Mr. Brian McEnery:

I will begin by addressing the issue raised by Deputies Ó Caoláin and Kelleher in regard to HIQA reports being used for other purposes. HIQA is an independent authority and its focus is on the safety of patients and residents in nursing homes. This is its agenda and the authority's focus will be to continue to apply a risk-based approach to our health services. We have no agenda other than that. This has been our mandate since our commencement and will remain the case for both the executive and non-executive boards which oversee our operations.

Deputy Doherty mentioned managing and getting feedback on patient experience. This is a significant part of our work and the HIQA inspection service seeks resident feedback and the feedback of the families of residents. This will be part of the inspection process of any of the additional services HIQA is mandated to inspect. I reassure the committee that we conduct our inspections and make decisions from a practical perspective. We do not just inspect the physical environment, but try to get an understanding of the experience of residents and patients and this will continue to be the case.

Deputy Ó Caoláin mentioned Rath na nÓg. HIQA has investigated the issue in this regard appropriately. This is an area on which HIQA, applying its risk-based approach, will continue to focus. Deputy Kelleher alluded to the shortage of consultants. Deputy Healy commented on resources in facilities and where we believe shortages cause clinical risk, we will allude to that when producing our inspection report. Currently, we do not have a mandate to inspect hospital resources. Our mandate for hospitals only relates to infection risk in hospital services.

I concur with Deputy Byrne in regard to the role of HIQA and the need to be out on the ground. I believe the authority operates in a cost effective manner. The expenditure on the authority is 0.1% of the health care budget and it is intended that we maintain a nimble, cost effective authority that is not overburdened with management at staff level.

It will be very focused on ensuring that what Deputy Kelleher said about safety and quality of care will be the case. There are 1,300 centres for disabilities, many of them with just two or three residents in them, and we will be very conscious of the fact that these are people's homes. They are destined to remain in them for quite a period of time, and we will treat them accordingly, while ensuring that they are in a safe and appropriate environment for care.