Mr. Sean Egan:

Such an environment is clearly very difficult to manage for staff and people working at the front line. It is completely unacceptable and makes it very difficult for staff to provide the care they would like to provide. From HIQA's perspective, and as outlined in some of the answers to earlier questions, we have a specific role in ensuring the environment in which care is provided is as good a standard as it can be. What we have seen is that if you are providing an environment that is not overcrowded and is properly staffed, the potential for that type of behaviour to occur is reduced. It is not necessarily completely eliminated. That might be difficult to do given that ultimately these are public services and they are open to any member of the public to access. On the other side, it is important that hospitals have proper systems and processes in place to ensure a safe and secure environment and one in which staff feel is appropriate and safe to work. We have a role to ensure those measures are in place but there is a requirement for personal responsibility here as well and a recognition that staff are doing their best, often in very difficult circumstances.