Geraldine Feeney (Fianna Fail)

I welcome the Minister for the debate on this groundbreaking legislation. I am delighted this Bill is being taken.

I am unusual in that I am a former member of the Medical Council. I sat on the council from 1999 to 2004 and on each occasion I entered Lynn House in Rathmines during that period I was greeted by people screaming and wanting to know when the Medical Practitioners Bill would be introduced. I congratulate the Minister, Deputy Harney, on the leadership she has shown in bringing forward the legislation. I have to smile at Senator Henry because many were the days on which we asked each other if we would see the Bill being introduced. We thought that we would never do so. When attending meetings at Lynn House during the period to which I refer, I never thought I would be a Member of the Seanad when the legislation emerged.

I have never been lobbied so much on an item of legislation as I have been in respect of this Bill. Some of the lobbying to which I was subjected was good, while some of it was terrifying. I received items of mail in which I was called horrible names and had terrible things written about me. This frightened the living daylights out of me. However, I decided to put them to one side in the hope that nothing further would happen.

I may be the only person in the House who welcomes the fact that there will be a lay majority on the board. I congratulate the Minister in that regard. I recall that she took similar action when she was Minister for Enterprise, Trade and Employment. I spoke to an accountant at the weekend who informed me that there is a lay majority on the board of his profession's regulatory body. He stated that when this was introduced, those in his profession were not too enamoured of the Minister's actions. However, the profession has turned itself around and those in it are now delighted with the lay majority. The Incorporated Law Society of Ireland introduced a lay majority on its own initiative. I have no difficulty with the putting in place of a lay majority and, in fact, I welcome this development.

When I was a member of the council, there were 25 members on the board — 21 medics and four were lay people. Of the four lay people, one was a GP. The latter spent more time dealing with Medical Council issues than he devoted to his practice because he was so committed to upholding the role of the lay person. The individual in question took that role very seriously.

I have the height of respect for Senator Henry, particularly in the context of what she has to say on medical issues. It is because of some of the points she made that I wish to outline some of the experiences I had when serving as a member of the Medical Council. The Senator stated that not having a majority of medical practitioners on the board would be a matter of concern. I do not believe that this will be the case. When I served on the council, it was difficult to encourage members, particularly doctors, to sit on fitness to practise committees. Lay people were always putting their names forward in this regard. I must have been involved in 80% of the fitness to practise cases heard during my five years on the council.

In the latter half of my time with the Medical Council, I chaired the ethics committee. When I first became a member of the council, there was no question but that a lay member could not chair any of its committees. After two and a half years of service, I had obviously proved myself and I was approached by the doctors and asked if I would allow my name to go forward for election as chair of the ethics committee. I reluctantly said "Yes" and was opposed by only two doctors. When I won that vote by double numbers, the sky did not fall and the ethical standard did not drop. I was a safe pair of hands who carried out my duties as well as any doctor. I make these points to show that a lay majority will not be bad for the council.

It was difficult at times to find a quorum of doctors at meetings of the education, ethics and fitness to practise committees. I say this not as a criticism but to acknowledge that the doctors were very busy in their practices. One of the reasons for their inability to attend meetings was that their work for the Medical Council was additional to the responsibilities of their practices.

With regard to the Neary case, the sterilisation of women and the fact that the board of the hospital had a lay majority, I am very familiar with the issues because I sat on the board at the time and none of the 13 cases I investigated involved sterilisation. The women were robbed of their wombs. Sterilisation was an issue from another world and a different decade to the one with which we dealt. From my understanding of the case, Dr. Neary's colleagues turned a blind eye. The pathologist and the anaesthetist did nothing except write a report. I will not use all my time on a discussion of Dr. Neary but if I were a pathologist who received a diagnosis from a doctor that a fungus or other defect necessitated the removal of a uterus but did not find the problem, I might write a report and say no more. If I received a second diagnosis, bells would start ringing in my head. However, if I received 48 diagnoses, I would be breaking down every door in the hospital to see the man directly rather than send him a report because I would be afraid for my practice. The same would apply in the case of the anaesthetist.

I am not sure whether it is fair to compare this Bill's provisions with a lay majority on the board of a hospital run by nuns, clergy and medics at a time when lay members were too afraid to speak out. I make my argument because I hold Senator Henry in high regard. She is a stalwart on medical issues in this House and has a finely balanced mind which I respect.

This Bill will have ground-breaking effects on the medical profession. It is broadly welcomed by the profession and, while certain issues remain to be worked out, I am sure they will addressed on Committee Stage. I was glad to see that the Bill passed through the Dáil without any major hiccups. The council will continue to carry the responsibilities it did when I served on it. I welcome the Minister's clear explanation of the Bill's main functions in protecting the public and regulating the profession.

Education and training is an important area for the Medical Council, so I was glad to read in an article by the Minister in today's issue of The Irish Times that she would not and could not interfere with the setting of standards in medical education and training. The Bill is drafted to prevent any Minister from interfering in that area. The Minister's article was written in response to an article by Dr. Wann published in a previous edition of The Irish Times which suggested that a Minister could use the Bill to unleash unqualified doctors on patients. The profession is indulging in a degree of disingenuous scaremongering in that regard.

I think this a great Bill, although I probably would not know as much about it if I had not had the benefit of sitting on the Medical Council. The council was one of the best educational experiences I have had. It certainly gave me an experience which knew no bounds and I remain in awe of what I learned during my time there. I will, however, speak tomorrow about the exclusion of local authority members. I was not a local authority member but I was often referred to in the Medical Council as a political hack, as the Taoiseach's eyes and ears or as the yes woman of the Minister for Finance. However, I made my mark and people know me best as Ger Feeney who served on the Medical Council.

When I was appointed to the council, people would ask me to explain it to them. I even asked myself the same question when I was appointed. The public does not really understand the role of the council and I would go so far as to say that the medical profession regards it as little more than the body which takes registration fees and strikes doctors off when they get into trouble. Therefore, I am glad to learn there will be better communications with the public. If a member of the public feels he or she has a grievance against a doctor, it takes him or her a lot to put pen to paper to make a complaint. I can say, with my hand on my heart, that any complaint received by the Medical Council while I served on it was dealt with by the doctors and lay members in a fair way. There were times when I would question whether a prima facie case could be made, even though I always put myself in the position of the patient, but when I might have put up my hand to say there was no case to answer, the doctors would have found one.

Fitness to practise is the area of the council's work with which most people are familiar, mainly because of recent high profile cases. I am glad that section 7 provides for the health committee, which was not established until three or four years ago. Many of the doctors who came before the fitness to practise committee did so on health grounds. Members of the public do not expect alcohol or drug addictions to affect their livelihoods if they seek treatment but if a doctor suffers an addiction or a mental health problem, all hell breaks loose and he or she is brought before the fitness to practise committee. During my time on the council, we set up a health committee and I am glad to say that I continue to sit on that committee to represent the public interest. It is the best committee of the council because it deals with doctors in a humane manner. The worst thing to happen to any of us is to undergo an inquiry by our peers in whatever profession we practise. Even if it is decided there is no case to answer, the stigma remains of being inquired into. That is particularly relevant in Ireland, where we say there is no smoke without fire.

We had to stop recruiting for the health committee because too many people offered to sit on it. A wide range of external expertise will become available if there are insufficient medical professionals on the council. I am also delighted to see provision for competence assurance, peer review and clinical audits. To a certain extent, the doctors who appeared before the fitness to practise committee were victims of their environment because they did not have competence assurance. I have spoken at several medical conferences, where I gave the analogy of a pilot who never upgraded his or her skills. I do not think anybody would feel happy to sit in an aircraft flown by such a pilot in the knowledge that he or she had received no further training since receiving a pilot's licence. I will have a great deal more to state tomorrow. I wish the Minister well with the Bill and I look forward to Committee Stage.