Mary Harney (Dublin Mid West, Progressive Democrats)

There is no question of giving a Minister inappropriate powers, nor should there be. We can discuss the issue further on Committee Stage but I do not want to see political interference with fitness to practise or other ethical issues.

The examples provided by Deputy Twomey from his experiences as a doctor were frightening. Our hospital system is overly dependant on juniors, although I did not realise that a junior doctor could be asked to carry out the complex procedures performed by the Deputy on his first day in the job. Until we reach the stage where we have sufficient consultants, I am certain that juniors will continue to do inappropriate work which should be supervised or carried out by consultants.

Although 15,000 doctors are registered in Ireland, of whom 12,000 are in the country, we need to switch the balance in hospitals between junior and senior doctors. Appropriate supervision is also needed, which will require competence assurance. I am not in a position to indicate the number of doctors in Ireland who are not competent to practise or the number of bad doctors, although I hope they are very few. However, if we do not continue to educate and keep apace of the rapid developments taking place in medicine, we will not be competent to do our jobs. De-skilling happens in medicine as well as other areas.

Competence assurance, which Deputy McManus claimed was initiated by the Medical Council, involves self-assessment and peer review on an ongoing basis. I am not the competent person to set out that process. Several months ago, I launched a voluntary scheme for general practitioners developed by the Medical Council and the Irish College of General Practitioners. I understand 350 doctors are participating in that scheme, along with their patients. The competence assurance model which the Medical Council wants to have introduced will be expensive and that is why we have enshrined a commitment to public funding.

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