Various Health Professionals

Table of Contents

Opticians

The legislation in respect of opticians is older and contains less detail in terms of modern constitutional standards. The Opticians Board consists of persons elected by opticians, persons interested in certain related professions and other persons who may be appointed by the minister. Provision is made for representatives of ophthalmic opticians and dispensing opticians.

The legislation does not specify in detail, the circumstances in which persons may be removed from the register. However constitutional justice would require a procedure similar to that provided under more modern legislation. There is provision for appeal to the High Court.

The board maintains the register of ophthalmic opticians. There is a register of dispensing opticians. There are parallel provisions in relation to the register of dispensing opticians and the register of ophthalmic opticians.

Regulation

The board may provide for

training and education,
the holding of examinations and
approval of training institutions.

There are restrictions on prescribing spectacles and dispensing prescriptions for spectacles. Persons must be registered medical practitioners or ophthalmic opticians. It is an offence to improperly take or use the name of an ophthalmic optician or other similar words or imply membership of dispensing optician register.

The board has the powers to make rules as provided under the legislation. It may make rules regarding the regulation and control of prescription of spectacles by ophthalmic opticians, registered medical practitioners. The board may make rules in respect of advertising and canvassing.

Modernisation

Ophthalmic opticians are re-titled, optometrists. The register of ophthalmic opticians became the register of optometrists under amending legislation in 2003. Penalties were updated.

The board maintains the register of optometrists. It deals with recognition of persons with EU qualifications.

The 2003 legislation deregulated the sale of ready readers Spectacles do not include ready-made reading spectacles, sunglasses, goggles. Contact lenses are included in the definition of spectacles.

Health and Social Care Professions

The Health and Social Care Professionals Council regulate the following professions:

Clinical biologist;
Dietician;
Medical scientist;
Occupational therapist;
Orthopedist;
Physiotherapist;
Podiatrist;
Psychologist;
Radiographer;
Social care worker;
Social worker;
Speech and language therapy.

Further bodies may be designated by the Minister for Health.

Role of Council

The Council oversees the activities of the various registration boards. It provides administrative support and assistance. It establishes committees of enquiry into complaints against the designated professionals.

The Council may make rules in relation to the establishment, management and functions of registration boards for each profession. It may maintain registers.

Registration boards are established for the above-designated professions. Registration boards

establish registers of members,
monitors continued suitability of programmes of education and training for applicants,
gives guidance concerning ethical conduct,
makes recommendations in respect of sanctions.

Membership boards are to be appointed by the minister to include persons from the profession, with others who are representative of educational interests, management and representatives of the public interest.

Registration Boards I

The Council’s chief executive is the registrar of each registration board. The registration board may make bye-laws relating to the appointment of professional members of the Council,

qualifications and proficiency,
applications for registration,
procedures for awards, training, education
continuous professional development,
codes of conduct and other matters.

Registration boards may establish committees to perform their functions.

Registration Boards II

Registration boards approve education and training standards. They must monitor continued suitability of education and training bodies and providers.

The registration board must maintain the relevant registers. Professional designations may not be used without the requisite registration. Failure to do so is an offence subject prosecutable by summary proceedings or indictment.

Fees must be paid for the maintenance of registration on an ongoing basis. There may be provisions for appeals against refusals of registration.

A person may apply to the Council for cancellation of the decision by a registration board refusing registration or refusing restoration of membership. There are provisions for appeals to Court against the Council\’s decision.

Conduct and Discipline

The Council establishes a preliminary proceedings committee, a professional conduct committee and a health committee analogous applicable to the Medical Council. The grounds for complaint and procedures are broadly similar to that applicable to the Medical Council.

The preliminary proceedings committee may refer the matter to the disciplinary committee of enquiry. They may refer the matter to mediation if and where agreed.

There are procedures for the conduct of hearings. Witnesses may be summoned and the hearing committee has similar powers to those of a High Court Judge. A report to Council is made by the committee of enquiry in relation to its finding.

If the allegation is substantiated the Council requests the opinion of the registration board in relation to disciplinary sanctions. The registration board may recommend to the Council sanctions ranging from censure to the imposition of conditions, suspension, cancellation or strike off.

The decisions should not take effect until confirmed by Court. A person affected can appeal to Court on the merits. Otherwise, the Council applies to Court to confirm the decision. The Court confirms the Council\’s direction unless it has good reason not to do so.

2014 Amendments

The Health (Miscellaneous Provisions) Act 201 4has three main purposes:

to subsume Bord na Radharcmhastóirí (the Opticians Board) into the Health and Social Care Professionals Council by providing for the repeal of the Opticians Act 1956, under which the professions of optometrist and dispensing optician were formerly regulated, the dissolution of the Opticians Board and the application of the Health and Social Care Professionals Act 2005 to the professions of optometrist and dispensing optician; •

to amend the Health and Social Care Professionals Act 2005 to divide the designated profession of radiographer into the two designated professions of radiographer and radiation therapist, to permit a registration board to regulate two or more designated professions, and to introduce uniformity between that Act and certain provisions of other Acts which regulate medical practitioners, nurses and midwives; and

to ensure that statutory contributions are payable by recipients of residential support services who are maintained, though not directly accommodated, by or on behalf of the Health Service Executive.

The decision to subsume the Opticians Board into the Health and Social Care Professionals Council and to bring the regulation of the professions of optometrist and dispensing optician within the ambit of the Health and Social Care Professionals Act 2005 was taken in accordance with the Government’s programme of Agency rationalisation.

The Health and Social Care Professionals Act provides for the statutory regulation of the twelve professions currently designated under the Act, namely the professions of clinical biochemist, dietitian, medical scientist, occupational therapist, orthoptist, physiotherapist, podiatrist, psychologist, radiographer, social care worker, social worker and speech and language therapist.

Regulation is primarily by way of the statutory protection of professional titles by confining their use solely to persons granted registration under the Act. The structure of the system of statutory registration comprises registration boards, a committee structure to deal with disciplinary matters, and a Health and Social Care Professionals Council with overall responsibility for the regulatory system.

The Act increased the number of designated professions to fifteen by designating the professions of optometrist and dispensing optician and by dividing the designated profession of radiographer into the two designated professions of radiographer and radiation therapist.

The professions of dispensing optician, optometrist and radiation therapist are designated. The Health and Social Care Professionals Council (the Council) is to elect a deputy chairperson. The Health (Miscellaneous Provisions) Act 2014 allows for the delegation of the functions of the Council or a registration board to the chief executive officer or to a member of staff of the Council if the chief executive office is absent or the position is vacant.

The Optical Registration Board is the registration board for the designated professions of optometrist and dispensing optician. The Radiographers Registration Board is the registration board for the designated professions of radiographer and radiation therapist.

The registration board is to establish a register for each of its professions and to delegate its functions to the registrar of a registration board.

The Registration board has power to make bye-laws including power to make bye-laws relating to the prescription and sale of spectacles. Aregistration board shall enter in the register the name of a temporary service provider entitled to use a title specified or prescribed under the Act and whose professional qualifications have been assessed and verified under Title II of Directive 2005/36/EC on the recognition of professional qualifications.

The radiographers division and the radiation therapists division of the radiographers register are deemed to be the register of radiographers and the register of radiation therapists respectively.

Optician & Optometrist

The Health (Miscellaneous Provisions) Act 2014 provides for the registration of

optometrists and dispensing opticians who had previously been registered under the Opticians Act 1956,
existing or former health or social care practitioners holding certain historical qualifications awarded in the State,
optometrists who satisfied the training and examinations requirements of the Opticians Act 1956 immediately prior to its repeal, and
persons holding qualifications awarded in the State that renders them eligible to be employed by the Health Service Executive.

A registration board, in the interests of public safety, may attach conditions to the registration of a person who has a relevant medical disability. The Council, if it is in the public interest, to immediately cancel the registration of a registrant in the case of a complaint on the grounds of conviction of an indictable offence.

The Council may appoint persons to assist the preliminary proceedings committee. The Council may make an ex parte application to the High Court for an order directing a registration board to suspend the registration of a registrant and that the application shall be heard otherwise than in public unless the Court considers it appropriate to hear it in public. Provision is made for the publication of a transcript of all or part of the proceedings of a committee of inquiry.

There are provision for restrictions on prescribing, dispensing prescriptions and selling spectacles, for the making of bye-laws for the regulation and control of these activities and for the control of advertising.

Regulations may be used for the provision of additional professional titles that may be used by the members of categories of registrants where registers have been divided into divisions. The Council has general powers to investigate possible contraventions of the Act by persons other than registrants.

One half of the members of a registration board first constituted will hold office for a term of 3 years instead of 2 years.

2012 Act

A number of amendments were made in 2012 to the Health and Social Care Professionals Act 2005 to ensure the effective functioning of the Health and Social Care Professionals Council and the registration boards established under the Act. These amendments mainly concern membership, fees, fines and registration criteria. Amendments are also required to take account of the provisions of Directive 2005/36/EC of the European Parliament and the Council of 7 September 2005 on the recognition of professional qualifications and also to provide for the assessment and recognition of qualifications obtained outside the State which are outside the scope of the Directive.

The 2005 Act provides for the establishment of a system of statutory registration for the following twelve designated health and social care professions: clinical biochemist, dietitian, medical scientist, occupational therapist, orthoptist, physiotherapist, podiatrist, psychologist, radiographer, social care worker, social worker and speech and language therapist. Only registrants will be permitted to use these titles when all the registers have completed their two-year transitional periods.

The structure of the system of statutory registration comprises a registration board for each of the twelve designated professions, a Health and Social Care Professionals Council with overall responsibility for the regulatory system and a committee structure to deal with disciplinary matters.

The Health and Social Care Professionals Council was established in March 2007. In August 2010, the Minister established the first of twelve registration boards, the Social Workers Registration Board, and, following the making by the registration board of the necessary bye-laws, the board established its register in May 2011. When the two year transitional period ends in May 2013 the social worker profession will be fully regulated under the Act.

The Radiographers Registration Board was established in December 2011 and it is envisaged that it will establish its register in the fourth quarter of this year. A further four Registration Boards are due to be established by the Minister during 2012.

Purpose of 2012 Act

The main purpose of the Act is to amend the Health and Social Care Professionals Act 2005 to allow the Minister to continue to appoint professional members to the Council until such time as the twelve registration boards are established under the Act and are in a position to nominate elected members. Due to unforeseen delays in establishing the twelve registration boards and their registers under the 2005 Act the Minister for Health was unable to appoint professional members to the Health and Social Care Professionals Council on the completion of the terms of office of the twelve such members appointed when the Council was first constituted.

The Minister for Health was given power to continue to appoint professional members to vacancies arising on the Council until such time as all registration boards were established under the Act and were in a position to nominate elected members for appointment to the Council.

When their registers have been established, registration boards will be (i) designated as competent authorities under Directive 2005/36/EC; (ii) empowered to act as competent authorities for their designated professions under Directive 2005/36/EC; and (iii) empowered to assess qualifications obtained outside the State which are outside the scope of the Directive. This section also provides for necessary transition arrangements in relation to applications under the Directive.

A Registration Board may make bye-laws relating to (i) procedures for the assessment of professional qualifications, training, experience, aptitude tests or adaptation periods of applicants for registration whose professional qualifications have been obtained outside the State and are outside the scope of the Directive; (ii) practice/training requirements for professionals who wish to resume the practice of their profession having not practised for a specific period of time; and (iii) the practice periods that may be required of existing practitioners wishing to register during their register’s two-year transition period.

Persons returning to practice must satisfy criteria and fulfil conditions specified by bye- law before they are granted registration; A registration board must notify applicants of the time they are allowed to apply to the Council to cancel a decision or to appeal to the High Court. The proviono also applies to notifications of decisions relating to the recognition of qualifications obtained outside the State.

The registration board has functions in respect of the assessment and recognition of qualifications obtained outside the State.There are time-frames in which a registration board must (i) acknowledge applications for such recognition and (ii) notify applicants of decisions. There is a right of appeal to the Council in relation to the performance of the qualifications recognition function.

There is an appeal to the High Court from decisions of the Council on applications (appeals) relating to decisions of a registration board on qualification recognition.

Temporary service providers (professionals who are established in another EEA state who provide services in the State on a temporary and occasional basis), whose qualifications have been assessed by a Registration Board, may be permitted to use Irish professional titles; this is a provision of Directive 2005/36/EC.

The 2012 Act increased the maximum fine for offences relating to the use of professional titles or the making of a false declaration or misrepresentation for the purpose of obtaining registration under the Act.

There are practice periods required of existing practitioners in order to be registered during the transitional period to be not less than two years or such other period as may be specified by bye-law by the relevant registration board

An existing practitioner to use the relevant title until the end of the transitional period and, where an application for registration is made during the transitional period, while the application or related appeal is being determined. The 2012 Act amends Schedule 1 of the Act to permit the Minister to appoint a member of the Council.

2017 Act

The Health and Social Care Professionals (Amendment) Act 2017 amends certain provisions of the Health and Social Care Professionals Act 2005 to

Address identified gaps in the provisions relating to the appointment of professional members to the Health and Social Care Professionals Council and to registration boards;
Permit a registration board to apply training and education conditions to applicants for registration who have not yet practised their profession; and
Provide further conditions for the registration of physiotherapists/ physical therapists in the register of physiotherapists.

Background

The Health and Social Care Professionals Act 2005 provides for the statutory regulation of the 14 professions designated under the Act, namely the professions of clinical biochemist, dietitian, dispensing optician, medical scientist, occupational therapist, optometrist, orthoptist, physiotherapist, podiatrist, psychologist, radiographer, social care worker, social worker and speech and language therapist.

The Act addressed identified gaps relating to the appointment of professional members to the Health and Social Care Professionals Council and to the registration boards. It allowed the Minister for Health to make the initial appointment of a professional member to the Council when a new profession is designated by amendment of the Act and also to fill casual vacancies among professional members where the relevant registration board had not yet established its register.

The Act will allows the Minister to appoint professional members directly to the registration boards during the transitional period of the professions concerned.

The Health and Social Care Professionals (Amendment) Act 2017 amendd the 2005 Act to permit a registration board to make bye-laws to apply conditions in relation to education, training, etc. to applicants for registration who are qualified for a specified period of time but who have never practiced their profession. The Act already has such provisions in respect of applicants who wish to resume the practice of that profession after not having practised the profession for a period specified in the bye-laws.

In relation to the profession of physiotherapist, the Act facilitates the Minister’s proposal to make regulations to prescribe the title of physical therapist as a variant of the title of physiotherapist in order to eliminate the ongoing risk of title confusion and the consequent risks to public safety. Specifically, it permits the registration in the register of physiotherapists, on a once-offbasis and for a limited period, of qualified users of the title of physical therapist, of recent graduates (since 2013) of the Institute of Physical Therapy and Applied Science, Dublin (IPTAS) and of current students that graduate from the final IPTAS programme that commenced in 2016 and will end in 2019.

The effect of prescribing the title of physical therapist as a variant of the title of physiotherapist will be to protect both titles under the Act by confining their use solely to registrants of the profession of physiotherapist. The decision to allow certain qualified users of the title ofphysical therapist and graduating students to register as physiotherapists and to use the titles of physiotherapist and physical therapist took into account, appropriately and subject to ensuring public protection, the legitimate concerns of the practitioners involved and the other parties that will be affected by the regulations.

Health and Social Care Professionals (Amendment) Act 2017 allows the Minister for Health to make the initial appointment of a professional member to the Health and Social Care Professionals Council when a new profession is designated by amendment of the Act as well as by regulation. It permits the Minister to appoint professional members to the Council to fill casual vacancies where the relevant registration board has not yet established its register.

The Minister appoints professional members to a registration board of 2 or more designated professions during the transitional period of the profession concerned.

Health and Social Care Professionals (Amendment) Act 2017 amends the registration board’s power to make bye-laws to permit a registration board to make bye-laws to apply conditions in relation to education, training, etc. to applicants for registration who are qualified for a specified period of time but who have never practiced their profession.

It provides for the registration in the register of physiotherapists, on a once-off basis and for a limited period, of recent graduates (since 2013) of the Institute of Physical Therapy and Applied Science, Dublin (IPTAS) and of the current students of the IPTAS programme that will graduate with the relevant qualifications.

It provides for the registration in the register of physiotherapists, on a once-off basis and for a limited period, of existing users of the title of physical therapist who hold specified qualifications awarded by the Institute of Physical Therapy and Applied Science, Dublin or equivalent qualifications or who successfully complete an assessment of professional competence set by the Physiotherapists Registration Board.