Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I am pleased to have the opportunity to address the House on the Bill, which was initiated in the Dáil last February and passed on 6 November. The principal aim of the Bill is to improve registration and fitness to practise processes in the health professional regulatory bodies and to amend their Acts in accordance with the modernised professional qualifications directive.

While the Bill was widely supported by the parties in the Dáil, Deputies raised concerns on Committee and Report Stages about the mandatory publication of all sanctions and the additional cost and publicity associated with High Court confirmation of minor sanctions. On Report Stage, a commitment was given to review this and I am pleased to advise that significant progress has been made. Officials from my Department have been liaising with the unions, the professional representative bodies and the health regulators. While these discussions have not yet concluded, proposals are at an advanced stage and I intend to introduce a number of amendments on Committee Stage. As Senators will appreciate, I must balance the necessity to achieve public protection and enhanced transparency in professional regulation with the legitimate concerns of registrants who receive a minor sanction. I am confident that this balance can be achieved and I look forward to discussing the finalised amendments in more detail with Senators on Committee Stage.

This is largely a technical Bill containing seven Parts and 179 sections. The Bill amends the five health professional regulatory Acts, which are the Dentists Act 1985, the Health and Social Care Professionals Act 2005, the Pharmacy Act 2007, the Medical Practitioners Act 2007 and the Nurses and Midwives Act 2011. Many of the Bill's provisions are intended to be common across the five regulatory Acts. The Bill also makes some minor amendments to the Health Act 1953, the Health Act 2004, the Health Identifiers Act 2014 and the Children and Family Relationships Act 2015.

The Bill contains a number of measures intended to improve and streamline the fitness to practise procedures employed by the five regulators. With the increased mobility of health professionals, the importance of maintaining patient safety, while supporting professional mobility, is ever important. Additional grounds of complaint are being introduced. These additional grounds will mean that a complaint can be made against a person who has a restriction or prohibition on the provision of one or more than one kind of health or social care service in Ireland or in another jurisdiction. This will mean, for example, that a complaint can be made against a person who has had a restriction or prohibition on his practice as a doctor, but who may be practising in the State as a dentist by virtue of his separate qualifications and registration in that field.

Amendments are also being made to the fitness to practise provisions of the five Acts to provide that regulatory bodies can use disciplinary information from other countries in fitness to practise cases in Ireland. Currently, the modernised professional qualifications directive provides important mechanisms for alerting health regulators across Europe when a sanction has been applied. However, under the directive there is no obligation on third countries to share information on restrictions or prohibitions on the practice of health professionals in their jurisdictions. It is important that the regulators are aware of such restrictions or prohibitions on the practice of any registrant or applicant for registration, including those from third countries. This will be especially important in respect of the UK post Brexit. The Bill, therefore, provides that all regulated health professionals will be required to make declarations at registration and annually thereafter regarding any restrictions or prohibitions on their practice in this State or another state, as well as any relevant proceedings that are pending or in process. It is important to note that the health regulators have been actively engaging with their UK counterparts to ensure that robust mechanisms will be in place for the exchange of information post Brexit, and the Bill includes provisions to ensure compliance with data protection legislation.

The five Acts also provide that information on sanctions is notified to the Minister, the HSE and the employer, where known. The Bill is removing the requirement for the Minister to receive such notifications, as the Acts specify no function or legal powers associated with receipt. Notification to the HSE and employer will remain. Currently, information on sanctions imposed by each of the five regulators is published if the regulator is satisfied that publication is in the public interest. The Bill sought to change this and, when initiated, it provided that all sanctions imposed in the State would be published. Concerns were subsequently raised by the health professions' representative bodies about vulnerable registrants and on Committee Stage an amendment was introduced to provide for publication unless the court determines otherwise. The provisions on the publication of sanctions continued to be a matter of debate during the Bill's passage through the Dáil and, as I indicated earlier, it is intended to address these in detail on Committee Stage.

The Bill includes a number of amendments intended to increase the effectiveness of the fitness to practise processes. Currently, under the Medical Practitioners Act 2007 and the Nurses and Midwives Act 2011, complaints are directed to the preliminary proceedings committee for investigation, and progress on investigations is dependent to an extent on the scheduling of committee meetings. To expedite investigations, the Bill provides that complaints will be made to the chief executive officer, CEO, and will be investigated prior to being referred to the preliminary proceedings committee for decision. This will shorten the time to process complaints and will mean the preliminary proceedings committee's time can be used more efficiently in making decisions on complaints. This will be of benefit to the regulator, the complainant, the registrant, witnesses and, ultimately, the public.

Another important provision is the separation of qualification recognition from registration in those Acts where it is not currently provided, namely, the Dentists Act 1985 and the Medical Practitioners Act 2007. These Acts currently provide that a professional whose qualification has been recognised must be registered. Separating qualification recognition from registration will allow these regulators to introduce language and fit-and-proper person checks prior to registration and will enable the regulators to take the appropriate action where these checks are not satisfactory. Additional changes provided by the Bill include an amendment to the Health Act 1953 to remove specific requirements regarding the composition of interview boards for medical consultant posts. These requirements are an unnecessary burden and do not lend themselves to efficient recruitment processes.

A number of amendments were made to the Bill during its passage through the Dáil. These include changing CORU's fitness to practise process from three stages to two stages to bring it into line with that of the other health regulators. This additional step generates a significant cost and delay and places an administrative burden on the regulator. Its removal will significantly improve the fitness to practise sanction process for CORU registrants.

A Committee Stage amendment was also sought to create an eligibility for registration on the specialist division of the Medical Council's register by a small cohort of medical practitioners who were correctly appointed to consultant posts prior to 2008. These medical practitioners, for various reasons, did not avail of a grandfathering provision provided for them to register in the specialist division when the Medical Practitioners Act 2007 was enacted. The amendment provides that a consultant must have been correctly appointed to his or her post under the terms in operation by the HSE in 2008 and must satisfy competency requirements for registration by the Medical Council. This amendment benefited from close examination on Committee Stage in the Dáil and I am pleased to advise Senators that suggestions proposed by the Opposition spokespersons were taken on board and agreed on Report Stage.

Following publication of the Bill, concerns were notified to my Department about some possible unintended consequences relating to the composition of committees of the Nursing and Midwifery Board associated with the Bill's drafting. These were addressed by amendment on Committee Stage in the Dáil. The Bill was also amended to give the Minister the power under the Health Act 2004 to designate the HSE as the competent authority under the professional qualifications directive to compare the equivalence of non-Irish qualifications to the qualifications the HSE sets. This applies for certain health professions which are not regulated on a statutory basis, but which are regulated for the purposes of the directive. The professions which currently come within the scope of the directive are those of audiologist and environmental health officer.

These are the Bill's key provisions and the changes since its initiation in the Dáil. I look forward to discussing the Bill in more detail on Committee Stage. I commend the Bill to the House.