Maurice Hayes (Independent)

I too welcome the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, to the House. It is always a pleasure to have him here. I also welcome the Bill. I am strongly in favour of its main thrust and have just a few points to make, most of which will echo what Senators have already heard.

I am concerned about the qualifications and how they are described, particularly, as Senator Brian Hayes said, in the Third Schedule. The Minister may tell us that people who qualify in Northern Ireland or elsewhere in the UK will be covered by the recognition of EU degrees, but it is very important that qualifications be stated in such a way that there is both recognition and transferability on the grounds that many of the courses proposed as proper for recognition were pioneered on this island by the University of Ulster. They are of very high quality. Equally, when I was working in Northern Ireland, we were blessed with people in various disciplines who had trained in Dublin and elsewhere in the Republic of Ireland. They made an enormous contribution to services.

In passing, perhaps I might deal with the point that Senator Brian Hayes made about tying people to service. I believe that it will be very difficult. I have seen it tried in the past, and when tested it becomes extremely difficult to enforce. There must be a matching of the number of training places to the number of professionals likely to be needed in a society, and that is also a difficult piece of arithmetic. However, I argue for the expansion of most professions supplementary to medicine. Most of the time we have been thinking of such people in hospital settings, but they can transform primary care and keep many people out of hospital through work in the community. I have a little difficulty with the description of a social care worker. I know what a social worker is, but I am less familiar with a social care worker, apart from the child care aspect. I need a little more definition.

I would not like to see bodies tying themselves to the chariot wheel of a university qualification in everything. Some professions, in a desire for legitimacy, have over-estimated the need for university degrees. There is a great deal to be said for the introduction of what in the North are known as NVQs and HNVQs — vocational qualifications. There is much to be said, particularly in hospitals but also for those caring for the elderly in the community, for enriching the jobs of people such as home helps and care workers to give them an interest. Cleaners in hospitals, for instance, are an enormously important part of the caring team, and there should be a way of recognising that too. I am glad that the Tánaiste and Minister for Health and Children, Deputy Harney, has left room for the recognition of other groups. I am thinking of people such as chiropractors, since I am lucky enough to be looked after by one with a four-year degree. Their body seems to be as professionally competent and controlled as any other.

The Bill provides for dealing with malpractice and complaints. However, it does not deal with the question of insurance as opposed to indemnity. Many such people will be working in a health board setting where the employer will look after them, but some may not. There must be something roughly comparable with the Medical Defence Union so that patients who feel that they have suffered and have a case for civil action do not find that there is ultimately nothing with which to compensate them. Like other Senators, I am worried by the emergence of counsellors of various kinds, some of them of doubtful provenance, but some very good. An effort must also be made to provide definition and regulation in that field.

I would like to see attention paid to alternative medicine for two reasons. Some is very good, and some practitioners are excellent, but in recent years many abuses have arisen in the field, including cases of people being exploited both financially and emotionally. The matter is worth addressing, be it in the Bill or elsewhere.

I commend and welcome the Bill. It is a good idea to bring together professions which are supplementary to medicine, and have one body rather than a proliferation thereof. I am concerned about the transferability and mutual recognition of degrees and qualifications across the island.