Catherine Murphy (Kildare North, Independent) | Oireachtas source

As the Minister stated, this is a technical Bill to facilitate his nomination of people to the Health and Social Care Professionals Council. Ten of the disciplines have not been properly established on the council, yet the Minister has no power to extend the terms of the council's appointees. Given the fact that the Health and Social Care Professionals Act was enacted in 2005, why have these disciplines not been properly constituted yet? Not all of the period in question was a time of financial stress or cutbacks. Since 2005, everyone has learned what can occur when there are regulatory failures. The idea behind the council is to put proper regulation in place. It is not just in terms of finance that we need regulation. We need systems that can anticipate developments and work in co-operation with and deliver services to the public.

The explanation of "efforts have been made" offered by the Minister and the Bill's digest is anodyne. What efforts have been made? Has an onerous obligation that cannot be met been placed on the individuals coming forward? Is there a campaign of not co-operating? Why have the other disciplines not been established? Do they view the council as unnecessary? What dialogue has been held to determine why the council has not been properly constituted, something that has made it necessary for the Minister to intervene and introduce this legislation?

The disciplines in question, including occupational therapy, physiotherapy, psychology, social work and speech and language therapy, are the primary care areas with which we have been engaged for the past two weeks. In many cases, the quality of the service they deliver, especially in the public system, depends on one's address. Some parts of the country might have no waiting lists while other parts could have two year waiting lists. Deputy Ó Caoláin referred to speech and language therapy. There is a world of difference between diagnosing a three year old, delivering the therapy then and sending him or her to school at five years of age and making him or her wait two years for that therapy.

The option of a multidisciplinary approach is being missed because the council has not been properly constituted. The commitment of the specialties must be questioned.

Although Deputy Ó Caoláin was referring to Northern Ireland and the Republic when he spoke of cross-jurisdictional matters, county boundaries being crossed is also an issue. Children attending a special school in west County Dublin will receive speech and language therapy if they are from the area, but not if their addresses are in, for example, north County Kildare. This is despite the fact that the same organisation is involved. The systems failures have progressed past being regulatory. They have to do with people's locations, the numbers involved and the architecture of the HSE itself.

The Bill is a modest measure to plug a gap, but it will not deliver a vastly improved service to those who need it, which is what is urgently required. We cannot say that often enough. The stupidity of the situation is that the five year old who starts school without having received therapy must be picked up by the education bill if he or she fails in school later.

We also pick them up by way of underperformance in ability to work and so on. There is a certain element of economic stupidity about how this is handled and seen within a so-called silo philosophy.

I also wish to speak to the elements that are not included. Perhaps they are not appropriate to this Bill but I should highlight them anyway. For example, medical devices and the practitioners using them are not covered. There was a significant failure in regulation with the PIP implant case, and in the US in 2000, a failure in the licensing system in France was identified with regard to the company in question. The process involved the company being regulated by a German-licensed organisation. The problem could have been identified much earlier if the published material had been picked up by the professions. We can see how that played out for people.

The private clinic area, including those dealing with cosmetic surgery, is not taken in with these regulations. Where there is a failure and no one to pick up the problems, the State ends up picking up the issue through the public health care system. Regulation of areas not included in this measure is required urgently. I understand the European regulatory system is being considered, although individual member states have been warned that this may take some time to flow through by means of directive and legislation. It will be necessary to act on an interim basis in order that we can learn from those mistakes and ensure they are not repeated. There is a similar case with invasive implants like DePuy's hip replacements, which have also failed. These failures have caused individuals to have to endure pain and concern arising from another big operation. This is one of a range of other areas that must be tackled through regulation.

I would like to hear the Minister's thoughts on this when he wraps up the debate. I share the concerns of Deputy Ó Caoláin about the Minister not being present. I respect the Minister of State, Deputy Lynch, who will give a report to the senior Minister. Nevertheless, the Minister should have stayed in the Chamber to deal with this legislation and at least listen to the opening statements. It is very important for the Minister to revert to us on these issues. Not all of the problems occurred under his watch and the legislation dates from 2005. It is important to understand what is going on and why there is disengagement by these professions. The only person who can tell us is the Minister because he has been having the dialogue for the past 18 months. It is vital that he tells us about the dialogue and why there has been a failure that prevented a board being set up without this sort of intervention.

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