Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance) | Oireachtas source

We support the Bill. As I understand it, the Bill essentially deals with one of the outworkings of Brexit by trying to recommence a situation that was the case before Brexit whereby medical graduates from the UK and the North can do internships here. That would be beneficial for the health service here. We support what the Bill is trying to achieve. As others have said, it highlights the fact that we have a more general problem in recruiting and retaining healthcare professionals in multiple disciplines across the health service to the point that it is fair to say our health service is creaking at the seams. Many people in the health service are demoralised and burnt out, and are leaving the public health service to work in the private sector. Alternatively, they leave the country entirely or leave the health professions because they simply cannot bear the pressure, stress and conditions they face across much of the health services. Indeed, a family member of mine has been in hospital for several months. He sings the praises of all the staff who look after him but every time I go to see him he tells me that the nurses and health care assistants are run off their feet.

They are burned out, are dealing with too many patients and they just cannot cope quite a good deal of the time. We have a problem. In broad terms, as Deputy Gino Kenny has said, we have to listen to the people on the front line as to what they think is necessary in order to resolve the situation and we are not doing that. I am not going to list all of the different groups of healthcare professionals that we should be listening to but I want to speak up for just a few that I have been talking to recently.

The first of these groups is physiotherapists. I hope that the Minister is aware that physiotherapists are making what seems to me to be a very reasonable request and it may be something that could even possibly be dealt with by amendments to this legislation. It certainly seems to be a very easy legislative change that could have a significant impact in addressing some of the waiting lists that we have in our health service. The Chartered Society of Physiotherapy is saying that physiotherapists need to be included in the list of people who are allowed to refer for X-ray. I did not know this until up they informed me of it but physiotherapists cannot refer people for X-ray. As a consequence, they have to needlessly chase after other people who are on the legislative list, because it is set down in law, of either doctors or certain grades of nurses - there may be some other groups - who are allowed to refer for X-ray.

This is wasting the time of those doctors and nurses who could be doing other things when the physiotherapists know that somebody needs to be referred for an X-ray. This is adding unnecessarily to the stress on other healthcare professionals and it means longer waiting times for people to get the treatment they need. The simple measure they are requesting is that they be allowed to refer people for X-ray, as is the case, they inform me, in many other health jurisdictions and I believe it was in fact committed to as part of Sláintecare. That is very elementary stuff and I would appeal that this might be done.

The legislation that is referred to is a statutory instrument, SI 256/2018, that needs to be changed to simply include physiotherapists, as a group, who along with others - I believe dentists are among them - who are allowed to make such referrals, and so on. Physiotherapists should be allowed to do this. That seems like a good measure and I recommend that the Minister of State might read their submission on this because the figures are quite stark. It says that the numbers that this could potentially deal with and the impact on waiting lists could be very substantial. I will not go through all of the details but this is about joined-up thinking and having the most efficient use of the skilled people that we have in our health service and not unnecessarily burdening others who are already overrun with demands on them, in particular, doctors and nurses. I hope that the Minister of State will listen to this request, please.

The second group I would like to speak up for is one I have spoken up for on many occasions. This has been well-aired and the Government should be aware of the issue of psychologists. As we know, we are in dire need of a great deal more psychologists to do assessments for people with disabilities, children with special needs, in particular, and then to provide services for children with special needs, and so on. There is a whole range of other areas, indeed, where there is a shortage of psychologists. We need them and the paradox and irony of this is that there are many young people who want to be psychologists but there are totally unnecessary obstacles being put in the way of these people who want to study psychology, who want to work with children with special needs, with people with mental disabilities, mental health issues, and so on. As we know, we have absolutely dire waiting lists where people are not getting their assessments in the time that they are legally entitled to get them and are not getting the services. We know in our mental health teams, our child and adolescent mental health services teams and community mental health teams, that there is a very urgent need for more psychologists. Yet, if one wishes to do a doctorate in psychology, one has big obstacles if one is doing this in the area of education or counselling psychology. Clinical psychologists who are doing their doctorates will get a salary for the placement work they do and will get a very substantial amount of the very high fees that they are asked to pay. These are fees of up to €15,000, which is extraordinary.

Many, and I have talked to these young people who want to be psychologists, if they are not being paid on placement through the counselling psychology doctorate, and if they have to shoulder fees of €15,000, as some of them have put it to me, if they are working class, on a low income and do not have the money, they cannot be a psychologist. They will be forced to drop out and it is just too much. Why do we have a situation where we fund some - not enough I would suggest - clinical psychology doctorates, to some degree, by giving them a salary and paying most of their fees and we do not do the same for educational and counselling psychology? It makes no sense.

Again, I refer the Minister of State to the Psychological Society of Ireland’s budget submission and is not the first time-----

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