James Reilly (Dublin North, Fine Gael) | Oireachtas source

I thank Senators for their support for the Bill and for their contributions and the questions raised.

Senator MacSharry raised the issue of fitness to practise committees under section 6. We need at least two committees to be in place and these have not commenced yet because the three new registers and the social work register have only recently been added. These committees will commence next year.

A number of Members asked about establishing registers for other health-related fields. They could make submissions to the Department. Many of them mentioned specific areas, some of which I am interested in. For instance, acupuncture is valuable and it works, particularly for pain relief. I would much prefer people to have acupuncture on a weekly basis than to take non-steroidal anti-inflammatories, which can destroy their kidneys and cause gastrointestinal bleeding.

Acupuncture is a safe alternative, particularly in older people, but we do not have any university here that has a prescribed course, therefore, one is at the mercy of the person delivering the service. It is an area I would like examined. I would like to see some of the colleges provide a course on which we could rely to produce suitably qualified individuals to provide these services. The same applies to reflexology, not to the same extent, but it certainly can have a role in respect of relaxation.

Senator Marie Moloney asked about registration costs, an issue also raised by Senator John Kelly. The reason it is more expensive for social workers to register is that they number only in the hundreds whereas there are 60,000 nurses. If one has to support the same super structure with fewer people it will obviously cost more. As to who set the fee, at the behest of the unions I entered a long discussion with them on the fee because I did not want people to have lots of frills in respect of the register that are unnecessary when those who have to register have to pay the bill.

Senator Mary Moran raised the issue of an individual from the US. The same processes apply. Obviously it is in our interest and I would like to see a minimalisation of red tape in respect of professionals coming to this country as we need them. As the traffic is often in the other direction, it is good to get some coming this way. The time period allowed is four months. That should be the case unless they have not provided the appropriate documentation which can hold up the process. Clear information is provided on the Department's website but that is not to say that individuals do not run into difficulty from time to time. It is an area that must be kept under active review because we should not do anything to obstruct suitably qualified people coming to the country to deliver care.

Senator Ó Clochartaigh mentioned the recruitment embargo. The reality is that the embargo has to stay in place but we said we would be much more flexible around it; we will be and have been in the past and will be more so next year. However, we face a serious challenge - I do not want to get into that discussion - in the health budget next year. There are 3,500 staff who must go. Considering that there are 37,000 plus nurses in the Health Service Executive manpower, sadly nurses cannot escape, therefore, we have to go back to changing the model of care that I mentioned, that is, ensuring that the right patient is seen by the right person in the right place at the right time. So often, that is not the case in the current system. There are nurses looking after people that health care assistants could look after. There are general practitioners looking after patients that nurses and physiotherapists should be looking after. There are patients being looked after in hospitals that should be looked after in the community. There are consultants looking after patients that others should be looking after. A big job of work is being undertaken through the clinical programmes, the SDU. That is ongoing and we continue to make progress. Obviously we would like if the progress was faster but the reality is that one never gets to where one wants to as quickly as one would wish but that does not mean one should not continue to strive to do so and we certainly will.

The issue of herbalism and herbalists was mentioned. Currently the product is regulated under the medicines legislation rather than the actual practitioner. One could look at herbalism and traditional medicine. That is a whole area that needs to be explored. Just because I am a doctor does not mean I close my eyes to these issues. My view is very simple, if it works, it works and as long as it can be proven to work and in repeated control trials to be seen to work, why not have it available to one's citizens. There are other jurisdictions we can look to where they have got structured training in these areas and have degrees from universities that ensure that the individual who is practising is competent in the area. We know this can be looked at but the most pressing issue for us, outside of those mentioned here, has to be counselling and psychotherapy. Given the high rate of suicide in the country we have to ensure we have got the professionals suitably qualified to help us deal with the mental health requirements of our people.

I thank all the Members for their contributions and support.