Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I thank Deputies for their constructive contributions and broad support for the legislation that is before us today. As I indicated earlier, the chief purposes of this mainly technical Bill are to subsume the Opticians Board into the Health and Social Care Professionals Council, make a number of amendments to the Health and Social Care Professionals Act 2005 in the interest of efficiency and to ensure consistency with legislation governing other health regulators, and correct a lacuna in the Health Act 1970 concerning residential support services maintenance and accommodation contributions.

Parts 1 and 2 will achieve the first two objectives by repealing the Opticians Act 1956 and amending the Health and Social Care Professionals Act 2005 to apply its provisions to the optical professions. Part 2 also seeks to update the 2005 Act in many other respects. Part 3 ensures the new statutory framework for contributions by service users towards ongoing daily living costs will be applied appropriately across the various models in place to support independent living in community settings.

I agree with Deputy Billy Kelleher that a new, streamlined regulatory model will lead ultimately to increased public confidence in the health and social care professionals regulated under the Bill. People are sometimes at a loss to know where to go if a particular complaint arises. It does not happen very often, but that eventuality is covered in respect of the professions regulated.

In response to Deputy Caoimhghín Ó Caoláin, I can clarify that the rules regulating the prescribing and sale of spectacles will not change under this Bill. In other words, people who work within the premises can still deal with the cash or other transaction and may help with other aspects of the purchasing of spectacles. The current practice of employing sales assistants to help with choosing frames and processing sales will not be affected. In addition, since 2003, the definition of "spectacles" specifically excludes ready-made reading spectacles, and this is carried forward in the new Bill. It means that reading glasses can still be sold by persons other than opticians.

Deputy Finian McGrath raised concerns about staff transferring from the Opticians Board to the Health and Social Care Professionals Council. The Bill provides the standard public service provisions in these cases such that all benefits and conditions of employment will transfer with staff as on a no less favourable basis.

I share Deputy Olivia Mitchell's frustration with the relatively slow implementation of the provisions of the 2005 Act. However, the rate of progress is accelerating. Six registration boards have been established and the remaining six will be up and running by the end of next year. In addition, the order commencing the Act's fitness to practise regime will be made at the end of this year. This will be a crucial milestone in the regulation of these professions.

We have made significant progress on negotiations in regard to the regulation of counsellors and psychotherapists, and it is hoped the regulations can be made early next year. The first stage of the designation process, involving a detailed consultation with the Health and Social Care Professionals Council, is under way. I acknowledge the concerns expressed regularly by Deputy Dan Neville on this issue. Qualified and competent counsellors and psychotherapists are just as concerned about regulation and will welcome the provisions set out in the Bill. The details are still open for discussion, but we are making progress.

Deputies Kelleher, Ó Caoláin, Finian McGrath, Mitchell and Healy-Rae raised a range of issues relating to the resourcing of care and standards of care generally, particularly care in the community for persons in residential placements. Part 3, in common with the Health (Amendment) Act 2013, relates only to service users' contribution towards maintenance and accommodation costs. It is a case of keep, not care. Care standards and the resourcing of care are of crucial importance, however, and there will be many opportunities to debate these issues with a view to continual improvement of standards across the health system.

I refer to the contributions of Deputies Ó Caoláin, Finian McGrath, Mitchell and Kelleher. HIQA does not yet monitor, supervise or inspect the provision of care in the community. I hope that will happen as we progress, as it is essential. However, we have a whole set of standards and reports and it is the Government's intention that people in congregated settings will live in the community. It is important we regulate that as far as we can. There is a concern, which I share, in regard to residential settings for people with disabilities. The new regulations in regard to disabilities have been in place for 12 months and we will take a look at them because it is not fair to impose the type of regulations which are crucial for long-term care for older people. That is not how we want people with disabilities to live their lives. These places are their homes and we should not apply that type of medicalised standard to them. If HIQA came into my house to inspect standards, I probably would not pass, and I do not believe I would be in the minority in this respect.

I appreciate Deputy Mitchell's supportive comments in welcoming the Bill generally and, in particular, her supportive remarks in regard to the flexibility of the HSE in providing different models of provision of residential supports. Deputy Finian McGrath also welcomed the Bill. I take their contributions, not more seriously than other ones, but from the point of view that they are both parents and have had personal interaction with the disability services. From that point of view, it is important we listen to those issues raised.

Deputy Kelleher mentioned concerns regarding the potential impact of Part 3 on those in respite care. There is nothing in this Bill or in the 2013 Act which introduces any difference in regard to respite care as between the existing system and the new framework nor is there any separate reference to respite care or to any other subset of long-term residential support services. The current provisions in regard to charges for long-term respite services will continue under the new residential support services regime.

Deputy Ó Caoláin sought reassurance that reductions referred to in Part 3 could not be interpreted in a manner which could result in reductions in supports to service users or in reductions to service levels. I am happy to provide that reassurance. The Bill contains no provisions which could be interpreted as relating in any sense to reductions in supports or services to service users. There is a reference in section 43(c) to reducing the contribution amounts which service users will be required to pay, in certain circumstances, towards their accommodation and maintenance costs. I presume the Deputy has no difficulty with that. If it is considered beneficial that someone go on social outings maybe twice a week or whatever, the same are the rest of us, there will be enough flexibility in that section to allow the HSE or service providers to take that into consideration in terms of the contribution made. It is about standardising the system and giving a degree of security to people. These places are their homes and they need that degree of security.

I thank Deputies for their contributions to the Second Stage and look forward to further constructive examination of the Bill on Committee Stage.

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