Seán Fleming (Laois-Offaly, Fianna Fail)

I welcome the opportunity to contribute to this debate. Again, the whole emphasis is on the patient and that is as it should be. Thankfully, we have come a long way from the situation where a hospital administrator would claim the hospital would work perfectly were it not for the patients. That attitude needed to be rooted out of the system and hopefully it is now long gone.

I particularly like the commitment in the amendment to a new social services inspectorate, to be run on a statutory basis, and that will be brought forward shortly in the new legislation. That is essential and I hope it will be an inspectorate with teeth and power. It is important that it be given graduated powers and sanctions. If there are minor problems sanctions may be taken against the nursing home in question while more serious offences will justify graver penalties. Ultimately, if a situation is unacceptable, the inspectorate will have the power to close a particular establishment on a temporary or full-time basis, depending on the circumstances. However, the idea of a sole option available to an inspectorate as the draconian all or nothing — to close an establishment completely or take no further action — has often led to mistakes being made in the past and I hope the legislation will take this into account.

It is important that the new inspectorate deal with public and private nursing homes and facilities. The view at present is that it is the private sector establishments that need inspections. It is good for staff and those who run the public sector facilities as well to know that they are subject to independent inspection and it is good for morale to be given a nice clean comprehensive report. It is also to be welcomed that inspection reports for nursing homes are on the Internet. That is a major step forward, one that everyone will agree is a welcome and modern development.

The legislation will provide that staff can make complaints without fear of retribution. Although it is not being highlighted as a major achievement, that, in practice, could be the most important element of the legislation. With more than 100,000 employees in the health service, there is a complete range of service providers in each section from medical care to catering staff. It is good, if people believe a patient is not being treated properly, that they can make a complaint without their careers being affected. It is important that this protection is in place. It is welcome, too, that the statutory complaints process will be enshrined in the new legislation, so that people may make formal complaints. An independent review mechanism and a proper system should be set up.

Up to now the role of the Ombudsman has been an underused resource as regards the HSE. From my experience as a public representative I have encountered some difficult cases in tragic situations, where the official shutters come down in the HSE, or in the health boards as they were. Sometimes the Ombudsman can help to mediate successfully without matters having to reach the litigation stage. The Ombudsman, Ms Emily O'Reilly, has the ability to go into the HSE and make recommendations for improvements. I believe the HSE would welcome this and we should see greater use of the Ombudsman's office in HSE affairs in the years ahead for the betterment of the health service.

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