Mr. Brian McEnery:

If I do not cover all the questions that have been asked, I will be happy to come back in. I will begin by responding to Senator Crown's observations about the remit of HIQA. While I am relatively new to the position of chairman of the authority, I have seen the work of the authority on the ground since its initiation in 2007. I believe the work of HIQA has resulted in the quality of many people's lives being improved. I am thinking particularly of HIQA's work on the provision of care to older people, which is one of the most obvious reasons I was delighted to be asked to become the new chairperson of the authority. I know it makes a significant impact for older people.

We have just started to get involved in the area of disability services. I believe HIQA will have a significant impact on the improvements in services delivered to people with disabilities, as it has done in the cases of services delivered to older persons and services delivered in other areas.

Equally, I believe HIQA will have a significant impact on improving the services delivered to people with disabilities as it has for older persons and other areas. I believe that the provision of services, not just in terms of the physical environment, and the more important operational standards of delivering care has improved as a consequence of having a regulatory authority such as HIQA. My experience, even before I became a member of the board of HIQA, is that the role of the authority is paramount to improving care for older persons and persons with disabilities.

Deputy Mary Mitchell O'Connor asked if there are better services for older persons given that standards and regulation of that sector have been in place since 2009. I believe that is the case. I think that has been acknowledged by the providers and their representative body, Nursing Homes Ireland, which has welcomed the introduction of the standards. It acknowledges that the operational and physical environment has improved as a consequence. I believe that, both for the public and the private sector. The continuing application of those standards to operational matters on the ground but also the physical environment where there is a derogation in respect of those standards will continue to push improvements in those services. I absolutely believe that to be the case.

On the issue of preschool care and after-school care, that is not an area over which the authority has a remit. Our plan for 2013-2015 outlines a very significant mandate being given to the authority over and above our current role but preschool care is not one of those. As an authority we must be careful that we do not overextend our mandate and become ineffective in the roll-out of our services. Licensing of other areas is on our horizon but that aspect is not currently in the plans.

Deputy Seamus Healy asked about resources. Down the years I have reviewed very carefully HIQA inspection reports and have seen many references to inadequate staffing levels, this being an item of clinical risk which the authority would have raised, be it in nursing or care assistants. If the authority believes there is a risk to resident or patient safety as a consequence of inadequate or inappropriate staffing levels that will be highlighted in the inspection reports because it is a key aspect of care. More often it is not the physical environment that is the key determinant of the quality of care but the amount of staffing and the proficiency of the staffing who are in the care setting which is the important issue. HIQA does not avoid commenting on that issue where it believes the level is inappropriate.

Deputy Dan Neville has correctly outlined that an important issue is the level of resources which the authority has to enable it carry out is mandate. I am glad to say that at the start of the year the authority had 160 staff, now it has 180. Following full implementation of the monitoring role of disability services the number will grow to about 220 by the end of the first quarter of 2014.