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

On nursing homes and facilities for older people, public ones are better staffed, generally speaking, and have a higher proportion of nurses. It is worth bearing that in mind. In contrast and from a building-standards perspective, private sector nursing homes are generally much newer and in better nick than the public ones, some of which are in old workhouses which date back to the 19th century. The private sector has had to bring its buildings up to standard more quickly than public institutions. The private sector thinks that is unfair and I can understand where it is coming from. While the private sector has had to meet the highest building standards quicker than the public sector, in the real world we would not have anywhere for the older people to go if we started closing all those old nursing homes and district hospitals around the country. That was just not a viable option. Perhaps there is an element of unfairness but the legislation acknowledges that HIQA must have regard to the HSE's resources. That is written into the legislation.

HIQA has significant powers to remove licences and takes public and private facilities to the District Court to remove licences on occasion. I consider that the heavy-handed, bata-mór approach is probably not the right one. I would prefer to see HIQA take a more compliance-based approach to work with providers whether they are voluntary bodies, charities or the HSE to help them to comply. Obviously, if there is a major patient safety issue, it must be dealt with straight away. However, there are other areas where we would do better to adopt the approach the Health and Safety Agency adopts with employers, which is not to shut down a factory or business, unless there is a major safety issue, but rather to help them to comply. That would be a better approach than to say "Here are the rules. You must implement them. We are gone now".