27 April 2005
Dr. Henry: I move amendment No. 1:
In page 9, line 3, to delete "chiropodist" and substitute "podiatrist".
I welcome the Minister of State at the Department of Health and Children, Deputy Seán Power, to the House to discuss this important Bill. The reason I want the word "podiatrist" substituted for "chiropodist" is that the professionals referred to in the Bill are required to have degrees in podiatry, not in chiropody. My understand is that "podiatrist" is the word considered to be more explicit. Apparently, chiropody has more to do with both the hands and the feet than podiatry. Podiatry therefore becomes a more important issue in the medical field, as the correct word to use. I would be grateful if the Minister of State would accept these amendments, just from the point of view of clarity and in terms of modern usage of the words. It is no more complicated than that.
Mr. Browne: I second the amendment.
Minister of State at the Department of Health and Children (Mr. S. Power): The amendments tabled by Senators Henry and Quinn reflect the current debate within the relevant profession on the most appropriate title. The title "chiropodist" is used in the Bill because that reflects the current more common title by which the profession is known to the public in this country. I appreciate that it is different in other countries.
However, I am aware of the discussion within the profession on the title and the different views held by various groups within the profession. As Senators will recall, on Committee Stage of the Bill my Department undertook to contact the four professional bodies representing chiropodists in Ireland to ascertain their formal views as to which word, "chiropodist" or "podiatrist", should be used as the primary title in the legislation. Two of the professional bodies expressed a preference for "podiatrist", while two wanted to retain "chiropodist" as the primary title.
One of the bodies which wishes to retain the title "chiropodist" claims it represents over 70% of chiropodists and podiatrists in Ireland. The Department's position is to encourage all stakeholders involved to develop an agreed solution to the issue of protection of title, and this is the best way forward. The Department has therefore asked the four professional bodies to revert to an agreed position as to which word should be used as a primary title. The outcome of this request is still awaited.
I hope the Senator will appreciate that in the circumstances I do not propose to accept these amendments.
Dr. Henry: I regret this very much because I do not believe that the 70% of chiropodists, represented by the body mentioned by the Minister of State, are those with university qualifications in podiatry. As the Minister of State knows, we are enthusiastic supporters of the Bologna process, which tries to ensure reciprocity of degrees across Europe. Some 40 countries now subscribe to this and Ireland was one of the earliest signatories. From the viewpoint of transparency and accuracy, it would be much better to use the internationally known name. "Chiropody" may be more commonly used in Ireland at the moment but the degrees we are looking for are in podiatry. In fact the Minister of State is taking advice from people who, while no doubt worthy, are not those who will be among the wave of people looking after foot care in Ireland in the future.
As the Minister of State knows, with the rise of diabetes, this is becoming more and more important. I regret very much he has not taken these very simple amendments on board because the Bologna process is one of the most excellent processes we have been involved in for many years. I wish that had been the framework, rather than consulting with people who will not be determining the future of this discipline in Ireland.
Question put: "That the word proposed to be deleted stand."
The Seanad divided: Tá, 26; Níl, 12.
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Dr. Henry: I second the amendment. Like Senator Ryan, I feel Senator Browne's amendment is more precise and that it would be the better amendment for us to accept.
I return to the Bologna process. What consultation has the Minister had with the officials of the Department of Education and Science about that process and its implications on this Bill? The situation is serious. The document that issued from the meeting of Ministers in Prague on 19 May 2001 describes further actions following on the six objectives of the Bologna process.
An Cathaoirleach: Is this relevant to the amendment?
Dr. Henry: It is very relevant because it is to do with comparability of degrees and the fact that confusion can be caused if we are not careful in the matter. This is the problem here because one qualification involves a university degree whereas the other does not appear to be linked to any third level institution in this country.
On the adoption of a system of easily readable and comparable degrees, the document states:
Ministers strongly encouraged universities and other higher education institutions to take full advantage of existing national legislation and European tools aimed at facilitating academic and professional recognition of course units, degrees and other awards, so that citizens can effectively use their qualifications, competencies and skills throughout the European higher education area.
It is clear that this is not just so that they can move between educational institutions but in order that their employability will be the same. If we allow any confusion in this area, the situation will be serious.
The document went on to state with regard to the promotion of mobility that people should be able to move between different educational institutions and become involved in employment because their degrees are considered comparable. Will the Minister of State in his reply state what involvement he has had with the Department of Education and Science with regard to the Bologna process and the fact that we have done our utmost to ensure there is comparability of qualifications? We want a situation where this is achieved.
I cannot see the situation being helped by the sort of fuzziness being introduced in this Bill. Both professions are highly paid, but they have different entry standards. The physiotherapy degree is one of the most difficult to gain admittance to in our universities, but the entry requirements to get into physical therapy here are much lower. I suggest we make a clear distinction between the two professions. I am not implying there is anything wrong with physical therapists, but they should have a section of their own. The words "physical therapist" should apply only to those with the qualifications of physiotherapist to avoid confusion until we have a situation where we have a special section for physical therapists as qualifying in this country.
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Dr. Henry: On a point of information, the Minister of State did not answer my question and say whether the Department of Health and Children had discussed the Bologna process with the Department of Education and Science when it was introducing this legislation.
Amendment, by leave, withdrawn.
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Dr. Henry: I second the amendment. I am glad Senator Glynn is present because he has a great deal of experience in the psychiatric area. He understands that the damage done to people who are treated by unregulated practitioners is often not just physical. Serious emotional and psychological damage can also be done in such circumstances. That the various groups, many of which have contacted Senators, cannot reach agreement about the qualifications which should be designated does not mean that the Department of Health and Children should not take the initiative in this regard. It should decide which qualifications will be accepted. Other qualifications can be added as the Department sees fit.
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Dr. Henry: I move amendment No. 4:
In page 12, line 21, to delete "not".
It is foolish to dictate that "a registrant is not eligible to be appointed chairperson", as a registrant may transpire to be the best person for the job. We are always ruling people out of jobs. In this instance, we are deciding that a registrant may not be considered for the role of chairperson. I have proposed this amendment because it may be the case that a registrant is the best person for the job.
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Dr. Henry: I never suggested putting forward a registrant with a spine like a begonia. I think it is a pity to rule out people in this way. One might find just the right person for the job and he or she could be ruled out because of this stipulation.
Amendment, by leave, withdrawn.
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Dr. Henry: I move amendment No. 10:
In page 20, line 38 to delete "fostering" and substitute "assuring".
As I said when tabling a similar amendment on Committee Stage, we must do more than foster high standards. Registration boards must ensure high standards. The word "fostering" does not place a sufficient onus on them to do so.
Mr. Ryan: I second the amendment. Senator Henry makes a valid point. Standards should be achieved, not aspired to. Quality assurance involves being as good as the standard that is set. It cannot be merely fostered. People must be assured that standards are met.
Mr. S. Power: In instances where complaints are made against a registered practitioner it is a matter for the council to establish a disciplinary committee to investigate the complaint. The role of each registration board in the disciplinary process is, following the completion of a fitness to practice hearing, to recommend a sanction to be imposed on a registered practitioner. A registration board has therefore no role in assuring high standards of professional conduct. As set out in section 27(3), its function in this regard include giving guidance to registrants concerning ethical conduct and giving guidance and support to registrants concerning the practice of the designated professional. This will be achieved primarily through the formation of by-laws governing codes of professional conduct and ethics. The Bill is intended to protect the public but if, for instance, a person decided against making a complaint they cannot be guaranteed full protection. The word "fostering" is the appropriate word. I am not in a position to accept the Senator's amendment.
Dr. Henry: I do not accept the Minister for State's explanation. This section refers to the object, function and powers of the registration boards. It is stated that the objective is to protect the public, which should require more than fostering high standards of professional conduct and professional education, training and competence among the registrants. That is insufficient assurance for the general public.
Question, "That the word proposed to be deleted stand", put and declared carried.
Amendment declared lost.
Dr. Henry: I move amendment No. 11:
In page 22, lines 22 and 23, to delete "who are engaged in the practice of the designated profession" and substitute "who hold the qualification as indicated in Schedule 3 of the relevant profession".
The wording as it stands is too loose. It implies that no professional qualifications might be required. It is not specified that a person must possess professional qualifications. That is the reason for my amendment. The Minister for State is saying through this wording that it is sufficient to be engaged in practice but professional qualifications should be necessary. It means I could in the morning begin to practise as a councillor, chiropodist, podiatrist or other profession. If this legislation is allowed to go forward, nothing could be done about my lack of qualifications.
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Dr. Henry: I move amendment No. 12:
In page 22, line 28, after "profession" to insert "or where there is no such institution in the State, a person engaged in the education and training of persons with respect to the practice of the designated profession in another Member State of the European Union".
It is important that the Minister examine this amendment because there is no training institution in this country in respect of some of the professions already described in the Bill, for example, podiatrists. I had hoped we could include such an amendment in the Bill because it is very important to have someone who is involved in education on these boards. If we do not have such a person from an institution in the State, and this goes back to the Bologna process, we should get someone from another European country who has the necessary training to assist us until we have institutions as are required.
Mr. Ryan: I second the amendment, which makes eminent sense.
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Dr. Henry: I am very disappointed because it would appear it is better to have no representation from education than to have someone from a country which is aspiring to have the same academic qualifications in that discipline. Again, I go back to the Bologna process and ask if the Department of Education and Science was consulted about this legislation because it has a major bearing on it. We are concerned, as the Minister of State is aware, about mobility of labour and these are the sort of issues that are important. Where will we be if we are told that because we do not have someone from an educational institution on a board, that will not be considered as adequate under the Bologna process?
Amendment, by leave, withdrawn.
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Dr. Henry: Amendment No. 21 deals with the proposals set out in my amendment. I could barely believe the provisions set out in the original Bill whereby a register could be published at the times and in the manner a registration board considered appropriate. The most important point with a professional register is to ensure that those who should be off it are taken off it while those who should be on it are included. Members of the public can then find out who is on the register. The only appropriate approach is to publish the register every 12 months at the latest.
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Dr. Henry: As Senator Browne said, this addresses the concern I expressed on Second Stage. Sometimes complainants do not realise how much information will come out in public. They have to be given the opportunity to have their complaint brought forward in private. People should not be put off by the fact that there may be publicity. I welcome the Government amendment.
Amendment agreed to.
Amendment No. 30 not moved.
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Dr. Henry: I second the amendment. I am sure Senator Ryan is right, in that it would be challenged and that we would all end up in the High Court with this.
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Dr. Henry: Joy will be unconfined when Senator Quinn discovers that this amendment has been accepted. However, of all the amendments that we tabled, which were of great importance to the Bill, this was probably the one about which we were least concerned. However, we must be grateful for small mercies as that is all we have been getting in this debate.
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Dr. Henry: I move amendment No. 35:
In page 50, line 35, after "profession" to insert "for a minimum period of three years full-time practice".
I am aware of the difficulties in dealing with existing practitioners. Grandfather or grandmother clauses are extremely important because we do not wish to see people who, because of the form of training they underwent in the past, are ruled out of practising in their profession. However, the Bill is rather loose in stating that an individual can be registered if he or she has been engaged in the practice of a profession at any time during a period of five years, ending on a relevant date. An individual should be engaged in his or her profession for a substantial amount of time in the previous five years, not just the occasional weekend, which section 90 could be construed as meaning. It is essential to have a minimum period and I have proposed three years, full-time, but I am not rigid on this. However, we need a better description than that contained in the Bill at present.
Mr. Ryan: I second the amendment. It makes perfectly reasonable sense. The wording "at any time during the period of 5 years ending on the relevant date," is incredibly loose.
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Dr. Henry: I am sorry that many of the amendments we tabled were not accepted. I am particularly concerned about the Bologna process. I went to Trinity College and got the relevant documents. Before this Bill goes into the Dáil someone needs to look at it very carefully as regards the Bologna process and to consult with both the Department of Education and Science and the universities as well as the other institutes of higher education involved with these professions. Parts of this Bill will be in conflict with the Bologna process, which Ireland has so strongly supported. No Department is totally independent in so far as the legislation it enacts does not affect any other. I respectfully request that someone looks at the legislation from that perspective before it goes into the Lower House.
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