Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I will address the policy questions and leave the various service areas to the directors, as they have the most up-to-date and comprehensive knowledge about them. Deputy Kelleher asked about the oversight implementation and recommendations. It is a very pertinent question. One of the specific eight recommendations made in the HIQA Portlaoise report is that the Department would set up a steering group to oversee the implementation of the recommendations of that report. I can commit that it will be done; there is a commitment led by the Department to oversee the implementation of all eight recommendations in the report. This applies not just to the recommendations made to the Department but also those made to the HSE.

What is particularly helpful and strong about this report is the fact there are eight recommendations. They are specific, measurable, achievable and realistic. They can be time-bound. What can be difficult with other reports, not just from HIQA but from other bodies in the past, is that there may be 70 or 200 recommendations that are not very specific or time-bound. Sometimes they are not achievable. That would put anybody in a very difficult position as it is arguable as to whether they could ever be implemented. HIQA have set down a good marker by having eight very clear and doable recommendations that we can implement. The truth is that, on occasion, sometimes HIQA has made recommendations that cannot be done. With respect to ambulances, it specifically made a recommendation that would be in contravention of European law, and we would have to tender the ambulance to do what it recommends. That is obviously not something we intend to do. Sometimes the recommendations cannot be achieved because of financial limitations, and that is particularly the case with accident and emergency departments. We are building a new accident and emergency department every year in Ireland because we can only afford to do that. I wish we could build 20 new departments but we cannot. That is the reason we are certainly behind on some of those recommendations regarding the emergency department in Tallaght that could be applied across the country.

There may also be problems with recruitment and sometimes it is hard to recruit people in filling certain posts, no matter how hard we try. The fact that recommendations are not necessarily implemented does not mean they are being ignored. Sometimes we are still working at trying to implement them. We need to move to an approach of "comply and explain" with HIQA recommendations. I have asked the Department to go through and audit all recommendations made over the past number of years and have a rolling programme of checking every couple of months where we are in implementing them.