Kate O'Connell (Dublin Bay South, Fine Gael)
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I will be brief. I want to get my head straight on the licensing of services. HIQA, therefore, does not have a role in the acute hospital setting. It was said that a particular menu of services would be commissioned, such as knee replacements. The Department of Health sets a standard against which boxes must be ticked. Will it be so prescriptive that two consultants are needed on site to do ten hip operations or will it be a case of hip operations being done to a particular level of outcome without any professional input? I want to be clear on whether it is the mechanics of it rather than the professional input. Are these lines blurred or is it all together? If the Department of Health is not being prescriptive about who does the operation, does it fall down somehow? I hope I am making myself clear.

The witness was talking about regulatory cycles for nursing homes and mental health services in a social care setting. Three-year and five-year cycles were mentioned. When it comes to commissioning particular services, such as knee replacements or whatever, will there be a built-in review? In that way, it could be checked out in three years. What sort of protections are there for the operator, that is, the person providing a service, be they private or public? In that way, the goalposts cannot be changed and it would protect the provider, be it the State or somebody else.

Home care was also mentioned, including moving people - I do not want to misquote the witness - from a regulated setting to an unregulated one.

I assume what the witness was getting at is that we do not want to do any harm to anyone. We do not want to take people out of a good place and put them into a bad place. We are all okay with that. By saying that, is the witness saying that we are doing that already? My understanding is that there is very little regulation of care in the home. There is a correlation there with the idea of funding child care or any sort of care in the home in which the State is giving money to somebody to perform something in an unregulated setting. For me personally, there is an issue in that there is no governance or regulation of standards. Is the witness now saying that this is happening and that we are bringing people from regulated settings to unregulated settings? In light of the witness's comments, have there been issues there already? What are we doing about this for the future?

Data and data protection are so important. We have had so many things happen in the health service in Ireland. I am delighted that Deputy Durkan has left because I am referring to the health boards. We have moved from the health boards to where we are now. We are looking at patient identifier numbers and that sort of model. Is the Data Protection Commissioner looking at a particular hospital group in which to roll the model out or will it be a national roll out? Is it a case of seeing how it works out in fixing the mid-west and, from that, rolling it out elsewhere, or will it be a national picture straight off? Depending on which answer is given, why is that model being chosen?