Liam Twomey (Wexford, Fine Gael)

We will wait and see because the Minister might believe she could override them.

A more important and immediate issue, on which the Minister has not touched, is that of competence assurance, about which I have asked her on many occasions in parliamentary questions before this Bill was drafted but she has never indicated her position. How will it work? The Minister stated she would provide funding for competence assurance and that the HSE would look after it. From my experience, I note that competence assurance is a massive undertaking. The 9,000 doctors in the country, including the neurosurgeons in Beaumont Hospital and general practitioners in County Wexford, are to be competence-assured to determine whether they can do their jobs. One cannot make wild statements that one will do this without demonstrating how.

The logistics of competence assurance are unbelievable and the cost could also be such. Who competence-assures the cardiothorastic surgeons in the Mater Hospital to determine they are doing their jobs properly? Will representatives from a consultant organisation or external experts be sent to do so? Will the assessees be asked to fill out a form or answer multiple-choice questions? These are the questions the Minister should be answering when she is telling patients she will protect them.

Competence assurance will have a great impact on the health care profession. If we are to find the 20 or 30 doctors we do not want working with patients, we need to know what we are doing. We do not want to collapse the health service completely; neither do we want to relieve doctors of their clinical duties to examine other doctors, thus exacerbating the existing problems in the health service. There are 29,000 patients waiting to see a consultant and 40,000 procedures are cancelled every year, mostly because the resources are lacking rather than because doctors are not available.

The worst step we could take would be to introduce a system of competence assurance that would not work and which would simply be more farce and window-dressing and have nothing to do with protecting patients. The Minister must answer my questions. We will address some of the points I am raising in more detail on Committee Stage but, now that we are talking about the overall thrust of the legislation, we must be clear on what we are discussing.

It is very easy to include in the explanatory memorandum a reference to "a new statutory framework for the maintenance of professional standards of registered medical practitioners". That is relatively straightforward and can be set up quickly. The Medical Council is working on the matter. The explanatory memorandum also states fitness to practise inquiries will generally be held in public. As the Minister knows, there is a doctor who did no justice to patients engaged in proceedings in the High Court to try to have his fitness to practise inquiry held in public. The complainants want it held in camera but he wants it held in public in order that he might intimidate them. If held in public, the complainants might not want to talk about their experiences with the doctor concerned 20 years after the event.

One must remember that it is not always positive to push for public fitness to practise inquiries. They are beneficial most of the time but one must be careful in deciding what complaints should be heard by a fitness to practise committee. I want incompetent and dangerous doctors and those who significantly abuse their patients to appear before it. A number of complaints have been made about medical practitioners and there were even some about significant sexual assaults. I am all for exposing the doctors involved, if this needs to be done, but we must be careful about how we proceed. We need to discuss the matter in much greater detail and not play to the gallery by claiming patients are being protected when nothing of the sort is being done.

I have asked the Minister about competence assurance five or six times in the past 12 months and would like her to outline her position thereon.

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