by Deputy Finian McGrath, as aiming to provide a modern, efficient, transparent and accountable system for the regulation of the medical profession.

To properly evaluate this legislation it must be seen as part, and in the context, of the raft of legislation that has been brought forward by the Minister and her predecessor aimed at delivering a medical service that is patient centred, effective in all its aspects and responsive to the ongoing change that is a feature of life in the world of medicine today.

The Bill focuses to a great extent on the operation and make up of the Medical Council, the profession's governing body. It is clear from reading the Bill that the emphasis is firmly placed on ensuring that the Medical Council operates with the public interest as its number one priority at all times.

Despite the controversy that continues to surround the ongoing reform of our health services, the public at large have great confidence, and justifiably so, in our medical professionals. Throughout the country our general practitioners provide a valued service in local communities and generally retain close and ongoing contacts with their patient group. The overwhelming majority of people report real satisfaction with the level of care and expertise they benefit from when they are admitted to our hospital system. If there is a weakness in the system, and we must all admit there is, it occurs most often in accident and emergency departments in not all but some of our hospitals. Many have had the experience, as have I, of waiting endlessly in an accident and emergency department that is obviously well staffed, with no apparent shortage of hospital doctors, yet has nothing like the rapid throughput of patients those waiting or on trolleys would expect.

The Donegal man, Gerry Robinson, held British and Irish TV viewers spellbound for a number of nights as he set out to transform an NHS hospital. I am sure the Minister, Deputy Harney, who has worked very hard in her portfolio can empathise, to say the least, with the level of frustration clearly experienced by Robinson in his TV documentary, as he set out to reform the system in just one hospital. Management, management, management, was the message coming from Sir Gerry and it is reasonable to assert that as we move here towards increasing the number of consultants working in our hospitals by 1,500, as indicated by the Minister, we have a right to expect a correspondingly significant improvement in the management of our services at every level, including accident and emergency. It may well be a mistake and an over-simplification of the challenge to see the difficulties in accident and emergency departments as the major problem, when these difficulties may be no more than symptoms of an overall lack of integrated management in some of our hospitals.

In the publicity that surrounded the publication of this Bill much attention was given to Part 8, which deals with the matter of complaints referred to the Fitness to Practise Committee of the Medical Council. This is not in any way surprising, coming as it did in the aftermath of the publication of the Lourdes Hospital Inquiry into the activities of Dr. Neary. "Horrific and shocking" are mild terms to describe the extent of patient abuse which this doctor was able to inflict over a protracted period. Clearly the system currently in place and in place then abysmally failed to protect the interests and wellbeing of the many women who were victims of Dr. Neary's professional misconduct.

It is essential that the public has confidence in the regulatory system and, therefore, the reforms contained in this Bill are timely and deserving of our support. However, given the old maxim that "hard cases make bad law" I wonder if we are adopting the right approach in section 65, which deals with fitness to practise hearings, which it proposes will normally be held in public. I would be concerned about the possible impact on a medical professional's career in the aftermath of a public hearing at which the practitioner had been found innocent of any misconduct, given the propensity of the Irish people to believe that there is no smoke without fire. Would it not be more reasonable to provide for public hearings in situations where there was a prima facie case of significant wrongdoing against a medical practitioner? Such an approach would help maintain the high level of public confidence, which currently exists in the medical profession, and would also ensure that a new and demonstrable level of accountability was put in place for the future.

I congratulate the Minister on the provisions included in sections 17 and 20, which provide for a lay majority in the membership of the council and the Fitness to Practise Committee. This was adversely commented upon by a number of Members today. As a matter of principle it is prudent that the regulatory body for any profession comprise a majority of members who represent the most important stakeholders, those whom the profession aims to serve.

Section 86 deals with education and training and it brings me back to the point made earlier about the recruitment of up to 1,500 consultants. These positions are pivotal to the delivery of improved services on many fronts. Their arrival on the scene should significantly improve outcomes for patients and, through more effective management, deliver greater hospital throughput. In addition, these new consultants will be a major resource for the education and training of our postgraduate doctors who will benefit from the resulting, as it were, lower pupil teacher ratio. However, the key to the success of the recruitment project surely will lie in ensuring that the new consultants meet the same rigorous standards upheld by our current accreditation system.

Section 86 places the responsibility on the HSE to assess the number of intern and specialist training posts required by the health service on an annual basis. I noted again today the number of criticisms and direct attacks on the HSE made by Members. While it is politically expedient at this time to attack the HSE, it certainly does not serve the public interest to do so. It behoves us all to support this new initiative in a drive towards ensuring better delivery of service to the public at large.

I pay tribute to the Minister for Health and Children, Deputy Harney, and the Minister for Education and Science, Deputy Hanafin, for their joint initiative announced in February 2006, whereby €200 million will be invested in a major reform of medical education and training from undergraduate level through to post-graduate specialist training. In particular, I acknowledge the positive development that involves the introduction of a new graduate entry programme for medicine as part of the overall expansion of places from 305 to 725 by 2010. Traditionally, straight As were the prerequisite for entry to undergraduate medicine. However, academic excellence alone does not a doctor make.

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