Ms Mary Dunnion:

It might be helpful for clarity to explain what we mean about the fitness of the person. When we talk about the fitness of the person of charge, whoever that might be in the hospital or wherever, we talk about basic but important things to begin with. Is the person competent in safeguarding people and patients in the hospital? That involves Garda vetting. Has the person the appropriate qualifications? Those might be in the general management context. One looks at the person's regulatory history. Has this person in charge been responsive in a positive way to findings relating to adverse events or regulatory non-compliance, if that is the case? One also sees if the person took a proactive approach to the planning of the service, and if that proactive approach is cognisant of both the clinical and the corporate governance arrangements. It takes in what Senator Colm Burke was describing in the context of where there might be divergence of views. Is the person's approach proactive in that? Also, is there a good system of peer review? If one looks at that, it might be in one hospital and where the Senator referred to individual hospitals and groups, one would hope to see that the person in charge demonstrates that he or she can learn from what is happening in his or her hospital but equally, that such learning is shared across a group or through the legal entity, be it the HSE or whatever else. They are broadly the criteria one considers in the context of the fitness of the person being in charge.

It equally extends to the fitness of the persons participating in management. Unlike a designated centre where a single service is being provided, a hospital is a very complex organisation so that is where it becomes important to give consideration to the fitness of people participating in management. The heads of the Bill define certain criteria in that regard. That is a whistle-stop tour but they are the things one examines in assessing fitness.