James Reilly (Dublin North, Fine Gael)

Many issues have been raised and I wish to comment on them because they are important. Deputy Neville's statement on psychotherapy and counselling in particular is something I have been concerned about since my time on the health board with Deputy Durkan. As a GP, one refers people to a physiotherapist or another fellow professional who has a base qualification. In the area of counselling, unfortunately, without the required regulation, patients end up going to people who may have done six weekend courses and consider themselves qualified. This is highly dangerous and detrimental to patients. The matter needs to be addressed, but not tonight.

Similarly, Deputy Dooley's concerns were well expressed. As I have said before, we need a patient safety authority that can act as an advocate for patients. HIQA admits that it cannot do this. The idea of a patient safety authority would allow for a discussion of problems without recourse to law. It would be a safe place for patients to go who feel aggrieved where their issues could be addressed. Their advocate could address the medical profession or the hospital concerns, allowing for an honest conversation to take place. According to insurance companies, at the end of the day most patients want an acknowledgement that wrong was done, an apology for the harm caused to them and an assurance that things will change so it will not happen to another patient. In most cases they do not want to go to law, but when they have no other option, frustration will lead them to the courts.

Deputy Naughten raised a point on which I have commented previously. Childhood vaccination is safe, but nothing is 100% safe. When parents vaccinate they are making a decision to protect their children. However, if they decide not to vaccinate that is not sitting on the fence - it is a decision not to protect one's child. Parents should bear that in mind. Some children are at risk and need to be identified. In addition, vaccination can cause adverse effects; it is well known and the statistics are there. It is not due to any fault of the doctor who administers the vaccination, the patient who receives it or the manufacturer who made it. It is simply a fact of life that different people have immune systems and some may get bad reactions. We need a no fault compensation fund to catch those people, compensate them and look after those who have suffered as a consequence. They should not have to go to law and mortgage their homes in order to get justice for their child or other loved ones. In this respect, I am interested in New Zealand's no fault compensation fund, which is working quite well.

I wish to thank everyone who took part in the debate on this Bill today and yesterday. Their contributions have been informative and useful, and will be considered on Committee Stage when any necessary amendments will be made. It is important to reassure all interested groups, such as the Medical Council, the IMO, the IHCA, insurers, indemnifiers and other groups with concerns in this area, that there will be time for them to have an input during this three-month moratorium. Their concerns can be considered on Committee Stage and any necessary amendments made. In getting this Bill to the floor of the House, I fully acknowledge that it is by no means perfect. However, the thrust and principle of the Bill is to protect patients from uninsured rogue doctors, or doctors who through negligence or otherwise inadvertently let their insurance lapse. There will be resource issues for the Medical Council in getting the necessary expertise to carry out that function, but it is important and worthwhile doing. We will find our way around this because where there is a will there is a way.

With regard to Deputy Connaughton's comments, I am told by experts in insurance and indemnity that there could be 30 to 40 doctors in this country who do not have the necessary insurance. This is tiny number out of the thousands of doctors who are responsible and have insurance. Our citizens and our health service depends on them. I do not think doctors have anything to fear from this proposal. As Deputy Thomas Byrne said, this is of no consequence for most doctors because they have insurance. This Bill is aimed at the rogues who let their colleagues down, and for people who come from abroad and do not have appropriate insurance.

The Bill seeks to close off the loophole which allows doctors to register here with the Medical Council without having insurance. As the Minister of State mentioned, the ethical behaviour guide expects that doctors will be insured. It advises that they should be insured, but this Bill will make it a legal obligation punishable at law if it is not observed, which is not the case at present.

I wish to thank the Minister for not opposing the Bill. I construe this as an acknowledgment that all sides of the House seek to improve the protection of patients in the area of medical litigation. In this regard, I also want to thank Deputy Jan O'Sullivan and the Labour Party and the Sinn Féin Party for their support.

I commend the Bill to the House.

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