Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank colleagues for their support for the Bill and will address some issues raised. The first was whether CORU can do more and do it quicker. I would say most parts of the health service can do more and do it quicker. We have significantly increased the capacity in CORU for exactly these reasons. In 2018, it had 48 whole-time equivalents; now it has 79. There has been a big increase and we will look to do more as it regulates more professions.

The issue of psychologists is important. The background is as follows. The Psychologists Registration Board was set up in 2017. There was a public consultation in 2020 on draft standards for proficiency, criteria for education and criteria for training. There is not a common view within the sector. Many conflicting views were expressed on the use of the title, registration, continuous professional development and all of the other pieces involved. There is a phased approach being proposed. CORU came to me and asked if we could identify highest risk areas and get on with them rather than trying to do a one-size-fits-all. Regulation is always around patient safety. Put simply, who could kill a patient? Who can damage a patient? Those are the people who must be regulated most and quickest. It was proposed we would look at clinical psychology, counselling and educational psychology first as the highest priorities to regulate. I have agreed to that and that work is under way. They think it will take two or three years to regulate. There is a long process required. It is longer than it used to be because of a new EU directive around tests of proportionality that we have two go through.

At the same time, CORU will keep working towards the long-term objective of protecting the title "psychologist" for the reasons we all understand and which were raised. I have allocated €750,000 this year for counselling psychology training places. It is a help. The counselling psychologist were not getting the same support for their PhDs as others were. I met many of them, one of them on the main street in Greystones. We committed to doing it because we need a lot more psychologists trained. That is one useful thing that is being done.

On the political charges, I do not blame Senators for making them. It is fair enough. It will not surprise them to hear I fundamentally disagree. More importantly, the information to hand does not suggest healthcare is unfixable but the opposite. I do not think this is a political charge. I do not think Fianna Fáil and Fine Gael are on one end of it, nor anybody else in politics. The waiting lists were so bad for so long that, for the nation, the narrative was about whether this was fixable. The answer is that it clearly is. Two things need to happen and this Government is pursuing both. One, we have to increase capacity in the public health service to a level never before seen. Two, we need fundamental reform of our health service. Both of those things are happening. Clinicians called for more beds. We have delivered 1,000. There are about another 500 to be completed this year or next. That is about 1,500 beds. As colleagues will be aware, I am seeking agreement across Government for an additional 1,500 beds through a rapid-build programme. If I get Government agreement on that, this Government will have signed off on 3,000 hospital beds. Nothing like that has happened, to my knowledge, before, or certainly not in a very long time.

At the same time, we have increased the workforce. This has been the fourth record year of recruitment into the HSE in a row. It has been about 6,000 per year. We have more than 20,000 extra people working in our healthcare services today versus when Covid arrived. That includes more than 6,000 nurses and midwives, about 2,000 doctors and dentists and more than 3,000 health and social care professionals. We are building up a new community-based service. We have been investing heavily in GPs. I agree that access to GPs is a real problem.

The result of all this is that while in many countries waiting lists are growing up post Covid, in Ireland they are coming down. Last year was the first year waiting lists fell since 2015. This will be the second year. There is a huge amount to be done. I am not for a moment saying the current situation is good enough. It is not acceptable. The number of patients on trolleys is not acceptable but there are record levels of investment and growth in our public service, combined with real reforms like building up a new community-based healthcare service and giving GPs access to diagnostics. I have just come from a meeting with lead emergency department consultants from all over the country on what support they need to get patients moved through emergency departments. The figures are there to be seen. We now have the highest life expectancy in Europe. The five-year cancer survivorship rates have doubled since the 2000s. There are services in women's healthcare that did not exist two years ago. We have built a new service of 94 primary care teams around the country. I am not shying away from the challenges. The challenges are real, the biggest being access. However, the information we see is clear: waiting lists are falling. We are more than capable of addressing the issues that arise.

On Ukrainian doctors, more exams have been put in place. The clinical observers' role is being finalised. We hope to have it in place shortly. With regard to independent practice, once PRES 3 is passed, clinicians can work independently. There will be another PRES 3 exam later this year, which will bring more of them on stream.

I will take a look at physio registration from the UK. I do not have the details with me.

On CORU and regulated professions, at the moment nine professions are regulated. Three more are being prepared for regulation: counselling and psychotherapy, psychology and social care workers, which is the main purpose here. There are another 22, two of which are designated for regulation and 20 of which are aspiring to regulation. It takes time. We need a different approach from the way CORU operates at the moment. It is not its fault. The way it was set up by us in the Oireachtas is every one of these has its own committee and its own complexities. I do not believe that is the way to go. We need to consolidate how this works and speed it up.

Not all professions need to be regulated. In plenty of professions the potential for patient risk is very small. We do not have to regulate everything. The feedback I have had is there are professions who want to be regulated because they think it is the pathway to employment in the HSE. You do not have to be regulated to be employed by the HSE. Psychology is not regulated yet we hire many psychologists all over the country. We need to change the process for professions to be regulated and then work on a patient-risk basis. Where there is a real potential risk of patient harm, they are the ones that need to be regulated first.

I thank colleagues for their contributions and for the broad support for the Bill. Go raibh maith agaibh.