Mattie McGrath (Tipperary South, Independent) | Oireachtas source

I am delighted to be able to contribute to the debate on the Health and Social Care Professionals (Amendment) Bill 2012. Although I mean no disrespect to the Minister of State, Deputy Lynch, I am also disappointed that the Minister, Deputy Reilly, left the Chamber so swiftly after making his opening speech on this Bill. The Act has been in force since 2005 but the Minister has only been in power 18 months. Nevertheless, we should have a proper debate and there are questions to answer. The Minister should try to explain some of these issues.

The Minister indicated that the Act provides for grandparenting, or a transitional period of two years during which existing practitioners must register on the basis of current qualified specifications. The Taoiseach, if he has the chance to appoint his next Cabinet, might insert a grandparenting clause to keep the likes of the Minister for Health, Deputy Reilly, under control so as not to allow what we read about every day in the Department to happen.

I compliment the new Minister of State, Deputy White, at the Department of Health but I also pay tribute to the former Minister of State, Deputy Shortall. I served with her on the last Oireachtas committee dealing with social welfare and know her to be a tireless worker and advocate of the underprivileged. She is a champion for fairness and equity. She was forced into a position where she had to resign from office, which is both scary and disappointing. The Taoiseach has already lost two Ministers of State in 18 months, which is a concern. Nevertheless it is not my business but a matter for the Taoiseach to run his Government. While I would not dare to lecture him on how to do it, a small bit of common sense and mutual respect would go a long way.

As I noted, this legislation is originally from 2005, when a system of statutory regulation was designated for health and social care professions. We all know this to be badly needed. The regulatory system comprises a registration board of 12 designated professions and also allows the Minister to make 12 appointments. This begs the question as to why there has been a delay in getting these bodies up and running. There is plenty of expertise and legal advice around so we should have been able to foresee whatever problems may have been down the road with this legislation, which is less than seven years old. I know the Minister is only in office 18 months but the fact remains that the legislation has not worked, so I must ask why there is a delay.

Does this arise because it is part of the dysfunctional organisation of the HSE? There are many thousands of excellent staff in the HSE, both office and front-line workers, including all kinds of health care professionals. Nevertheless, there is a significant deficit and much baggage and administration, red tape and bureaucracy. We must tackle that problem.

The bodies involved in this issue are collectively and informally known as CORU, and they are responsible for protecting and regulating health and social care professionals in Ireland. CORU promotes high standards of professional conduct, education, training and competence among registrants. That is something everyone in this House and the wider country wants and demands.

CORU covers some delicate areas, including biochemists, dieticians, medical scientists, occupational therapists, physiotherapists, psychologists, radiographers, social workers and speech and language therapists. Many of these people have made a career choice arising from career guidance and family or peer advice. They have dedicated time in third level institutions, doing research and masters degrees, ending up in a highly qualified position after a massive cost to the State and the individuals or families, which may have struggled to help the people achieve the qualifications. Deputy Murphy, on the other hand, referred to the people in many disadvantaged areas, waiting for treatment. Every Deputy knows of many cases of people waiting for orthodontic treatment, speech and language treatment and access to many similar such services.

With the embargo on recruitment to the HSE and the health needs that exist, it beggars belief that people are told the special treatments their children need, having waited a year or two years and then going into secondary, are not covered by the State. That is a huge cost on the family and a huge social pressure on the individuals who badly need the treatment. Whether it is speech therapy or dental treatment, they need it. They were recommended by health care professionals to have it and they applied for it. As was mentioned, some people have worked as volunteers. There are many people waiting for such treatment and there is a high demand for it, but many of our highly qualified people are emigrating and we are losing that valuable resource to other countries. Many of those people do not even work their chosen profession in the countries to which they emigrate. It is a disgrace.

I said during the debate on the children's referendum Bill that it is pointless passing laws and amending this legislation if we do not have the wherewithal, the resources and, most importantly, the vision and the passion to follow through on these measures. There is no point in amending Acts, putting them on the Statute Book and filling up the law libraries. We must make sure we are able to provide for what we legislate. I know we are in a deep dark recession but this legislation has been hanging around since 2005 and during the peak boom years of the Celtic tiger, but it is still not up and running.

I was interested to hear the research Deputy Ó Caoláin quoted. On an island the size of Ireland and having regard to the peace process and people coming together, the Administrations in both parts of the island must come together, pool, unite and share expertise for the benefit of all the people. This is still a small island even when one includes the populations of both jurisdictions relative to the size of our neighbours. My late brother could not understand how we had 13, or whatever is the correct number, health boards at the time and Manchester where he was working, which had a population of 3 million had one body looking after this area. When we consider many such cases, we can see where bureaucracy has got a grip. The health boards were disbanded because we wanted openness, transparency and accountability but we got the gigantic monster that is the HSE and no job was lost at the time. I am not blaming the current Minister for that but it happened and it got more unwieldy, entangled and bureaucratic and, worse than that, it operates at arm's length from ordinary people.

On the other hand, there are the private practitioners, some of whom are accounted for in the legislation, who have set up their own systems. I go back to the time of Barry Desmond and I saw him in the Dáil trying to break the grip the consultants had on the public hospitals. I have often said that if one is a veterinary practitioner, one must provide one's own specialist designated research, operating theatre and whatever. Why should consultants have access to public facilities and beds if they are not playing ball? Such access should be removed from them. They should get their own house in order if they do not play ball, cutting out the waiting lists and work longer hours. I cannot understand how there have been so many commitments to change this but it has not been changed. It is the stark naked fact that big powerful lobby groups in this country are the tail wagging the dog and they are refusing to budge. It is a long time since Barry Desmond - I think he is alive and well and I hope he is - stood in this House and as Minister tried to break that cartel and he failed. Successive Ministers have also failed to do so but it must be broken. What we, this Bill and all other legislation are about is service to our people and not to any particular sections or elite group of our people. These people have excellent qualifications and worked hard to gain them and they must be recognised for having done that and paid appropriately but not for having a logjam and a closed shop. We saw what happened with the pharmacists - young pharmacists could not become practitioners. Now there is the issue of the price of generic drugs. We have to deal with this matter. The Minister, Deputy Reilly, and the Labour Party promised that they would deal with it but they have not. It is not easy to do so: they cannot simply wave a magic wand and have it dealt with but they have to deal with it because the public are tired of it. We are all tired of it because it has gone on for too long. In the recession we must examine the pooling of resources North and South on this island.

We must not allow a situation where racism against foreign national practitioners could be encouraged. They were encouraged to come here and we needed them. Unfortunately, most of them were working junior doctors. It was 18 months ago when the Minister, Deputy Reilly, embarked on a crusade abroad to recruit these people, whom I am sure were suitably qualified, but we found they were staying in bed and breakfast accommodation and all kinds of places and they could not operate. There were queues for procedures. I would not want anybody who does not have proper qualifications and certification working in our hospitals but they were recruited abroad to a set of standards, must have been interviewed and must have got the nod to come over here at great expense to the State, I might add, and then they were kept here in abeyance as if they were in some kind of quarantine. Then we had to do some kind of a cleansing in respect of them before they could work. It was horrible for those people to have been put in that situation plus the fact that we did not have them working at the front line where we needed them. That was another case of bureaucracy gone mad. I do not know who was keeping the door closed, keeping them out or did not want them here but that is what happened and it was not that long ago. I am sure it will happen again but it should not happen. Those eminently qualified people, regardless of their colour or creed, are entitled to work here and they have worked here. We cannot discriminate against them because some people are anxious, as others have said, to jump on the bandwagon and discriminate and denigrate people because of their colour, race or because of where they come from. That should not be allowed or contemplated anywhere.

Where does health and social care and the HSE fit into all this? It is all about health and social care but that is not being meted out to ordinary people who are trying to access ordinary, simple, basic treatments. In many cases when people get into the system they are very well treated but such access is not made available to many people. It is the preserve of those who are able to go private and access the system. I read in the newspaper today that VHI health cover will increase again. The minute any changes affect these people they pass on the cost to the insurers. We have to question the cost of treatments and bed nights in terms of insurance cover. They are too high. The rackets must be stopped. The cartels must be broken. Health and social care must be delivered to people. It is part of their civil right under the Constitution. That must be recognised and we must set out to deliver that. The delay from 2005 to 2012 in getting this legislation up and running and the need for it to be amended now to enable its unfolding is patent nonsense because that should have been identified at the time the legislation was introduced. I am not saying we are infallible but there are legal people who understand if there are legal pitfalls and blockages in the context of legislation. If there are, there should be a back-up model in order that the blockages can be cleared and dealt with and the legislation, as enacted, can be put into practice. It is all fine to hear pious platitudes but we must be mindful if there are various reasons legislation cannot be implement or is not workable. Do we ever in the Oireachtas test if legislation is fit for purpose before we pass it? That applies to all legislation. One wonders if some legislation passed was ever tested to establish if what it proposed was sane, realistic or achievable or if it was all in deep chapters, which no one could unravel or implement. I thank the Minister for introducing this legislation now but why is there a need for it and why did it take so long to introduce it? Will he answer those questions? I know the Minister of State might attempt to and that the Minister is not present. I think he is one of the 11, like the Flight of the Earls, who will be flying off. It is important to be prepared for taking over the EU Presidency. I remember when I was on the opposite side of the House a few years ago Ministers being criticised for travelling abroad for St. Patrick's Day celebrations.

If it was Halloween, I would say it was something else but this is similar to the Flight of the Earls with high powered Ministers, officials and their entourages. I do not know if that is necessary. If the troika can come over here to tell us what to do, surely the European officials could come here to meet departmental officials and say what they want out of it. I wish the Taoiseach and his Ministers well with the EU Presidency but is this amount of foreign travel needed? Nothing has changed since I sat on the Government benches other than the personalities on the seats and the public is growing weary of it.

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