Geraldine Feeney (Fianna Fail)

I welcome the Minister of State, Deputy Tim O'Malley, to the House. Like other speakers, I welcome the Bill. It is long overdue and, while I did not examine it in detail, the memorandum makes good reading.

I speak from a unique position as a former member of the Medical Council and An Bord Altranais, which are governed by Acts that mirror the Bill before us. In so far as they mirror it, one can take a sheet out of the Medical Council's book or that of An Bord Altranais and state they are well regulated professions. There are a few problems at the edges — perhaps I am being flippant in putting it that way — but I was glad to hear the Tánaiste state that reform of both professions and the Acts that relate to them is due in the near future. Hopefully, whatever is wrong with those Acts will be put right. In saying that, the 26 year old Medical Practitioners Act 1978 has stood both professions in good stead. I do not see why this Bill will not be just as effective.

The Bill, as pointed out by other speakers, is good for the professions given the ever-changing medical world. During my time with the Medical Council, I discovered that patients now go to their doctors armed with much information. They search the Internet, based on their symptoms, and then they quiz the doctor. However, the medical and nursing professions lend themselves to this. There is a partnership between client and doctor or patient and practitioner. While I am never comfortable with the word "consumer" and prefer the word "patient" when talking about medical matters, patients or consumers increasingly take control and organise their own health care, which is quite new. The Bill gives protection to the practitioner but also allows the patient greater accountability and greater insight into what his or her practitioner might be doing.

I have much experience in the area of fitness to practise. In my six years on both medical bodies, dealing with the issue of fitness to practise was the best education I have had. It opened my eyes and ears to matters one would not believe were going on, some very sad and with dire consequences for practitioners as well as members of the public. I am glad fitness to practise is dealt with in the Bill, supported by the capacity of the High Court to deal with certain cases.

I welcome the establishment of a health committee. While the Medical Council set up its own health committee, An Bord Altranais does not have a health committee, or did not when I left it one year ago. Such a committee is a more humane way of dealing with sick practitioners than subjecting them to a full fitness to practise examination, especially when the issue is one of mental health or addiction. They should be dealt with in a kinder way. I am glad the health committee cases will be held in private before being held in public if the case involves the issue of fitness to practise.

Section 59 of the Bill is essential. It enables the council to apply to the High Court for "a section 59", as I am sure it will become known, to suspend a registrant's registration where the council feels the protection of the public may be interfered with in any way. I agree with Senator Henry that if somebody comes off the register voluntarily and is off it for a number of years, continuing education and training should take place.

While I did not examine all the detail of the Bill, I am interested in the area of competence assurance. It is a hard lesson learned by the Medical Council that the competence of practitioners is now as important as their experience. With regard to competence assurance, perhaps measures dealing with peer review could be included in the Bill.

That the Bill deals with mediation is also welcome. As Senator Henry stated, in most cases if one could bring the complainant and the person complained of together, a simple apology would normally sort out the issue and there would be no need for the lengthy legal costs often inflicted on both sides.

I have a concern about other sub-committees of the 12 boards in question. These are all in the health area and ethics is a significant issue for them, including the matter of the confidentiality of patient records. I do not know how detailed they will be compared to medical records and medical histories but there would have to be a history of some kind. What protection will the public have in regard to their records being maintained in a secure manner rather than being exposed?

Registration takes up much of the Bill from section 35 to section 46. I am interested in having some amendment made to the Bill in this area, a matter I will raise on Report Stage. When a certificate is issued, there should be an onus on the practitioner to display it. This does not often happen and certificates are left in drawers or facing down on desks. How are members of the public to know a practitioner is registered unless they see a certificate displayed? Other medical practitioners have their degrees displayed on the wall. While I do not mean certificates must be displayed in nice frames, they should be displayed in paper frames similar to those of children's first day at school photographs. They should also be displayed on practitioners' desks, visible to members of the public.