Keeping a watchful eye on the health professionals

Did you know that if you are unsatisfied with a treatment you received from a dietician, a social worker, a speech and language therapist, a radiation therapist/radiographer or an optometrist/dispensing optician, you can make a formal complaint.

All these professions are now regulated by CORU, the health and social care regulator which operates a public complaints procedure which is overseen by each profession’s fitness to practice committee.

A number of other professions – including occupational therapists, physiotherapists, social care workers, podiatrists and psychologists – will also be subject to public complaints once their registration with CORU is completed within the next two years.

"We are the first multi-profession regulator in Ireland. We currently regulate just under 10,000 health and social care professionals and by the time the 15 registers are completed, we will have registered about 30,000 health and social care professionals in total," explains Ginny Hanrahan, the CEO of CORU.

The name CORU is derived from the Irish word, coir meaning fair, just and proper.

The public body has had a low profile since it was established by the minister for health in 2007 to protect the public against charlatans and unethical health and social care workers. CORU also has access to registers in other countries including the UK, Australia and Canada.

“There is also a new alert system in place through the EU professional recognition scheme where each EU member is informed if a professional is struck off in that country,” says Hanrahan.

Because each professional register is statutorily regulated rather than voluntarily regulated, CORU has the power to take legal proceedings against a practitioner they deem to be in breach of their professional code of conduct and ethics. Through an application to the High Court, CORU also has the power to strike off a practitioner from their professional register.

Occupational therapist

“We have had 75 complaints since we started taking complaints in December 2014 up until December 2016,” explains Hanrahan, who is a former occupational therapist.

While most of these complaints were ironed out, about 10 individuals were suspended from practicing while the cases were examined. Former HSE employee, Jennifer O’Driscoll, was struck off the social workers register for embezzlement of HSE funds.

Hanrahan is keen that GPs and the public know about CORU and use it to check whether practitioners are on their professional registers or not.

“It’s a simple process on the website to check whether someone is on a professional register or not,” she says. And, it’s important for people to know that it’s now standard practice to assist patients in getting a second opinion if they so wish, she adds

Hanrahan says most professionals are pleased to have their professions statutorily regulated – not least because it protects the title. It costs €100 per year for each practitioner to remain on their professional register. CORU, which has a staff of 46, is funded by the Department of Health and through the registration fees.

However, chartered physiotherapists are one group of professionals who have boycotted CORU, while awaiting the Minister for Health’s legal definition of physiotherapist and physical therapist. This dispute arose in Ireland because in most other parts of the world, physiotherapists are called physical therapists whereas in Ireland, physical therapists refer to another group of professionals working mainly with musculoskeletal conditions.

“The term physical therapist will become a protected title from September 30th, 2018. Those who have used the title physical therapist [in Ireland] with appropriate qualifications and experience will be invited to join the register from September 2017-2018,” explains Hanrahan.

Another 22 professions have expressed interest in being regulated by CORU in the future. These include osteopaths, chiropractors, medical physicists, clinical engineers and creative arts therapists. However, decisions about which of these professions will become regulated by CORU have yet to be made.

Each professional organisation must establish its own code of professional conduct and ethics, plus a fitness to practice committee with a majority of lay members on that committee. And while CORU manages the public complaints on behalf of each professional organisation, the profession’s own fitness to practice committee decides whether proceedings should be brought against the person who was complained about.

Lay people

Hanrahan sees the strong representation of lay people on registration boards as an important step forward in regulatory practices.

"It's significant that we were the first regulator to have a majority of lay people on the registration boards and the Health and Social Care Professionals Council which oversees and co-ordinates the activity of the registration boards," says Hanrahan.

Lay CORU council members include UCC Professor of Law, Deirdre Madden, National Adult Literary Association CEO, Ines Bailey and former president of the dental council, Professor Bernard McCartan.

Hanrahan says that the role of CORU is also to encourage professionals to use their knowledge and expertise.

“At a time when healthcare is moving more towards a community-based treatment, it’s important that health and social care professionals can work within the limits of their knowledge, skills, expertise and training rather than within their [individual] profession’s scope of practice.”

In other words, if occupational therapists or physiotherapists add on specific training to their core expertise, they will be encouraged to use it whereas in countries such as the United States, each professional is encouraged to stay within their so-called "scope of practice".

Hanrahan is also keen to ensure that CORU supports professionals to look after their own health and wellbeing.

“These individuals are in demanding jobs, dealing with serious issues. We want to make sure that they look after themselves so that they don’t burn out, putting themselves at risk of making mistakes.”