Mr. Phelim Quinn:

The additional budget we have received for this area is €3 million per annum. I have already outlined the fact that we have 41 new staff for the disability area, including direct and indirect staff involved in inspections. In regard to the first inspections to be carried out, we will engage with service providers. Due to the fact the profile of service providers is very different for disability services, we hope a number of service providers will come forward or volunteer to be first for inspection and registration. There is significant anxiety among providers in regard to registration and we need to be able to demonstrate to providers that the process for them will not be overly onerous.

One of the other anxieties that has been expressed through engagement with service providers and some of the special interest groups concerns the ability of HIQA as regulator to acknowledge the range and diversity of service models in the area of residential services for children and adults with disability. Reference was made earlier to the way we will deal with them. We must acknowledge there are large congregated settings and that there are also very small residential units. We will apply the standards within the various contexts where we do the inspections. The key issue for us in terms of consistency is to ensure we apply ourselves using the authority monitoring approach.

I would like to pick up on the issue raised by Deputy Conway regarding the inspection of social care services and services provided by social workers. Since coming to HIQA, I have acknowledged that we need to make a better match regarding the skills, qualifications and experience of some of our inspection staff for the services we are inspecting. Therefore, in the most recent round of recruitment for children's services, we have had specific job specifications for social workers with child care experience and inspector managers with social work management and child care experience. We have had similar specifications with regard to those being recruited for services for adults and children with a disability. We have looked specifically for people from a health and social care background with explicit experience within the disability sector. I believe there is a credibility issue we need to ensure we continue to address. On the prevention and control of health care acquired infection, we recently recruited a cohort of people with specific infection control backgrounds. These recruitment programmes demonstrate we are trying to build a credible inspection process.

I want to try to address some of the issues raised earlier by Senator van Turnhout regarding the inquiry chaired by Robert Francis QC and how it links to some of the questions raised regarding infection control within hospitals. One of the key issues is culture. I believe the introduction of announced inspections tackles the issue of culture. In the case of inspections, what we are trying to do is to look at the governance and leadership systems within our hospitals and at how they connect to front-line staff. We also need to look at what employer accountability exists and at the relationship between that and employee accountability. We believe practitioners need to be held to account in this way. There also needs to be continuous liaison and communication between us and professional regulators. One of the other key findings from the Francis report - on the back of the medical staff scandal - was the inability at times to demonstrate a good, flexible and constructive relationship between the system regulator and the professional regulators. We need to have a dialogue about how we hold registered professionals to account for what may be assessed as neglectful care.

In the course of the last quarter of this year and throughout the next three years, we will publish a three year assurance programme. This will consist of targeted, thematic and service reviews across a range of services and themes within our hospitals. This will allow us, using the framework of the national standards for safer, better health care, to provide a board to ward assessment of specific issues. One example of this will be an assessment of our ambulance service - board to service delivery. Following the completion of an ongoing consultation service, we will also look at a range of services in the same way.