Mary O'Rourke (Fianna Fail)

I welcome this Bill and the Minister of State, Deputy Tim O'Malley, to the House. The Minister herself was very welcome here yesterday. When we think of health reform we think of hospitals closing, the Hanly report and various other matters. However, that is not what health reform is all about. This Bill is part of the health reform programme whereby the consumers, the patients availing of the services of the ten bodies enumerated in the Bill, will be ensured a proper regulated service. It is the right kind of legislation and regulation. We often think of regulation as being heavy handed and demanding. This regulation will guarantee that if one goes to a chiropodist or to another health provider or social worker enumerated in the Bill, one receives a certain level of service, knows what this person can do for one and where to lodge a complaint if one feels hard done by. This is serious medical reform that has nothing to do with infrastructure, hospital buildings or anything of that nature. It serves the patient and the consumer.

Patients and consumers are often overcome with mystification about the particular services a practitioner can carry out. I note that we will have legislation on medical practitioners and nurses, which will update and regulate these professions in the light of modern trends and the demands made on people today. Senator Feeney's idea of obliging practitioners to display their qualifications on the wall is a good one. When a Bill is published, we normally receive many letters and telephone calls. In this case, we only received correspondence from physiotherapists.

A survey was done that showed that more than 90% of Irish adults are aware of physiotherapists and almost 30% are aware of physical therapists. I have never heard of a physical therapist, but I have heard of physiotherapy and how difficult it is to get into it, how long and arduous is the course and the work undertaken by physiotherapists. When I hurt my ankle three years ago, I was lucky to have a chartered physiotherapist living near me and to whom I repaired very often. She displayed her qualifications on the wall explaining what she was entitled to do. I found that she was a wonderful woman practitioner.

I had never heard of physical therapists. A physical therapist clearly does more or less the same work, but does not have the same qualifications. There is room for confusion because the terms are interchangeable in 90 countries. If that is the case, we should clear it up and create a common parlance for the remit of the profession. I thank the physiotherapists for sending us the information, because it is useful and was backed up with a survey.

More than one in four people in the survey believe that a physical therapist requires a university qualification, which is not the case and therein lies the danger. We are not being elitist when we talk about a university qualification, but if one spends five years learning one's profession and receives a hands-on training, then one is highly qualified and is capable of carrying out one's profession. If that is not the case, then there is a danger for customers. While someone can claim to be a beauty therapist, how do we know that the person is one? The person may look beautiful, which is a good advertisement for what the person is practising. The person's name is often followed by a puzzling set of qualifications because we do not know where the person got them. I am suspicious of someone who parades 14 letters after his or her name. What does it mean?

I agree with the point made by Senator Ryan. We all become public representatives and we perform a counselling service in our clinics. I do not like the word "clinic" because it betokens that someone who attends it is ill. I do not use the word myself, but it has become common parlance for people doing constituency work. I often find that people who come to see me do not have a real query, but want to tell me something, so I have to develop a listening technique. Senator Ryan was worried that in so doing, we are professing to have a profession for which we have not been trained. It is an interesting question, but life brings forward those skills in people and listening is not a difficult component to acquire. It only requires that we shut up ourselves and listen to someone else. We like talking and like being listened to, so every Saturday there is a change of emphasis in our lives as we are doing the listening.

I have often commented on the lack of engagement between people. If they talked to one another rather than at one another, then the doctors' clinics might be empty. Doctors do not have the time for this. When someone goes to a doctor, the doctor wants to know that person is ill, what is wrong and then wants to write a prescription and send the person on his or her way. The lack of communicative skills is difficult in dealing with patients.

It is interesting that we are now going to impose strictures, qualifications and parameters on all of these practitioners. Years ago, if a patient was ill and in a hospital, he or she would lie there meekly while the doctor would discuss in loud tones what was wrong, where the patient would have to go and what would have to be done. Female doctors would be more discreet in what they were doing, yet no one questioned doctors. No one questioned their qualifications or their pronouncements and the patient went meekly along with it. We were supposed to assume that doctors know best.

This legislation will give us empowerment, a word I dislike but I use it here. Consumers will be empowered and will know the shape and the make of the person to whom they will have to consult on a one to one basis about their ills. That is real power for the consumer. The fact that it is enshrined in legislation will mean that the person who feels that he or she has been wronged by a practitioner can seek redress. I welcome that.

The Tánaiste previously worked in a Department where regulation was heavy handed. I believe in giving more power and knowledge to consumers. They should have a right to find out about who they wish to consult. If they feel that they have been badly handled, they will be able to find out how they can take a case against such practitioners. I like the idea that the general council is composed of 12 members who are from the professions and 13 who are outside people. Why should the professions have a majority? They would only regulate themselves if they had one. It should be weighted in favour of the consumer and that is what will happen with the proposed membership of the council. I welcome the Bill.