Mary Harney (Dublin Mid West, Progressive Democrats)

I thank the Deputies who contributed to the debate. It is not unusual that they wandered somewhat beyond the remit of the proposed legislation. It is fair to say there is broad agreement on the need for new legislation to regulate the medical profession. The current Act is almost 30 years old and, as I acknowledged in my opening contribution, much has changed in the intervening years.

I refer in particular to the expectations of patients regarding regulation. This Bill provides for a modern framework for regulating the medical profession. Sometimes there is confusion between the regulatory body, which must act in the public interest, and representative organisations that represent doctors. This confusion is often evident in Members' contributions.

The council is a public body established by statute. In the first instance, it must inspire public confidence, and this is greatest when there is a lay majority. Yesterday a White Paper was published in the United Kingdom by the Secretary of State for Health and the chief medical officer. They make the point that doctors should not comprise the majority. To be fair, one must realise they are discussing parity between doctors and non-doctors. We have a 25-member council and have chosen a ratio of 13:12. The lay majority is not just for optics. If it were there would be no point to it. It is a question of reassuring patients and the public that the body that oversees the regulation of doctors is, above all else, concerned with the public interest and is not involved in the regulation of the profession by the profession.

Deputy McManus referred to the comments of Mary Raftery. She is a journalist with whom I do not always agree but for whom I have high regard because she is insightful. I have spoken to former lay members of the Medical Council and they take a very different view from hers. When we were legislating for the Health and Social Care Professionals Council, nobody made an issue of its lay majority. The Bar Council recently decided to have a lay majority. It did so purely on a voluntary basis because it is not a statutory body. It felt this decision would inspire greater public confidence in the regulation of the Bar. Before becoming Minister for Health and Children, I established an oversight group to supervise regulation by the different accounting bodies. This has a 60:40 lay majority. Most accountants I meet tell me it has worked extraordinarily well although there was much fear and worry when the ratio was proposed.

We are not talking about appointing just anyone to the Medical Council. A number of bodies are mentioned in this regard, one of which is An Bord Altranais. Nurses work very closely with doctors. The HSE will have two representatives and the independent hospital sector will have one because it is a large sector. This sector has featured since the latter part of the 18th century and it is appropriate that it have representation. There will be a representative from the Royal Irish Academy because the area of research is important.

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