Professional Regulation in Ireland Presented at the 2005 CLEAR Annual Conference September 15-17...

Professional Regulation in Ireland

Presented at the 2005 CLEAR Annual ConferenceSeptember 15-17 Phoenix, Arizona


Speaker Contact Information

Speaker name: Eugene DonoghueOrganization: An Bord AltranaisAddress: 31/32 Fitzwilliam Square, Dublin 2, IrelandPhone: 00353 1 6398528Fax: 00353 1 6763348E-mail: [email protected]: www.nursingboard.ie


History of Regulation

Medical Act, 1858; Medical Act, 1886; Medical Act, 1927; Medical Practitioners Act, 1978.

Pharmacy Act (Ireland) 1875; Pharmacy Act, 1951; Pharmacy Act, 1962

Dentist’s Act, 1878; Dentists Act, 1921; Dentists Act 1928; Dentists Act, 1985.

Nurses Act, 1917, Midwives Act, 1950; Nurses Act 1985;

Health Professions Bill, 2005



Original regulatory legislation in Ireland was derived from United Kingdom judicial systems.

From the 19th century and the beginning of the twentieth century laws were enacted in Ireland regulating health care professions, and such legislation focused primarily on establishing registers for those who completed approved Education and Training Courses.

Boards were appointed by the government which included representation from the professions.



After independence was established in 1921 those regulatory laws for Nurses and Midwives and other health professionals continued to operate. In the case of Nurses and Midwives the Irish Government passed a Nurses Act, 1950, which established An Bord Altranais and put in place systems regulating Education and Training, the Maintenance of a Register, Fitness to Practice Procedures and Guidance to the Profession.



The Nurses Act was further revised in 1985 when for the first time elected nurses and midwives held a majority on the Regulatory Board.


Purpose of Professional Regulation

The general purpose of professional regulation is to protect the public through the promotion of high standard of professional education and training and professional conduct.


Operational Environment

Government

Health Service Executive

Representative

Organisations

Public

Professional

Regulation


Irish BloodTransfusion

Service

Food SafetyPromotion Board

Social ServicesInspectorate

Special ResidentialServices Board

NationalChildren’s Office

Irish MedicinesBoard

The Institute ofPublic Health

Health ResearchBoard

Food SafetyAuthority of

Ireland

Department of Health & Children

National HospitalsOffice

HIQA

Health Services Executive

Regional Health Offices(4)

Health & Social CareProfessionals Council

Local Health Offices

Adoption Board

Mental HealthCommission

PharmaceuticalSociety of Ireland

Medical Council

Dental Council

Opticians Board

An BordAltranais

National Children’sAdvisory Council

Drug TreatmentCentre Board


Regulation is Statutory

• Statutory Boards are representative of professions, public interests, health services and educational providers

• Boards appointed by election and appointment

• Regulatory bodies are autonomous subject to high court confirmation of decisions affecting the Constitutional right of a person to be employed.


Functions of Regulatory Bodies

• Education and Training – Standards and Requirements of practitioners

• Maintenance of a Register

• Fitness to Practise - Disciplinary

• Guidance to the Profession


Education and Training

• Approval of Institutions

• Approval of courses (site visits; curricula approval)

• Entry Requirements

• Scope of Practise

• Continuing Competency

• Ethics


Ireland is obliged by virtue of membership of the European Union and Directives enacted by the Union to put in place systems for the mutual recognition of diplomas, certificates, and other evidence of formal qualifications of nurses and midwives, doctors, pharmacists and dentists.


Registration

Member States (25) are obliged to apply Directives

• Sectoral Directives (No. 80/154/EEC and No.77/452/EEC) which stipulate for particular professions ther dureation and content of programmes leading to Registration throughout member states;

• General Systems Directives which provide member states with legal requirements which must be satisfied in processing applications of professionals from other member countries in accordance with their own national standards;

• New Directive – signed into law 7th September 2005.


The Process: Registration

Applications are appraised on an individual basis and verification of compliance with European Law is sought independently from the Competent Authority in the country of origin

Applications from outside the European Union are assessed individually and applicants must suppy to the competent authority: a current registration certificate (license), employment history, two character references and passport number


The Process: Registration (cont’d)

• Nurse applicants from some countries who are otherwise qualified to enter the Register are required to undertake a period of adaptation in a hospital approved by the Board and a recommendation is required from the Director of Nursing before full registration is granted.

• Dentists/Doctors/Pharmacists require non E.U. candidates to sit examinations.


Registration

New E.U. Directive

• Common platforms where possible

• Member states set standards

• Adaptation systems

• Language requirement

• Security emphasised


Fitness to Practice

The Act provides for the establishment of a Statutory Fitness to Practice Committee which requires the committee to enquire into allegations of professional misconduct or unfitness to practice because of physical or mental disability.


Fitness to Practise Committee

• Named and Registered Nurse

• Application for Inquiry

• Grounds for Inquiry:

- Alleged professional misconduct

- Alleged unfitness by reason of physical or mental disability


Fitness to Practice

Findings of the committee are reported to the Board whose role it is to administer sanctions. These range as follows;

• Removal from the Register;• Suspension from the Register;• Attachment of conditions;• Advise, Admonish or Censure.

Decisions of the Board effecting a nurse’s employment are not effective until confirmed by the High Court. A nurse has right of appeal against decisions for up to 21 days after the Court has confirmed the decisions of the Board.


Fitness to Practice

Inquiries are held in camera, and appeals are heard in open court.

In general the Irish constitution provides that only the High Court can impose sanctions which effect a citizen’s right to earn a living. Regulatory Bodies operate within the limits of the constitution.


Fitness to Practice

A nurse may apply to the Board at any time to have her/his name restored to the register

and

The Board may at any time remove in whole or in part the conditions attached to the retention of the name o any person on the register.


Section 44 of the Nurses Act, 1985

• Board Function

• Public interest at risk

• Seek Order from High Court preventing practice pending completion of fitness to practise procedure


Guidance to the Profession

In providing guidance to the profession the Board publishes a Code of Professional Conduct for each Nurse and Midwife

The Board has also published a Scope of Practice Framework which empowers nurses and midwives to practice in accordance with their education and training, experience and competence.

Currently the Board is examining in consultation with others the regulation of Nurse and Midwife Prescribing.


Funding of Professional Organisations

• Annual fees paid by professionals to maintain their name on the Register

• Other fees;-Overseas application fee-Restoration fee-Verification fee-Additional Qualifications-Reactivation of file-Duplicate certificate-Sundry charge


General Observations

• Continuing competence - proposed

• Language Requirements – IELTS / TOEFL

• Professional Conduct leading to Inquiries

• Professional misconduct

• Health Problems


THANK YOU

Professional Regulation in Ireland Presented at the 2005 CLEAR Annual Conference September 15-17...

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