Dr. Kathleen MacLellan:

It certainly was not the intent that this would run on for years. The intent was that licences would be processed as quickly as possible. Going back to some of the earlier heads in the Bill, the first document a hospital must put forward in order to apply for a licence is its statement of purpose, that is, to clearly outline who they are, how they operate, who the person in charge is, that they are publishing their patient safety statements and so on. A significant volume of information will be provided to HIQA. It will be up to the authority to decide how it processes the applications, but it would be expected that in those self-declarations for some hospitals, it would be clear that they can proceed quickly to licence. However, others may have to do significant work to meet the requirements for a licence. Looking across our whole system, there are different areas of risk in some hospitals, as Dr. Holohan said. The intent is not that this would go on for a long time. We cannot underestimate 60 hospitals coming forward at one time to be licensed and processed within one, two or three months. However, it is important that as they continue to operate, they come in under this stronger regulatory framework under HIQA as quickly as possible. We hope the patient safety Bill and the work up to this will allow hospitals to start preparing quickly in order that when they put in their applications, they will be as ready as possible.

I will come back to the mandatory regulations and standards because Deputy O'Reilly was a little concerned about them. We are conscious there are many technicalities within this Bill and that it is quite lengthy. Head 20 outlines the areas that will form part of mandatory regulations. They are based strongly on current standards for better healthcare. The regulations relate to:

(a) the provision of person-centred care,

(b) the provision of effective care,

(c) the provision of safe care,

(d) the promotion of better health and wellbeing,

(e) leadership, corporate and clinical governance and management,

(f) planning, organising and managing the workforce,

(g) the use of resources,

(h) the use of information,

(i) dealing with complaints ...,

(j) the management of patient safety incidents.

They are extensive in terms of clinical governance, and the requirement is for a strong clinical governance framework. There will, therefore, be a significant step forward in terms of the requirements that an organisation will have to meet and the opportunities that HIQA, as the licenser, will have to provide it to be able to go in and examine this.

Section 39Q concerns appeals to the District Court, the grading and the serious risk.

The Deputy's point is very well made. Perhaps Ms Dunnion from the Health Information and Quality Authority, HIQA, could look at how risk assessment applies and how problems are identified. HIQA do this on a day-to-day basis in that it looks across the system to see if risk assessment processes are in place. It might be worthwhile if that was taken on.