Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome Dr. Cooper and note that the corporate plan presented today is ambitious to say the least. I wish HIQA well in rolling it out in the coming months and years.

I wish to raise a couple of issues with Dr. Cooper, particularly in respect of residential services for people with disabilities, for which HIQA's inspection function is now coming on stream. Dr. Cooper states that in the State approximately 9,800 people with disabilities live in residential care in voluntary, private or State institutions and mentions an important word when she notes that often such places are their homes. In the context of inspections, obviously the priority will be to ensure such residential care is safe and in an environment that is conducive to providing for a good quality of life for such people with disabilities. Critically, however, there must be an understanding that often these are extremely vulnerable people and that such locations are also their homes. In the context of discussions with stakeholders, how much discussion did HIQA have with organisations representing people with disabilities or with people with disabilities as to what they needed or considered to be their priorities in the delivery of safe care?

While this does not pertain specifically to HIQA, my concern is that sometimes, when arbitrary decisions are made in the context of regulations, it can be very blunt and damaging to people who may experience a huge upheaval within a short space of time. In the context of such inspections, have there been preliminary discussions with the various providers as to what is expected, as opposed to this blunt instrument being applied when HIQA starts the inspection process? This primarily is for the residents themselves, not for the providers. I hope Dr. Cooper can elaborate on this point to an extent because it is critical. While this is not a criticism but merely an observation, in the case of residential care for older people, there were closures that had huge traumatic effects on the individuals themselves, as well as their families, and I do not wish to see this happening on a frequent basis in this context. However, I accept that it is most important to have safe facilities for people with disabilities. Nevertheless, flexibility and understanding are also critically important, as well as the realisation that if there is a need for closures or if orders are served on various organisations, the people at the heart of it should be those who are informed first and should be the first priority with regard to reallocation or an assessment of their needs and requirements, rather than making the decision and then being obliged to address their concerns.

Dr. Cooper has mentioned that obviously HIQA's vision is to provide safety for patients using health services in general. I note, for example, that the special delivery unit often arrives in hospitals and advises hospital management on how it may be more efficient in streamlining the movement of patients through hospitals. Is HIQA consulted in advance in this regard? Alternatively, if decisions are made on how a hospital should improve its services from emergency departments right through the hospital on to the other side, is HIQA involved in such discussions and are its views sought?

Dr. Cooper mentioned memoranda of understanding with stakeholders. In this context, is there a view that HIQA has a critically important role to play in advance of plans being finalised, as opposed to plans being implemented only to find thereafter that they are in breach of HIQA standards? To what extent does HIQA have discussions with hospital management, the special delivery unit and others?

While I apologise for going on a little-----