29th November 2004
The Health and Social Care Professionals Bill, 2004 is making its way through the Seanad at the moment. It is of great interest to all doctors not just because it concerns so many of our colleagues but because when the Tánaiste introduced the Bill in the Seanad she said she would be bringing in legislation similar to this Bill to regulate the medical and nursing professions. So we can expect the new legislation for the Medical Council not to allow for self-regulation as has happened with the professions covered by this Bill.
There is to be an over-arching Council and then various professional boards. There are to be two types of Committee of Enquiry on disciplinary matters, one a health committee and the other a professional conduct committee. This is a welcome development.
There are twelve professions covered. Firstly, chiropodists, who would prefer to be called podiatrists because podiatrist comes from the Greek meaning 'physician of the foot' and the recognised degree is B.Sc. in Podiatry. Clinical Biochemists come next, and they seem happy to be so named. Then there are the Dieticians - no one has contacted me yet to ask that they be called Human Nutritionists. For the Seanad elections those running for the Trinity seats know them as the Hum. Nuts., B.Sc. in Hum. Nut. being their appellation and a very useful group they are, too.
Medical Scientists are next. I was fascinated to see that at the most recent meeting of the Academy of Medical Laboratory Science obesity and overweight were the major topics. If the folks in the laboratory can see how fat the patients are becoming, we at the coalface will have to take even more notice of what is going on. The rates of obesity and diabetes in Ireland are now nearing U.S. proportions. At the meeting, according to a report in the Irish Times (15 November 2004), Professor Barbara Livingstone of the University of Ulster at Coleraine said that "Overeating, in the sense of taking in more energy than was needed, was the single biggest cause of being overweight, not genetic predisposition or other popular beliefs."
The week before this meeting took place I was at a meeting in the European Parliament, organised by John Bowes, M.E.P., on Research in obesity and Diabetes and the possibility of better co-ordination and resourcing of such research in Europe. It was fascinating to see the different approaches to the problems between the Europeans and the Americans who were there. Nearly 90% of diabetics are Type II, closely associated with overweight and lack of physical activity. The Europeans favoured behavioural change, getting people to eat less and exercise more whereas the Americans felt the search for the magic pill should be prioritised. It was interesting to hear one of the American speakers say that when he is seeking support from members of Congress for funds for research he always emphasises the economic argument of the boost such research will be to the pharmaceutical industry.
We Irish are a most adaptable group of people. Why don't we lead the way in reducing food intake and increasing expenditure of energy by normal methods such as walking? Look at the lifestyle change we made with smoking in pubs and restaurants! It didn't take a blind bit of bother out of us. And what about changing currency from sterling to punts to Euro, and all the calculations done in our heads?
Personally, I think people like Ms. Janis Morrissey, dietician with the Irish Heart Foundation, should be listened to. When she spoke at the Academy meeting she said tackling the weight crisis should not be left to the Department of Health alone. When the report of the Task Force on Obesity comes forth next year we should ask for a multi-faceted response. Departments such as Transport, Sport, the Environment, Education and others will need to be involved, too. Not to mind the County Councils who could make more of an effort to get after those who dig up our roads and pavements and do not replace them properly.
Next in the Bill come the Occupational Therapists, then the Orthoptists with straightforward degrees and training. The Physiotherapists have a problem in that internationally "physical therapist" is a protected interchangeable title for them. "Physical Therapists" who are not physiotherapists are quite new on the scene here and while they are valued colleagues some form of identification of who is who is needed. Psychologists are there and wouldn't it be great if we had a few more of them? But psychotherapists are not in the original Bill. Radiographers include radiotherapists. Social Care Workers and Social Workers with a wide variety of qualifications are covered. And finally, Speech and Language Therapists and would that there were more of them around, too.
This legislation has been sought for at least twenty years. Our colleagues deserve to be in a position to protect their titles and insist on proper qualifications for membership of their registers. Senator Feargal Quinn pointed out during the Second Stage debate that it wasn't all that long ago that people could set up a Chemist's Shop and describe themselves as "Chemist" even though they had no relevant training or experience at all.
Some disappointment has been expressed by some members of the professions covered that they will not be self-regulatory. Lay members are in the majority on all the boards unless possible registrants are put forward as lay members because the regulations do not preclude this. The Veterinary Practice Bill, also before the Seanad from the Department of Agriculture, has members of the veterinary profession in the minority too but, again, if bodies like the Food Safety Authority appoint a vet as their nominee, the vets could gain a majority.
Let us hope the lack of self-regulation for the professions in this Bill, which also allows for other professions to be added, is not because it is felt the medical profession policed itself badly. It is to be hoped the new Medical Practitioners Bill comes forward soon.
Senator Mary Henry, MD
