Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

The definition of a "health service provider" is detailed in section 3. It could be an individual hospital, for example. While I understand the points being made, I think they are probably beyond the scope of this legislation. This legislation is around trying to instil in law an obligation for mandatory open disclosure. It is one that will be taken very seriously by the healthcare providers and clinicians. What it is doing is backing up. It is another layer of defence because the HSE mandatory disclosure guidelines are already in place and are taken seriously.

There is a broader conversation into which we have very understandably moved around accountability generally. As I said earlier, the process by which that needs to happen, and I agree with the Deputies that it needs to happen, is through the regional health areas because we will be creating the one organisation in each region that is responsible for end-to-end patient care. I go to Galway, meet the nurses, doctors and managers and look at a situation that is not acceptable for patients or our healthcare workers. I am meeting some emergency medicine nurses shortly and I know the committee has been engaged in the same thing. As Deputy Shortall rightly said, the CHO has some responsibility in terms of stopping people from going into hospital in the first place and the GP network has some responsibility in terms of out-of-hours GP cover. Some community hospital care that is under the CHO has responsibility to ensure beds are available. The hospital group has a responsibility to make sure there is correct load balancing and so forth across the different hospitals. The individual hospital is responsible for patients coming in the door but it is reliant on the CHO and nursing homes to a large extent to make sure patients can be discharged. There is no single organisation that I and the committee can meet to ask what the head of organisation is doing and what its executive team is doing to sort this out. I agree with Deputy Shortall but it is well beyond the scope of this legislation. However, I would be very happy to discuss it with the committee on an ongoing basis.