Seán Power (Kildare South, Fianna Fail)

Senator Browne raised the matter of funding for medical education and training. Given the dissolution of the postgraduate medical and dental board by this Bill, it is appropriate and necessary for the HSE to take over this role. As the primary health employer in the State, it is in the HSE's interest to ensure an adequate supply of suitably trained medical and dental professionals is available. The Prospectus and Buttimer reports recommended the dissolution of the medical and dental board and the reassignment of its functions to the HSE and the Medical and Dental councils.

Senator Tuffy raised the matter of patient safety. The Minister has recently established a commission on patient safety and quality assurance to bring forward proposals aimed at the development of robust quality and safety systems across the health service. Deirdre Madden, a leading expert on medical law and ethics and who was recently elected by the council to chair its ethics committee, will chair the commission. The commission will report to the Minister within 18 months.

There was some debate on the powers of the Minister to issue policy directions to the council. This provision, which is not unique to this legislation, is necessary in that the council is required to undertake its role within the overall context of public policy. It is important the Minister should be able to give direction in public policy matters, for example, in the area of medical education and training. This section is qualified in several ways. The Minister may not issue such directions in respect of ethical guidance matters, complaints, inquiries and sanctions. In addition, any such policy directions may not be construed to prevent the council from performing its statutory functions. Concerns expressed that the section would allow a Minister to deflect the council from doing its statutory duty are therefore unfounded.

Senators Tuffy and Lydon raised the matter of the standard practice of the prevention of Oireachtas Members from membership of the council. This is a matter I discussed with the Minister last week. She has agreed to have the matter discussed at Cabinet with a view to establishing a commission to decide on what committees are appropriate for local authority members or Oireachtas Members. It is clear there are some committees on which elected members could serve a useful role while there are other committees where it might be preferable for membership to comprise non-elected persons. I take the point made by a number of Members that this almost paints local authorities in a poor light but that is not what any of us in this House would want to do.

Senator Quinn raised the issue of competence assurance. The introduction of a formal system for the maintenance of professional competence is new under this legislation and to the medical profession. While the Bill does not lay down in specific terms what each medical practitioner will have to do, it requires each individual to comply with the rules which will be set out by the Medical Council. With the introduction of any system, we must allow for flexibility to make changes over time with the benefit of experience as to what works and what needs to be adapted. There are many stakeholders involved in ensuring that this can take place. The Medical Council, as the competency regulatory authority for the medical profession, will take the lead and employers, including the HSE, will play their play. Individual doctors will have different individual needs, which must be addressed also.

Senator Cox raised the issue of funding. We have ensured that the Bill contains certain provisions which will allow funding for the administration of competence assurance structures and other matters to be provided for the Medical Council. While the council will continue to be funded in the main by the medical profession through the payment of registration fees, we recognise that the State must also share the burden of the costs involved in such issues. We consider that these costs will be offset in this case by the benefits of the quality assurance of the competence of medical practitioners.

A White Paper on future regulation of health professionals was published recently in Britain. It proposes that all health regulatory bodies should have, as a minimum, equality between lay and professional members. This would also include the UK General Medical Council. Therefore, we are not out of sync with our neighbours in what we are proposing in this legislation. While there might be resistance to it from certain quarters, by and large I believe it will be well received throughout the country and it will give us a better health service, which is what we are all working towards.

I thank the Members for their contributions. It is always nice to listen to them, some were from Members with medical experience but each Member brought their own experience to bear in his or her contribution. I thank them for the sincerity of their contributions. Go raibh míle maith agaibh go léir.