Patrick O'Donovan (Limerick, Fine Gael) | Oireachtas source

It is worth noting there was a great deal of new-found interest in the health services in recent days from supporters of the previous Administration. As per usual in all debates that take place in this Chamber, be they Second Stage, Committee Stage or other Stages, the Opposition benches are completely unmanned. It demonstrates the level of real interest within the Opposition ranks with regard to trying to bring real reform and change to the health services. It states a great deal about the commitment of the Fianna Fáil Party in particular to Oireachtas reform and how the Dáil actually operates, which is regrettable. Since my election, I believe this to be my fourth time speaking in the Chamber to entirely empty Opposition benches. The reality for me and others who speak and spend time examining legislation is that Members come into the Chamber during Leaders' Questions and blow off a great deal of hot air regarding their new-found interest in the health services. However, when they get an opportunity to make a contribution or to listen to some of the contributions being made, which have been constructive in nature, they do not attend. They see no merit in so doing because "Oireachtas Report" may not cover it tonight. Why would it, given this is legislation that is long overdue, makes perfect sense and which everyone supports? However, those who will blow off the most steam and who will run out to the plinth to make statements about the current Minister for Health, the former Minister of State in the Department of Health or the incumbent Minister of State in the Department of Health with responsibility for primary care or whatever, are not present today. This demonstrates the level of real interest those who destroyed the health services have in reforming them.

While it is very welcome that we are debating the Health and Social Care Professionals (Amendment) Bill, I take the opportunity to mention regulation of private home-care providers - an issue I have raised on a number of occasions. While legislation is promised in the area, it is of great concern to me because the people involved are also professional in nature. There has been considerable media speculation recently and many home-care providers are also looking for this. Many Members of this House would know family members and others who are in direct contact with home-care providers. Under the previous Administration we saw what happened when private nursing homes were allowed to operate unregulated. I implore the Minister of State to deal with the Law Reform Commission report, entitled Legal Aspects of Professional Home Care, which was published in 2009 and proposed minimum standards, minimum training requirements, supervision and inspection role, a role for HIQA and a clearly defined role for family members in respect of people who are in a key position of trust.

We have rightly debated at length the issue of children and people with intellectual disabilities, but unsupervised and unregulated people are attending to vulnerable old people living on their own. I do not cast aspersion on any person doing that job at the moment. However, as Deputy Buttimer said about psychotherapists, it is just as important for a home-care provider to be working in a statutorily regulated industry as it is for the person in receipt of it. As I said at another meeting yesterday, in light of renegotiation of the contract for consultants' pay, we now have an opportunity to renegotiate some of the home-care packages. Rather than just focusing on the number of hours allocated to people and how they might be reduced, we should investigate how much the person coming in to care the elderly person gets paid and how much the company employing that person gets paid. There is an enormous differential and considerably more could be done in that area to deliver cost savings without impacting on the needs of the person who is ultimately dependent on the home-care provider. They do very valuable work, but I have difficulty with the area being unregulated with the only role for the HSE to be the paymaster. I will take every opportunity to raise this issue continually in debates on health and social protection. It needs to be done for the people in this industry who have nobody to speak for them.

I believe we need regulation in the area of orthodontics. In 1985 provision was made for the creation of the post of orthodontic therapist. All Deputies will have come across people visiting their clinics whose children are waiting for braces. There is reluctance among some people to regulate the area. When we are discussing reform, shortening waiting lists and doing more work with less money, we need to address orthodontic care. Over a number of years in Pembrokeshire in Wales, orthodontic waiting lists were reduced practically to zero because the Welsh Assembly took an initiative to regulate the area of orthodontic therapists and take it out of the control of people who - for their own reasons - wanted to maintain that element of control. That is the type of reform people now expect. I welcome the suite of professionals to be regulated under this legislation, but there is another cohort of professionals. This legislation will need to be fluid and flexible so that it can be amended on an ongoing basis to allow for further councils and governing authorities.

I welcome the provisions of the Bill, which make perfect sense. I regret that no one from the previous Government bothered to turn up to listen to what we had to say, but that is their problem. There is an opportunity to do more for people about whom we are inclined to forget because they do not make the headlines. I know the Minister of State has a significant interest in this given her responsibility for disability and older people. I urge her to put the regulation of home-care providers on the top of the legislative agenda.

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