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

-----on the corporate plan. First and foremost, in the whole area of the reconfiguration of hospitals which is now part and parcel of the roll-out of the Government's strategy to move towards universal health insurance with the establishment of hospital groups, hospital trusts and what flows from them, there is a concern, that certainly those in opposition would hold but also in communities throughout the country, that sometimes HIQA reports can be used in a way to close down facilities. I do not mean that in the context of Roscommon, we all know about that, but in terms of ensuring that where there are deficiencies in services they are highlighted at the start of a programme rather than at the end when it becomes almost arbitrary that they are closed. I believe HIQA has a role to play in highlighting deficiencies and making recommendations and allowing time for those recommendations to be implemented. I am concerned that, as stated in the HIQA plan, fiscal constraints are causing difficulties for key stakeholders. The State is also a key stakeholder and it also has fiscal constraints imposed on it. When HIQA inspects a facility and finds deficiencies in the area of patient safety it makes a report. As that does not give stakeholders an opportunity to address those particular issues it is a matter that will have to be looked at both from the point of view of HIQA but equally from the point of view of hospital groups themselves.

That leads to another key issue. We have a shortage of hospital consultants and posts that cannot be filled for various reasons.

We can argue as to why that is the case and as to why consultants are not taking up the post, but the bottom line is we have a scarcity of consultants in the country. This has a negative impact on patient safety and the quality of care patients receive in our hospitals. Does HIQA have a role in highlighting for the Government, the Department or the HSE that there comes a stage where the shortage of personnel causes difficulty for the provision of care in a safe environment? For example, recently four CEOs clearly stated that they had concerns about patient safety in their hospitals in the Dublin area. We could discuss why their letters went public and why we had an issue over payments, but those issues are for another day.