Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I apologise for not being present earlier but I had to do a radio interview. There is no point in me saying I was doing something else because it was public. I have some questions which may have been asked. If they have, I will check the Official Report so the witnesses should not feel they need to answer them again. I will go through them in the order in which each issue appears in the heads of the Bill.

My first question is on head 4, which excludes alternative and complementary therapies. Will they be regulated elsewhere? Is it the Department's view they do not need to be regulated? I need to understand where that is coming from.

Head 5 states: "HIQA will continue to set non-mandatory standards for hospitals and designated activities and will monitor compliance with those standards." I am not trying to be smart but, presumably, if they are non-mandatory hospitals, they could just say they are not doing it and HIQA would have nothing to monitor. Was consideration given to making these standards mandatory given we have had difficulties and disagreements over what should and should not be mandatory? People came down on the side of mandatory standards because that would be better.

Head 9 deals with statistical information to gauge compliance. They may or may not provide it. We are all discussing the availability or otherwise of information for a particular cohort of patients. A lot of the work the witnesses do will be based on the information provided to them by providers. If that information is not forthcoming, would it be safer to use the word "should" rather than "may" to make this compulsory?

I have a concern about section 39F because the hospital groups comprise groups of hospitals and, therefore, there may be issues with individual hospitals and not with the group. This is a question for the future. When the hospital trusts and the groups are fully established, is it the witnesses' view that additional legislation will be required to take account of individual hospitals or will it be applied to the hospital group? That will be difficult.

Section 39Q refers to an appeal being brought to the District Court and section 39R refers to a belief there is a risk to the life or serious risk to the health and welfare of the patient. It also caters for the service continuing to be delivered. I was a member of the Joint Committee on the Eighth Amendment of the Constitution. I do not propose to go into that. One of the issues we discussed at length was the difficulty of grading risk. Doctors, consultants and medical staff appeared before us and said they did not feel comfortable grading risk. That means risk would have to be graded. We would have examine whether there is a serious risk to allow it to continue. Perhaps a definition is needed under the section.

In the same vein, section 39AK provides a hospital that has not applied for a licence can be allowed to operate until the outcome of the licence application is known. That does not sit well with me. If something is up and running and established, it becomes harder to revoke the licence. It is also dependent on many other factors. It is worrying that there could be a scenario where a facility is operating without a licence, notwithstanding the fact that some of the measures are not mandatory and so on.

Under head 20, the proposed section 101A(2)(j), states there should be an appropriate system in place for the management of patient safety incidents. Does this mean legislated for and mandatory open disclosure or something else? I will introduce a Bill next Thursday that will provide for mandatory disclosure. Is that what this means? What is the appropriate system for the management of patient safety incidents? I do not want to open a debate about mandatory versus non-mandatory because we have had that previously. We will get the view of the Oireachtas on that in time.

I apologise if those questions have been answered or addressed. The witnesses should feel free to skip over them and I can check the Official Report.