Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I apologise for not hearing the full presentation from Mr. Quinn, but we had prior sight of his presentation and I had the opportunity to read it. I am at a disadvantage as I do not know what questions my colleagues asked so if there is repetition, I apologise.

What changes, if any, did the authority make to the original draft report before the publication last Friday? Were any changes made or did the authority hold to the draft that was first advised to the HSE? Has the authority met with the families concerned since the issuance of the threat of legal action to prevent publication of the report and, if not, will it with regard to the Portlaoise cases? I understand the Minister is meeting them today. Has the authority done so or will it, in the context of the publication of the report?

The first recommendation refers to an independent patient advocacy service. One of the deficiencies in the relationship between HIQA and the HSE is that there is a serious lack of compellability to act on findings and recommendations contained in reports. I am unclear about the status of HIQA's relationship with the HSE in respect of the publication of reports and the recommendations contained therein. A recommendation, by its nature, is not necessarily an insistence that one must do something. Will the witness expand on that?

I have read what the authority says in the first recommendation regarding an independent patient advocacy service where patients' reported experiences are recorded, listened to and learned from. That is far too weak; it is not strong enough. We need something much stronger. The recommendations contained in the report are not made lightly. They are a professional assessment of deficiencies and needs within our health system, be it acute hospital settings or other settings across the health care sector.

I believe we need a patient safety authority, of which HIQA would be a significant component. I understand this was part of the programme for Government agreed in 2011, but that it has been parked in the period since. A patient safety authority would not only give teeth but would give certainty to those of us dependent on the health services, public health services in particular, that the required steps will be implemented. This must happen and I am anxious to hear Mr. Quinn's views on that. The second recommendation is that the Department of Health should ensure implementation of the recommendations of HIQA. This echoes the point I made already.

On the fifth recommendation, I welcome the proposition of the appointment of a director of midwifery in all maternity units across the State that do not have such a director. I note the sixth recommendation recommends systems to support a competent and appropriately resourced workforce. These two recommendations aside, there is no other mention of staffing or of nursing midwife shortages in any of HIQA's recommendations. Despite no explicit reference to overworked and under-resourced staffing at the Portlaoise maternity unit, and by extension across all maternity units, does HIQA accept there is a critical shortage of properly qualified full-time staff across all obstetric maternity settings? Does it accept this is a serious element in regard to the tragic outcomes at Portlaoise, at Cavan and other hospital sites?

I do not intend to stray, but I have just come from a Topical Issue engagement with the Minister of State in the Department of Health on these matters. It has been reported that the former Minister for Health, Deputy James Reilly, stated in an interview he gave in Cavan that he would request HIQA to look into the situation. He suggested that priority be given to a review of the maternity services in Cavan General Hospital against the national standards, in tandem with the address of the Midland Regional Hospital maternity unit at Portlaoise. However, the Minister of State, Deputy Kathleen Lynch, has just advised me that this was a "request".