Wednesday, 10 April 2019
Regulated Professions (Health and Social Care)(Amendment) Bill 2019: Second Stage
I am happy to speak to the Bill. To be fair to the Minister of State, Deputy Jim Daly, he met a delegation from County Tipperary today to discuss mental health issues. He is doing his best and I acknowledge his bona fides. It is a pity that he is not the senior Minister.
The Bill amends the five health professional regulatory Acts, in particular, in the areas of fitness to practise and registration. It is disappointing and sad that we see people who do not have the proper qualifications, make mistakes and carry out different procedures when they are not qualified to do so and do not have the experience needed. The key amendments include the following. First, applicants for registration must declare in their application and annually thereafter any conviction or sanction imposed by a regulatory body inside or outside the State. That is important. In a world where people move from state to state and there is ease of access and so on, it is vital that we look outside the State also.
Second, disciplinary inquiries in other jurisdictions can be used as admissible evidence in fitness to practise proceedings in Ireland. All sanctions will be published to ensure the public will have access to information on disciplinary sanctions imposed on doctors, nurses, midwives, pharmacists and other regulated health professionals.
Third, practitioners will have the right of appeal to the High Court when minor sanctions of advice, admonishment or a censure in writing are imposed on a practitioner. There is currently no right of appeal against these three sanctions. In fairness, any justice system must provide for a right of appeal. We cannot have cursory justice and must provide for a right jf appeal. It is, therefore, a good amendment.
All of the amendments strike me as being perfectly reasonable. We must have strong and robust protections for the public. While they are generally excellently served by the quality of our doctors and healthcare professionals, sometimes they do experience a horrendous level of care. We cannot lose sight of this, although the vast majority are well served by health professionals, nurses and front-line staff. For whatever reason, the few bad apples in a barrel can cause rot which can have bad consequences, including, for example, the eagerness of the legal eagles to become involved in many cases in an over-zealous fashion. In some cases there is malpractice, for example, in the case of the cervical smear tests, although it did not involve clinicians in the main but a systems failure. The Tánaiste was trying to explain to the House about a systems failure in the case of the national children's hospital, but there are systems failures every minute of every hour of every day of every week of every month of every year due to the monstrosity that is the HSE which is too big to function properly. I have said the Minister of State is doing his best to grapple with the problems and as we saw today at the meeting, there are many excellent people involved. However, there are too many design teams and people running and managing that it is nearly impossible to move forward because everything is too slow. While we have discussed the approval of a €2.2 million unit, because of the rate of inflation since 2015, the cost is now €2.6 million and the matter has to be referred back for approval. I know that the Minister of State will push the project and do his best, but, surely to God, when they are processing approvals, they should be able to index link the cost and not have to go back to the drawing board all of the time.
We must, as I said, have strong and robust protections. We must also, above all else, have accountability. Only recently we read that the President of the High Court had struck off a radiographer when he was satisfied that "she is a danger to the public" owing to her substandard knowledge of the basics of radiography. We are all sent for X-rays, including our parents, children and siblings, and expect to be seen by a competent person. I say, "Well done," to the High Court and Mr. Justice Peter Kelly for saying it and putting the matter into the public domain. As he said, she was a danger to the public owing to her substandard knowledge of the basics of radiography. I would love to know who interviewed her and how she got through the process to get into the X-ray room where she was unable to read X-rays. It is appalling. We now have managers where at one time we had a matron running a hospital and, by God, no one fooled her. The place was clean and tidy; patients were looked after and everything was done right. No one crossed her either. In her place we now have area managers, ward managers, floor managers, bed managers, linen managers, hygiene managers - the place is not even clean - and food managers. I have only mentioned half of them and they are going around with flip charts, while patients can be sent for an X-ray. I remember going to Cashel hospital with Mary T. who is now deceased. We knocked on the door and were given directions to where the doctor was. Patients now have to go to the diffferent reception areas and so on. It is a bureaucratic nightmare, instead of making sure the people who are doing the work are competent to do it. Mr. Justice Peter Kelly said the case involved a person who worked for a short period in 2017 at University Hospital Waterford in my area before she was let go. He underlined his concerns about the procedures used in recruiting professionals to work in hospitals. They are not my words, although I have the same concerns, but those of the eminent High Court judge Mr. Justice Peter Kelly.
It is vital that we do all we can to create a healthcare environment where people can trust those who are treating them and have certainty in their expertise. That is a basic prerequisite.
It is also clear that it is not only healthcare professionals who can be a threat to the public. This is also true of the health system itself. Last year the Irish Association for Emergency Medicine, IAEM, issued the dire warning that up to 350 people would die needlessly in hospital emergency departments in the next year unless the Minister for Health, Deputy Harris, definitively addressed the trolley crisis. This crisis has got worse. The Taoiseach told us yesterday that it is not as bad as last year or the year before. Conditions in my county are appalling. Cork University Hospital was nearly closed last week. A man lay in the street for two and a half hours after a fall because eight ambulances were tied up at Cork University Hospital.
What sanctions should we pursue against the Minister when his lack of action allows to continue a scenario where hundreds of unnecessary deaths may be occurring? That is a shocking statistic. We are not in a war, but when one looks at accident and emergency departments it seems like a war. If we seek to hold the doctors to account, the same should obviously apply to the Minister who has overall responsibility for the health service. He can squirm. He went on "Six One News" on his own yesterday to try to account for something that is inexcusable. Our colleagues in Fianna Fáil give him a pass. Deputy Micheál Martin and others come in here and criticise him every day, but when it came to a vote of no confidence they sat on their hands. They have been sitting on them so much we will need to get therapists to fix their hands before this Government is finished. It is a good job the seats are soft and they are not getting hurt, but they will definitely be badly damaged and may be unable to press the buttons when the time comes. This carry-on is unbelievable. Responsibility to the people does not matter. No Minister is held accountable.