Jillian van Turnhout (Independent) | Oireachtas source

I echo the welcome to our guests. I look forward to a discussion of the corporate plan at a future date.

The new inspection process will begin with inspections of residential services for children and adults with disabilities. I have a supplementary question following from Deputy Ó Caoláin's question. Does HIQA envisage a timeline for the inspection of all 1,700 centres? These inspections cannot happen soon enough. Given the staffing issues involved, what is the time period envisaged? When will it be possible to state with certainty that every service for children and adults with disabilities is provided in a good environment? I have a concern about the proposed strike action and whether HIQA has been advised of contingency plans to maintain the quality of care provided.

I wish to focus my remarks on health care associated infections. I was very troubled by the information included in the HIQA report and by Dr. Cooper's remarks, including her reference to the Mid-Staffordshire Trust inquiry. I read that document in advance of the meeting. Robert Francis, QC, who chaired the inquiry observed a culture where managers saw the glass as half-full when, in fact, it was half-empty, that it was the culture what did it.

I thought that was a really good summation, one we could apply to ourselves. At the Mid-Staffordshire Trust inquiry it was stated a system reset was required, that there was a need for better warning signals, greater accountability of senior managers and for staff, if not open and honest about mistakes made, to be open to criminal prosecution. In the Netherlands, about which I know a little, an incident at the Maasstad Ziekenhuis hospital in Rotterdam resulted in the resignation of the chairman of its board and disciplinary action against professionals, including microbiologists. We have seen instances in other countries where sanctions and accountability apply. That brings me to the situation in Ireland.

Following publication of a report, the response from one hospital was that we needed hand hygiene champions, by which I was flabbergasted. I am involved in work in the area of children's rights. One might employ a hand hygiene champion in a kindergarten to encourage children to wash their hands. However, in this instance we are talking about medical professionals who understand the potentially fatal consequences of not washing their hands. Are we really suggesting the answer in this instance is to appoint champions? Given the potential fatal consequences, who is accountable in hospital settings? I have not thus far been able to get an answer to that question.

When a report is produced, who is accountable? Are the warning signals, which it has been suggested in the case of the Mid-Staffordshire Trust need to be in place, given here such that a person working in a hospital who believes it is not acting appropriately can seek to change that culture? Are there consequences for health professionals for failure to comply? We know that without clear accountability and responsibility, culture will not change. We all have good intentions in life, but we need to know there will be consequences if we do not meet our responsibilities.

My father is in a nursing home where staff habitually change their gloves and aprons. I had not realised how much they did so until I read the report. Perhaps the delegates will answer my question about who is accountable? Who should we as a committee be inviting to attend meetings on foot of reports? As far as I am concerned, everybody but nobody is accountable.