Mary Henry (Independent)

I move amendment No. 2:

In page 12, between lines 6 and 7, to insert the following:

"(4)In subsection (3) 'medical practitioner' means a registered medical practitioner as defined by section 5 of the Medical Practitioners Act 1978.".

I tabled this amendment to the interpretation section on Committee Stage because a medical practitioner is usually described in a Bill. I do not know if it is an innovation not to describe it. It was explained to me by the Minister that she could not accept the amendment because section 24, where the term "medical practitioner" is also used, refers to the possibility of sending patients outside the country for a medical examination. Section 24(4) states: "For the avoidance of doubt the medical examinations which the Board may arrange to be carried out under this section include a medical examination to be carried out in a place outside the State." I hope that happens only in exceptional cases because I hope we have enough expertise in this country. Otherwise, the Bill will be extraordinarily complicated when it is enacted.

I do not want to corner the market for doctors by saying that only people with medical qualifications can give these medical reports. However, it will be the only report in the paperwork which will be available to those giving the assessment. As the Minister of State said when replying to the previous amendment, these assessments will be based on medical, not legal, issues. It is important that we are clear about what we mean as regards this report.

Doctors generally find their work tedious. Before the debate, I took the opportunity to meet Ms Dorothea Dowling, which was organised by Senator O'Toole. From my conversation with her about the medical reports, I understood they would be done by the patient's general practitioner. I am concerned about that because there could be a conflict of interest. While the general practitioner is like a family friend, in the same way as the family lawyer about whom we spoke recently, we have been warned by the Medical Council – I am glad Senator Feeney is in the House because she could give us advice in that regard – that in medical legal reports we should not act as an advocate for the patient. However, if a medical practitioner is the general family doctor, it could be awkward if the report does not seem to be extremely helpful to the patient. It will take little time for the patient to realise that the assessment hangs on the report, which is what I heard today.

Doctors' secretaries will be grateful if medical practitioners, as we generally consider them, do not have to do such reports because they usually have to chase us to do them. This would be an innovation. Perhaps there is other legislation under which one can get reports by chiropractors, acupuncturists, physical therapists, reflexologists or podiatrists. Those people could say they are involved in the treatment of the patient. One probably would be better to go to a chiropodist or a podiatrist with one's feet than to anyone else. I do not want to see these patients disadvantaged by the status given to their reports when they go before the assessment board.

It is important to remember that we have been looking for statutory recognition for such paramedical specialists for 20 years. Unless we have that – apart from the Incorporated Society of Physiotherapists – it will be difficult to know what standards people have attained in training and examinations. A patient will not know it. He or she may feel that someone from America, for example, who has given them good treatment for their back and who is well qualified as a chiropractor would be the best person to give the report. On the other hand, there are people with only paper qualifications who have not done any training or examinations and have little expertise. It would be wrong if such people were in a position to give reports and if patients then found out they would not be given the same status as those given by a doctor.

I do not know if the Minister of State has seen reports by people such as chiropractors, acupuncturists or reflexologists, but the language is totally different. I realise the board does not have any members with medical or nursing expertise unless some trade union members from such a discipline are appointed. The committees will have expertise. Is it proposed to include people from the disciplines I mentioned on these committees? It could become cumbersome if committees must include specialists in the areas I mentioned. I would be grateful if the Minister of State could explain that when he tells us what he thinks about it.

There is not any question that doctors want to corner the market. This seems to be a major change in the type of medical reports for personal injuries which usually come before the courts.