Michael Kitt (Galway East, Fianna Fail)
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As there are no amendments on Report Stage we will move to Fifth Stage.

Michael Kitt (Galway East, Fianna Fail)
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When is it proposed to take Fifth Stage?

Alex White (Dublin South, Labour)
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Now.

Alex White (Dublin South, Labour)
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The Health and Social Care Professionals (Amendment) Bill 2012 is a relatively short technical Bill, with 20 sections in total, Committee Stage of which was passed on 9 November, without amendment.

The Bill proposes to amend the Health and Social Care Professionals Act 2005 to provide for the enhanced and effective functioning of the Health and Social Care Professionals Council and the registration boards established under the Act. It will also amend the Act to better provide for the assessment and recognition in Ireland of qualifications obtained outside the State and to ensure compliance with the relevant EU instrument.

The 2005 Act provides for the establishment of a system of statutory regulation for designated health and social care professions. The regulatory system comprises a registration board for each of 12 designated professions, a Health and Social Care Professionals Council with overall responsibility for the regulatory system and a committee structure to deal with disciplinary matters. These bodies are collectively known informally as CORU. CORU is responsible for protecting the public by regulating health and social care professionals in Ireland. It promotes high standards of professional conduct and professional education, training and competence among the registrants.

I thank Deputies for the valuable and thoughtful contributions made on Second and Committee Stages. Deputies highlighted the urgent need to bring counsellors and psychotherapists within the ambit of the 2005 Act. I would like to now restate the commitment made by the Minister, Deputy Reilly on Committee stage to make the necessary regulations under the Act as soon as possible. A key regulation in this regard, namely, the regulation to prescribe the qualifications needed to register under the Act, will be made when the minimum qualifications and standards of knowledge, skill and competence for future counsellors and psychotherapists have been set by Quality and Qualifications Ireland. To explain further, the regulation of designated professions under the Act is, in the first instance, activated by the registration of persons with specific qualifications approved by the relevant registration board. These approved qualifications are awarded by the Higher Education and Training Awards Council, HETAC, now subsumed into Quality and Qualifications Ireland, QQI, or by the universities. In the case of counselling and psychotherapy, however, QQI is only now in the process of establishing standards of knowledge, skill and competence to be acquired by those wishing to practice in this field. When these standards have been determined, in consultation with the professional bodies and other stakeholders, the educational institutions offering courses and programmes in counselling and psychotherapy can seek QQI accreditation and, in time, QQI will be able to award qualifications to those graduating from the accredited courses. These QQI qualifications will be the minimum qualifications required of counsellors and psychotherapists to register under the Health and Social Care Professionals Act 2005.

The Minister, Deputy Reilly, will be asking Quality and Qualifications Ireland to conclude its work as soon as possible next year. In tandem, the Department will work with CORU to have all the other necessary arrangements in place so that there will be no delay in establishing the counsellors and psychotherapists registration board when the minimum qualification standards have been set. On Committee Stage, Deputies raised concerns about inadequately trained counsellors and psychotherapists advertising services to the public. While many services, private and public, have quality assurance arrangements in place, as have a number of reputable professional bodies, there is cause for concern that standards are not universally high. Deputies pointed out that these advertisements are often aimed at people in vulnerable or distressing situations. It was asked whether it would be possible to require those advertising counselling and psychotherapy services to alert the public to the fact that counsellors and psychotherapists are not currently regulated under the 2005 Act. This may be a worthwhile temporary measure in the interest of public safety particularly and the Department is now seeking legal advice on the practicalities involved. The Minister, Deputy Reilly, hopes to be able to come to a clear policy position on this proposal shortly.

I commend the Bill to the House.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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As previously stated, Sinn Féin supports this Bill, which as indicated now and previously by the Minister of State, is a technical Bill amending the Health and Social Care Professionals Act 2005, which established the Health and Social Care Professionals Council and, following a protracted debate in this House, which Deputy Neville will recall all too well, 12 health and social care professions. While the main purpose of the Bill is to allow the Minister for Health to continue to make appointments to the council because the 12 registration boards have not yet been established and, therefore, are not in a position to make their own nominations.

I ask the Minister of State to update us on this issue. Have there been further developments in terms of the establishment of registration boards across the identified 12 professions?

One of the issues which was the subject of substantial debate on Committee Stage was extending the number of stated professions. I refer specifically to an amendment tabled by Deputy Fitzpatrick on behalf of his colleague, Deputy Neville, in which he proposed adding the role of psychological therapist to the list. I record my support for that proposition which I also supported during the 2005 debate on the principal Act. I would like to see us moving forward speedily in including it and other health care professionals in the accredited list.

I wish to focus once more on the situation that applies across several of the professions mentioned. I will use the example of speech and language therapists to underscore what is a major need, namely, lifting the current recruitment embargo in order that the current demand for specific professional services can be met by the supply. There is no question but that we have significant numbers of highly trained speech and language therapists - as we have across other professions named within the cohort of 12 provided for in the Bill - for whom there are no vacancies or opportunities to perform their specific role in the health service. We are continuing to train a significant number year on year of highly skilled, highly motivated young speech and language therapists, but we are training them for export, for employment overseas. This is really sad because, make no mistake, there is a huge demand for both adult and child speech and language support services across the State. To lose so many unemployed, fully qualified therapists to other countries across the globe is a source of huge regret for every one of us and a terrible reality for graduates, their parents and communities. Again, I take the opportunity on Fifth Stage to make a special appeal on behalf of those who have chosen a particular career path across all of the listed professions provided for and enumerated in the list of those who will have immediate access to roles on the councils. It is not only in their interests, in terms of career opportunities, but also in the interests of those of us who depend on the health service that the recruitment embargo be lifted at the earliest opportunity in a programmatic way, if necessary. It is incumbent on us to open up opportunities for our highly trained young people to remain at home, as well as to seriously address the very significant and identified need that is not being catered for.

I welcome the passage of the Bill and look forward to the time when it can be declared redundant, when the Minister will no longer require these powers and the various representative bodies of the named professions will be able to make their own appointments.

Dan Neville (Limerick, Fine Gael)
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I too welcome the passage of the Bill which will bring to an end the delay in the introduction of the councils. It is seven years since the original Health and Social Care Professionals Act was passed. I was involved in the debate at the time and everybody accepted, including the then Minister of State at the Department of Health and Children, former Deputy Tim O'Malley, that the professions of counselling and psychotherapy should be included in that legislation. However, there was disagreement among the professional bodies at the time and the then Minister of State suggested there might be legal difficulties in doing so, but he gave a guarantee that once agreement was reached, he would do so, He also said that if agreement was not reached, he would do it anyway. Some 22 psychological therapies organisations came together, reached an agreement and drew up a report which was presented to the then Minister of State at the Department of Health and Children, former Deputy John Moloney in 2008. However, very little, if anything, has happened since.

I welcome the announcement by the Minister of State that he is progressing that issue to ensure regulations will be put in place because it is a very serious matter. Untrained and unqualified individuals are acting as counsellors and psychotherapists and engaging with very vulnerable persons who are suicidal, suffering from eating and various psychological disorders. There is no regulation in this area. The Minister of State referred to the fact that organisations were providing short courses and awarding "qualifications" to allow people to act as psychotherapists. He promised that he would try to deal with this issue before the regulations came into force, about which I am very pleased.

I will give Deputies two quick examples of the courses which cause concern. I have a leaflet advertising an advanced diploma in suicide studies, a three module course. The first on suicide prevention is run over two weekends. The second and third modules on suicide intervention and suicide post intervention measures are also run over two weekends. Therefore, the prospective student will receive an advanced diploma in suicide studies after six weekends. I have another brochure advertising a course on eating disorders. There are seven modules run over seven weekends. At the end of the course the student is awarded a diploma in practitioner skills for eating disorders. As Deputies will know, eating disorders are highly complex and involve psychological, psychiatric and general medicine aspects and sufferers have physical, mental and psychological issues. The cost of the aforementioned course is €3,000. The leaflet advises that the course is aimed at professionals, but when the brochure was brought to my attention some years ago, my secretary who has no interest in the area applied for a place on the course. She received a reply immediately, with a hand-written note welcoming her to the course, despite the fact that she had no related qualifications. Thus, over seven weekends, she was able to obtain a diploma in practitioner skills for eating disorders. This illustrates the seriousness of the issue. We must protect vulnerable individuals.

In November 2011, The Irish Timesreported on a high-profile psychotherapist who was charging €3,000 for a course leading to a diploma in the treatment of eating disorders despite having no official professional accreditation in Ireland or medical or psychological qualifications from any university. The psychotherapist claimed that diplomas were accredited to the British Psychological Society but a spokesman for the society stated that it did not recognise any of the courses offered by her organisation.

This case demonstrates the need for regulation. I have been dealing with reputable Irish professional psychology bodies for many years and they do very good work. A total of 22 organisations operate in the field of psychological therapies, including counselling and psychotherapy. This is a broad area which includes marriage counselling and a range of societal counselling. These organisations register people in a proper manner but the looseness of the regulatory environment should have been addressed many years ago. We would not dream of allowing a doctor or nurse to operate without being registered. Perhaps one of the reasons for the lack of regulation is that counselling and psychological therapy is a new field relative to other professions.

I acknowledge the Minister's position on the issue. There is no difficulty in regulating psychotherapists, but how does one define and regulate a counsellor? Are the members of the Council of State counsellors? They are, because they advise the President. There are good community counsellors who know where to refer people and are conscious of the limits of their knowledge. They will not go beyond those limits in advising people on finance, day-to-day living or household budgeting. They do good work within the limits of their knowledge, but we must ensure that people operating in the delicate area of psychotherapy and counselling are regulated. Bodywhys, the eating disorders association, has reported that people have been seriously damaged by unqualified counsellors. As Members will be aware, there is a high level of mortality among those with eating disorders.

I welcome the passage of the Bill. The Minister's objective is to finalise the Bill in 2013.

Alex White (Dublin South, Labour)
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I thank the two Deputies for their contributions on Fifth Stage. Deputy Ó Caoláin inquired about the progress made on registration boards. I can confirm that in addition to the two registration boards already in existence, three more were established on 1 November 2012, giving a total of five, and it is expected that the remaining seven boards will be established during 2013. I thank the Deputy for supporting the Bill. I also thank Deputy Neville, whose knowledge of and feel for this area was eloquently expressed. He also made strong contributions on Second and Committee Stages and the Minister has given a commitment on progressing the matters that he raised.

As is customary at this point, I thank the officials who invested a considerable amount of work in the legislation. Although the Bill is described as technical, it does not necessarily follow that the matters with which it deals are peripheral or easy to address.