Health (Miscellaneous Provisions) Bill 2014

When I and other Members of the House go around our respective constituencies and hold advice clinics, one of the perennial complaints we receive from people in business, farmers and various interest groups is that they are overregulated and that the EU has imposed too much regulation. I have never met, and I am never likely to meet, someone who would not accept the need for the most stringent regulation of health professionals. This is not to suggest for one moment that we should not be thankful and very happy with the high professional standards of the medical people in the country. Having said this, a person in the vulnerable position of being sick or dependent on a service should receive the service in the absolute knowledge it is subject to the most stringent regulation, and that the most stringent disciplines and standards of a professional nature apply. Those who are ill, people with intellectual disabilities, people with addiction and people with various illnesses and, in this very specific instance, people with difficulty with vision and related areas are vulnerable and dependent, and when one is in a position of dependency one needs to be assured of the highest standards and complete care. In this context I welcome the legislation and the tightening up and administrative changes involved.

The substantive matter in the Bill is to subsume the Opticians Board into the Health and Social Care Professionals Council. It merits saying, and I am very proud, that my niece has just opened her own business as an optometrist in Loughrea in the Leas-Cheann Comhairle’s constituency. I know from her and the young people in the profession whom I meet that the educational standards and entry requirements are very high. It is encouraging there will be transparent and very clear regulation. The work of the Opticians Board in ensuring the standards we have today needs recognition, but the Bill is an important reform and it is important every profession in the health area is brought into a very transparent and defined regulatory process.

The second objective of the Bill is to make certain amendments to ensure efficiency and consistency with the legislation governing other health regulators. The Bill will also ensure statutory contributions payable by recipients of residential support services who, while maintained, are not directly accommodated by or on behalf of the Health Service Executive. The Minister of State has explained this is custom and practice at present, and I understand it to be so, but it needs to be included in the legislative and regulatory framework.
The Health and Social Care Professionals Council is an independent regulator established to protect the public by promoting high standards of professional conduct and professional education, training and competence among the registrants of 12 designated health and social care professions. The highest educational standards are crucial.

It was established under the Health and Social Care Professionals Act 2005. It is the extension to include opticians that is at issue. The objective of the council is to protect the public by promoting high standards of professional conduct and professional education, training and competence among registrants of the designated professions. To date, six regulation boards have been established for the professions of social worker, radiographer, dietician, speech and language therapist, occupational therapist and physiotherapist. It is planned to have all 12 boards and their registers established by the end of next year. That is all to be welcomed.

I turn to a question that was raised earlier and is very dear to my heart; I look forward to the Minister of State’s response. I refer to the registration of psychotherapists and counsellors. We have an increasing need for psychotherapy and counselling in so many spheres to deal with the results of substance abuse and various psychiatric or psychological difficulties arising from the various stresses of modern living. People now tend to search the Internet for everything, including accessing the name of a counsellor or psychotherapist, and without much thought just become a dependant and client of that professional. Happily in many instances, there is no difficulty. However, if there are a few, we need to know that the highest educational standards exist, that the highest training and clinical practices exist, and that the counsellor or psychotherapist is of the highest standard or as they would say in the first language of our country, loved by you and me, a Leas-Cheann Comhairle, that they are den céad scoth, tharr barr or nach bhfuil amhras ar bith fúthu. It is important that they are of the highest standard possible and that people can enter into what is an extraordinarily dependent relationship fraught with all sorts of danger because in many instances the client becomes very dependent on the psychotherapist or counsellor.

Tragically, the whole country is blighted by death by suicide. It is particularly prevalent and I have come across many instances in my own community and area. It is a tragic outcome for people. Those who die by suicide do so through no fault of their own; they are in a very dark place from which there is no escape. I am told anecdotally that we need more intervention here. I would be interested in the Minister of State’s response. I believe we need a better cohort of professionals – not better in the sense of a higher standard, but a bigger number of professionals functioning in this area, in the whole area of addiction and the whole area of therapy to prevent death by suicide and to prevent various outcomes. This was drawn to my attention as late as yesterday when I met people at home. That is an important area. I look forward to the Minister of State responding in this regard. I understand from a remark I made privately to the Minister of State that it is her intention to ensure that psychotherapists and counsellors come under this legislation and are so regulated very shortly. It would be nice to hear that again on the record of the House during her response.

It is important that we have a system that investigates complaints which will be the case here. If there are specific professional complaints, we need a procedure for them to be investigated. There must be an assumption that there is a basis for a complaint without demonising the professional or putting his or her career in jeopardy for the rest of his or her life. At the same time, there must be a transparent process of examining complaints, following due process and ensuring that complaints are taken to the nth degree and fully investigated. It is very necessary for the public to know that process exists and that complaints will not just be treated as fanciful or fantasists’ material and they will be properly dealt with. Often tragically in the psychiatric area and in that space around depression and addiction there can be a tendency on all our parts to be slightly dismissive of complaints. That should be the last area that we are insensitive or unresponsive about.
It is important that the legislation brings optometrists and opticians into the regulatory framework and the proposal is to so extend into the future. I share the concern expressed by the Minister of State, Deputy Kehoe, and would be interested in hearing the response on the number of professionals available in the various spheres.

I ask the Minister of State to ensure the regulation of psychotherapists and counsellors, and to ensure there are an adequate number of these professionals to deal with the awful blight of suicide in our society and community. Tragically, the community that I have the privilege of living in and representing has been very blighted by death by suicide right up to the present day. I am particularly concerned in that regard and I look forward to the Minister of State’s response.

Senator Joe O'Reilly representing Cavan & Monaghan 2010. | An ExSite website