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

I asked the previous witness about the following also. It is the difficulty I have in terms of the regulation and inspection programmes and all of that. We talk about clinical governance and accountability. HIQA arrives in, makes an assessment based on the regulations, but clinical governance is always the one we target in terms of holding people to account. For example, we never seem to be able to hold the policy makers behind clinical governance or the administrators implementing the policy to account. While I do not want to make individual comments, it is very often the case that things have been highlighted about hospital settings, including in HIQA reports, but there is never a system in place whereby there is accountability for senior management. It is always left up to the clinicians and, by and large, that accountability is through the professional governing bodies. I wonder where we get to a system whereby there is regulation not only of clinical governance and accountability but also accountability for senior management as opposed to clinicians.