Ms Mary Dunnion:

Yes. It will be impossible for us to even determine at the moment what the resources would be. However, I know HIQA has the skill to do this because over ten years we have developed that regulatory knowledge.

In the context of disability services, which Deputy Kelleher referenced, I can understand how one gets the perception that on occasions, HIQA is a hard regulator. What we need to remember is that the regulations determined and described by the Department of Health, with which we have to ensure compliance, and the legislative framework are the most basic one could have. I would be remiss if I was not doing that. When I look at the services we regulate in the disability area, I am very encouraged by their excellence. By way of example, we published 22 reports last week, of which 11 were on really good centres. Where it becomes poor, it is not always a resource issue. It is about the concepts of institutionalised care. It is about the concept that these are citizens of Ireland who deserve the same human rights as any other citizen but somewhere along the line that may have been forgotten. That is what HIQA does and in that context I do not feel it is a hard regulatory approach. It is a just one and the right one and it is based on very baseline regulations.

In the context of decongregation of services, we are talking about moving people who have been in residential care for a long time into a more homely and welcoming environment. HIQA works with providers in this regard, but what we expect of providers is to show us not only where the person may be moving but also how they are rehabilitating people to allow them to transition to the new environment safely. One of the risks that HIQA is beginning to talk about involves the concept of the regulation of home care. What can happen as an unintended consequence is that people who have had the benefit of regulation may be moved to an environment where there is none. One is taking someone from residential care into a decongregated setting, which is positive, but there may be an unintended risk in doing that of moving a person to an unregulated place. There may be no choice about that. These are some of the issues that come when one begins interregulation.

There are huge opportunities to begin to look at how we regulate. Currently, we regulate a centre and people will hear us talking about the regulation of St. X. HIQA believes we should be regulating services, which would allow us to transition with people into a regulated environment. We could work with providers and people in the service to improve quality. I hope that answers the questions.