Brendan Ryan (Labour)

He is most welcome in the House as an old friend.

I feel the Chartered Society of Physiotherapists had a point on the use of language, particularly having read its admirably succinct submission. So many bodies believe that unless a submission is 20 pages long, one will not be impressed. The opposite is the case and I share the views of the former Taoiseach, Mr. Reynolds. If it cannot be put on one page, then the writer does not know what he or she is talking about.

The Tánaiste's speech was a mixture of brave and interesting comments. The brave ones referred to the health strategy again. Until some part of it begins to work as distinct from being an aspiration, the bravest action for the Government is not to mention it. However, the Tánaiste, being the woman she is, did refer to it. Whether one agrees with her, her comments are often interesting in a provocative way. The country should take seriously her reflections on professional regulation. Although I do not agree with her, there is a way of doing things in this country that achieves the worst of both worlds. For example, when one buys a brand new car to use as a taxi, one must have the national car test done on it. This is a classic example of regulation gone mad.

I have always expressed scepticism about self-regulating professions. My profession, engineering, is to a degree self-regulated but it is also regulated by a competitive market. In spite of occasional efforts by the engineering profession and its prominent members, the numbers of engineers qualifying in third level institutions has increased dramatically. The professional institutions have had no real option but to recognise all as professional engineers. Any self-regulatory mechanism must not become a vehicle for protectionism. I am intrigued that there is no section on poor professional performance in the appropriate legislation governing regulation in the Bar Council and Law Society. Although there is a provision for malpractice, no authority is given to either body to adjudicate on a lawyer or barrister who has done a bad job. It is an extraordinary omission and is the best argument against our understanding of self-regulation.

I welcome the Bill yet we are slow to take actions, which are self-evidently necessary. Let us consider the issue of unqualified people practising as physiotherapists. Their victims may have civil cases against them, but they must be entitled to more from the State than just the right to go to court when their spine has been permanently damaged by quackery. I have no political objections but certain issues in this process need to be addressed. I am glad that the councils to be established under this legislation will have a substantial lay membership. No profession should be regulated by a body controlled exclusively by its own members. There is a need for lay participation in, dare I say, the Law Society, the Bar Council and accountancy.

I am glad the Bill's remit covers poor professional performance. In this area, the public must believe there is a simple straightforward process for dealing with a person claiming to be professional, yet manifestly failing to do his or her job.

We often hear people say in dealing with allegations of medical malpractice that if somebody had only told them the truth from the beginning and let them know what was happening they would have had no interest in pursuing the matter through the courts. There is a conundrum there because if one admits to having done something wrong one gives one's opponents a strong case. That is why mediation serves a very useful purpose in this legislation. There are many people who simply want to feel vindicated in their belief that nobody looked after them properly in any profession, including engineering and teaching, the two hats I wear from time to time. I would be delighted to see some proposals to extend this remit on poor professional performance to other professions as well.

The listed professions are the nub of the Bill. I read the Minister's speech on how these professions were chosen with great interest. I do not have a major argument with her about the professions, none of which should be absent from the Bill. One might ask, however, what else should be in it. I am not entirely happy with the criteria. The Minister stated: "The 12 professions to be subject to the provisions of the Bill in the first instance were selected because they are long-established providers of health and social care within the health service and in most instances have experience of self-regulation." I accept some of that but I worry about many new quasi-medical professions in the area of therapy, counselling and so on which are not long established or well regulated. In many cases that is because the practitioners do not want too much regulation nor do they want any suggestion that they would be regulated in the same way as the medical profession. I am married to a consultant psychiatrist and while I have no professional interest in this I might be accused of being part of a lobby, which is not the case.

There are wonderful people working as therapists and counsellors but there are many who appear to be able to do a six or 12 month course in any university and put up a plate declaring themselves counsellors or therapists. This is very dangerous and is why I am not happy with the Minister's emphasis on "well established". This is not a political argument. We must also consider new professions. I am sceptical about practices such as homeopathy. The State has a role in evaluating many of these new remedies which may well work but consumers are entitled to some attempt at objective assessment of their effectiveness. If people want to sell coloured liquids which are otherwise harmless and claim they are cures for baldness then let them at it, as long as we are sure they will not do much harm.