Seán Kyne (Galway West, Fine Gael) | Oireachtas source

I welcome the introduction of the Health (Miscellaneous Provisions) Bill 2014. The regulation of health services is essential for patients and also for genuine professionals who spend so much time training and studying to become practitioners. Unfortunately, in most sectors we have seen cases where regulation failed, leading to negative consequences. However, there are few other sectors than health care where regulatory failures can be as devastating and actually be a matter of life or death. The Bill represents another step by the Government in further regulating health services and improving safety, confidence and, hopefully, medical outcomes.

The Bill builds upon the Health and Social Care Professionals Act 2005 which empowers the Health and Social Care Council, CORU, to regulate 12 professional groups. That principal Act played an important part in establishing that a health or social care profession is any profession in which a person exercises skill or judgment relating to preservation or improvement of health; diagnosis, treatment or care of persons with illnesses; resolving, through guidance or counselling of psychological conditions; and care activities for any person in need of protection or support.

These definitions emphasise how important this area is and how legislative amendments must be thought through and thoroughly drafted. We are gradually moving, perhaps not fast enough, from a system whereby only five professions were regulated, namely, doctors, dentists, nurses, opticians and pharmacists, to a system where the majority of medical professions will be regulated. This is necessary for several reasons.

First, advances in medical treatment and health care in recent decades have caused the establishment or recognition of new professions, of new distinct areas of care including dieticians, occupational therapists, biochemists, social care workers, speech and language therapists and radiographers. We can see the continued progression of this trend in this Bill where it divides the category of radiographer into two - the first being radiographer, the second, radiation therapist. The former is concerned predominantly with the traditional role of diagnostic services in hospital X-ray departments while the latter is more concerned with radiation treatment services for cancer patients, an area of treatment which is thankfully improving and advancing all the time.

Second, self or voluntary regulation has been the norm. While this type of system might be less expensive, faster to organise or in decision-making, it can also have substantial failings in independence, transparency and objectivity. Oversight and scrutiny will be better served by having independent regulation. The current Health and Social Care Council achieves this by getting the balance right on the council. The council has 12 representatives, one from each of the professions, as well as 13 representatives not connected to the professions, thereby ensuring a lay majority on the council.

Provision of proper, adequate care and treatment is an integral aim of our health care system. However, of equal importance should be the aim of keeping people out of the hospital system by providing enhanced primary care in the community. The Association of Optometrists Ireland welcomes this Bill, describing it as good for eye care. The association has also identified that it will facilitate the development of the role of optometrists by enabling them to “provide more care at primary level in the community rather than have to make immediate referrals to secondary or tertiary care”. This is an objective which must be facilitated by the Government and the Department of Health.

Another important objective to be achieved is ensuring the public has confidence in health care and in the professionals administering that care. It is particularly important considering the vulnerable position which a person with an illness will be in. It is thus encouraging to see the amendments contained in sections 27, 29 and 38. Section 27, which amends section 53 of the principal Act, promotes the public interest by enabling the council to cancel registration of a professional in the case of a complaint on the grounds of a conviction secured by judge and jury.

Similarly, section 29 amends section 60 of the primary Act which empowers the council to apply to the High Court to secure an order suspending the registration of a practitioner. However, in accordance with natural justice, the hearing will not be held in public in order to protect the reputation of the practitioner pending the outcome of investigations.

Another section - section 38 - creates a new section in the primary Act which further strengthens the council's powers to protect the public through powers to investigate contraventions of the Act by persons other than practitioners. The Bill continues the important role of regulating medical services. It strikes the important balance of ensuring the highest safeguards for the public while providing certainty and reassurance to genuine practitioners. I welcome the Bill.

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