Sean Barrett (Independent) | Oireachtas source

I welcome the Minister of State. We had the Minister for Health, Deputy Varadkar, in the House earlier in the week and he had many interesting thoughts, including his views on the ambulance service and how it might be adapted to treating people in their homes or in the ambulance, rather than being - without wishing to be derogatory - a taxi service to an already overcrowded accident and emergency unit. That was interesting thinking. He volunteered the Minister of State, Deputy Lynch, to come to the House and talk on mental health. I do not know if he has told her this yet but he did volunteer her to do this later on in the term.
The Minister of State mentioned, on the first page, the furtherance of the ongoing programme of State agency rationalisation. There is a danger, as Senator Crown said, that agencies become an end in themselves. Bureaucracy can have its own object, namely, to maximise its functions and its budget through mission creep and so on. The Department of Health and indeed central government, perhaps the Department of Public Expenditure and Reform, have to keep an eye on these agencies because they can just grow like Topsy. We had a bank regulator who mysteriously missed everything that was happening in the banks. He was recorded in the The Irish Timesas having forgotten vital facts about 89 times. Putting something under a regulator may not always be the complete answer. We have had some unsatisfactory experiences in other fields of endeavour as well. Statutory regulation carries its dangers.
George Bernard Shaw wrote that "all professions are a conspiracy against the laity", that is against the public interest. The professions devise new ways of keeping people out. That is something we have to watch out for. One example that particularly irritates me and the former Senator, Dr. Mary Henry, is the health professions admission test, HPAT, which seems to be a mechanism designed to prevent women from entering medical school when we need women doctors. It is as though the men in that profession decided on a new system because they felt that women were gaining far too many places through the leaving certificate points system. They have managed to get away with that, as far as I can see. That is on page 2.
The other danger I see is that when the State regulates a profession, the profession, with legal assistance, seems to assume that because the State regulated it, the State must provide compensation for every single mistake that it makes. That has a current cost of about €1 billion in the State Claims Agency. Our colleague, Senator Burke, has asked that there be compulsory insurance for people in cosmetic surgery, for example. I think he has a Bill before the House on that issue. Rather than say that the State regulates that profession and therefore the State must pick up the tab for incompetence, we should have a requirement that people have insurance in those cases.
The Minister of State mentioned that the Department of Health would ask CORU to prepare a risk assessment. The briefing document we got from the Oireachtas Library and Research Service quotes a statement from CORU that its name:

"...originates from an Irish word, "cóir", meaning fair, just and proper. These are values that resonate deeply within our organisation and perfectly reflect our commitment to protecting the public by regulating health and social care professionals. CORU is not an acronym.

I have certain reservations when people call themselves "the caring professions" in that way. We all care. Everybody in Leinster House cares, in the Dáil and the Seanad. Families care. Even dismal scientists and economists care. There is a certain sanctimonious content when bodies issue those kinds of statements about themselves.
There are misgivings, of which the Minister of State may be aware, on ophthalmology and the opticians. Senator Crown has referred to those. The president of the Irish Association of Dispensing Opticians expressed a fear that the reference to the selling of glasses could deregulate the more professional and technical areas as well. I am sure that is something the Minister of State will be thinking about between now and the next Stage.
As has been stated, the Bill does command wide support in the House. Senator Crown has spoken on behalf of the university panel. It is the right way to proceed. A point has been raised about the reference on the first page to the consolidation and furtherance of the ongoing programme of State agency rationalisation. We found that in a lot of cases there were no savings. That is a pity, because the less we can spend on bureaucracy, the more we have for the objectives that we all share and that the Minister of State wishes to promote. Notoriously in the case of water, we were supposed to save money by putting 34 bodies together and they went and recruited 900 extra staff. There must be some way in which the Cabinet can say "the case has been made that there will be a programme of rationalisation of bureaucracies and agencies so let us see the savings now". I hope there will be a stronger emphasis on that because just allowing bureaucracies to grow when we have so many vital national priorities is too expensive a way to proceed.
I thank the Minister of State for coming to the House and wish her well with this legislation.