Thursday, 3 May 2018
Health and Social Care Professionals
I thank the Minister for coming to the House to discuss this very important issue. I have been contacted by the Irish Society of Chartered Physiotherapists, which has concerns regarding the review last year of a statutory instrument that is currently being drawn up and that will include a list of health professionals entitled to refer individuals for X-rays. The statutory instrument in question is in draft format at present. Across Europe and the world, physiotherapists have the right to refer people for X-rays and this is in keeping with best international practice. However, physiotherapists in Ireland are not allowed to do so and they are included on the list to which I refer.The aim of the physiotherapists is to optimise the accurate diagnosis and clinical interventions they provide to people. It is in line with advanced physiotherapy practitioners internationally. The Irish Society of Chartered Physiotherapists, ISCP, was very disappointed that it was not invited to participate in the consultative practice that was held in June 2017. I understand the society has written to the Minister for Health, Deputy Harris, and to the Department and that the Minister referred the matter to Dr. Tony Holohan, the chief medical officer, for examination. I understand that a meeting is to take place shortly in respect of considering this matter. At present, people who attend a physiotherapist and who need an X-ray must be sent back to their doctors, who must then refer them for the X-ray. This is about time and better patient outcomes because the patient is at the centre of this process, after all. Physiotherapists do not refer people for an X-ray lightly. It is only if they have a concern and are not quite sure what the injury is. It quickens up the process as well in terms of the treatment the patient will receive at the other end. I am interested in hearing the Minister of State's thoughts.
I thank Senator Maria Byrne. I apologise on behalf of the Minister, Deputy Harris, who unfortunately cannot be here. He has asked me to reply to the Senator on this matter.
The matter relates to the transposition of medical provisions for the basic safety standards directive by the Department of Health and whether physiotherapists will be designated as referrers in the transposing regulations. The basic safety standards directive, for which the Department of Communications, Climate Action and Environment has overall responsibility, is important European legislation. It aims to protect the public, patients, workers and others from all forms of ionising radiation. While ionising radiation has had beneficial applications, as the use of ionising radiation increases so does the potential for health hazards if not properly used or contained. The directive enhances and strengthens a number of concepts in radiological protection. The directive stresses the need for a high level of competency and a clear definition of the responsibilities and tasks among all professionals involved in medical exposure. This is to ensure the adequate protection of patients undergoing medical radiodiagnostic and radiotherapeutic procedures. In transposing the medical provisions of the directive, the Department of Health sought the advice of the medical exposure radiation unit, MERU, in the HSE and a group it established to inform the transposition process. The Department conducted a consultation exercise in June 2017 on certain provisions of the directive. The consultation was posted on the Department's website and notified to likely stakeholders. The Department also made arrangements to ensure that licenceholders of ionising radiation equipment were notified of the consultation process. The directive defines referrers and practitioners with certain roles and responsibilities attached to the roles. The statutory instrument transposing the directive will designate some who may refer from radiological tests and in this regard, it is proposed to designate nurses, doctors, dentists and radiographers as appropriate.
The Physiotherapists Registration Board, established under CORU, opened its register in 2016. The two-year transition period ends in September 2018, when all existing physiotherapists must register, after which time only those registered can practise as a physiotherapist and use the protected title of physiotherapist. Physiotherapists are not registered as referred in the current regulations, Sl 478 of 2002, and it is not proposed to designate them in the new regulations. Not all regulated professions will be designated as referrers in the new regulations. It would not be appropriate to consider this matter in the context of the directive alone.
While there are no current plans to extend the scope of practice of physiotherapists, the Minister for Health launched the national strategic framework for health and social care workforce planning in November 2017. It is intended that the framework will support the recruitment and retention of the right mix of health workers across the health system to meet planned and projected service need. In that context it is envisaged that in due course, matters relating to health and social care professionals such as physiotherapists, including scope of practice, will be considered through the framework structure currently being established. The Department of Health is working to finalise the transposition of the medical provisions of the basic safety standards directive in the coming weeks.
I thank the Minister of State. It is disappointing in one way that physiotherapists are currently not included and that there are no plans. I acknowledge it is up for consideration but they have the support of many organisations such as the triage steering group, the national clinical programme for rheumatology and the national clinical programme for trauma and orthopaedic surgery. Basically, physiotherapists play a crucial role in people's health and in people coming back to health. They are fully trained and have their practice and experience behind them. I hope the Minister of State will be able to bring to the notice of the Minister, Deputy Harris, that he might be in a position to reconsider it in terms of the review and what he is currently examining.
I note the Senator's concerns in this regard and what she said about physiotherapists not being included. I will raise the issue again on the Senator's behalf with the Minister but there will be further consideration in the framework and as stated in the reply, until those structures have been established I cannot give the Senator any further information.