Mr. Phelim Quinn:

I will try to perform as well as Dr. Tracey Cooper has in respect of this committee.

On Deputy Ó Caoláin's question about Dr. Cooper's replacement, the process for the recruitment of the chief executive is a responsibility of the board of HIQA, but I am aware that the process for her replacement commenced before her departure. It is in train. I am less clear on the timespan within which that will be achieved, but the board is keen to ensure there is a replacement substantive CEO as soon as possible.

There are a number of key issues around the outcome of our inspections. Mention was made of safe care and support. What we can do here is look at safe care and support in relation to a number of the members' questions, specifically the questions on the safeguarding of vulnerable adults. There is a statutory notification process. We are required to receive that notification. In a perverse way, the increased notification of safeguarding issues, whether they are alleged, suspected or confirmed, to us is a good development because it indicates that there is at least an open culture for reporting of those events. However, the number is disturbing when one brings that back down to human level. The key issue here is for us to try to work together to effect improvements within the services.

I was asked whether we can detect improvements. In this instance, we follow up on all actions. The first line by which we follow up is that we require an action plan from every provider on the publication of a report. That action plan is assessed for its adequacy by our inspectors and if there are any inadequacies in a particular action, we go back quickly to the provider to seek further clarification or better actions in respect of those requirements made by ourselves. At times, a follow-up inspection will also be required to ensure that what they have told us is happening on the ground. One will see that there are always more inspections than there are centres. Over the course of the next number of years one will see that number increase. At times, that is linked to the concept of announced and unannounced inspection, because one of the triggers for an unannounced inspection is the need to clarify, for example, whether a specific action that has been claimed has in fact been carried out.

Deputy Conway asked about the issue of safeguarding and its equivalence to some extent with the concept of child protection and welfare. I suppose that is one of the reasons we introduced into this briefing to the committee the concept of wanting to move towards parallel legislation and a parallel national policy that enables such a co-ordinated and multi-agency approach to the concept of the protection of vulnerable adults. At times, as a regulator, we will go in and detect issues that point us in the direction of a series of types of vulnerable adult abuse. That can be physical, it can be neglect, it can be sexual, it can be financial, or it can be verbal. All of those issues of abuse need to be recognised, first and foremost, by those working within the sector, but we also need to have a singular and co-ordinated approach to ensure that allegations of abuse are appropriately investigated. They will be investigated at local level, but they may need to be escalated to another agency and on occasion may require the co-operation of the Garda if the abuse points to some sort of criminal activity. Current policy does not necessarily do that. It does not have the protection of vulnerable adults at its heart. Parallel legislation and a parallel national policy would assist us in our work and would improve the protection of vulnerable adults across the State.

Deputy Conway also asked whether we wait for improvements. We do as I said. We follow-up with the action plan on an administrative basis and then on the ground.

The Deputy also asked about the introduction of new beds. In that regard, one of the questions is whether we have a view on the number of beds within the system.

In our last appearance before the committee I remember Dr. Tracey Cooper talking about the demographic time bomb, to which I have referred in the foreword to the report. The numbers of people aged over 65 years and 85 years in the country are increasing at quite a rate, in some instances at a higher rate than that for our European neighbours. There is a balance to be struck in the nature of care provided within the community. Government policy points us in the direction of providing more care within the community, but it is not always necessarily about residential care. There is absolutely a place for residential care. However, we also need to look at alternatives such as supported living, as well as providing care in a person's own home. We must ensure the care provided in a person's own home is also of a high quality.