Brian Lenihan Jnr (Dublin West, Fianna Fail)

I listened to the debate this evening and I thank those Deputies who contributed. The Government is committed to ensuring high quality care is available to all patients and to the further development of the health services, in particular, addressing issues of patient safety.

Last night, it was stated that insufficient funding was provided. No Government has provided more funding to these services than the present one. A total of €110 million was provided this year for older persons in palliative care with an additional follow-on of €40 million for next year. This investment was the largest increase ever provided for older persons in palliative care. The total expenditure in the Department on services for the elderly this year was €1.2 billion.

Last night, it was stated that more support should be made available for the cost of nursing home care borne by individuals and their families. New funding arrangements for persons in nursing homes will be finalised by the Department of Health and Children in line with the commitments given in the partnership agreement Towards 2016. These arrangement will apply irrespective of whether a person is in a private or public facility. The new arrangements will propose co-payments by care recipients, based on a national standardised financial assessment, a principle also agreed by the Government.

A working group was established by the Department to review the standards last set down in 1993 for residential care settings for older persons. Membership of the group comprised officials from the Department, the Health Service Executive, the social service inspectorate and the Irish Health Service Accreditation Board. The group was involved in developing draft standards of both public and private residential care for older people. These draft standards will be circulated shortly to interested parties for consultation.

The Irish Health Service Accreditation Board examined the development of accreditation standards. These will be introduced when the national standards are in place. This board and the Department are involved in ongoing consultation on national accreditation standards.

It is a matter of public record that the HSE working group report on nursing home inspection and registration was completed in July. The executive's approach to nursing home inspection was strengthened in light of the report. One of the recommendations was the recruitment and establishment of dedicated national inspection teams which would include medical, nursing and mental health professionals and have access to other professionals as required.

All teams carry out inspections using a common approach based on a standard check list. Inspections were on an unannounced basis for the past 12 months. The transparency of the entire system is ensured by making reports available to the public. It was suggested in the media that one arm of the HSE continues to place public patients in nursing homes which are found to be substandard by the HSEs own inspection regime. I assure the House this is no longer the case.

The health Bill will be published before the end of the year and will establish the Health Information and Quality Authority on a statutory basis. It will be an independent body, incorporating the office of the chief inspector of social services. Reliable and accurate information on what is happening in our system is a critical prerequisite to effective action. We must improve our data collection, analysis and results dissemination and share information on preventing clinical error across our health services. The authority's role on information will also be a key driver of the quality and patient safety agenda.

I assure the House the Government is fully committed to ensuring patient safety is central to health policy and legislation. Significant steps were already taken to ensure improvements in this area. All steps necessary will continue to be taken to ensure real and lasting improvements in patient safety. The Government has done a considerable amount of work to progress the patient safety agenda.

The HSE provides centralised planning, which enables one area to more easily learn from another and best practice to spread. It provides national leadership in quality and risk management across hospitals and primary and community care. The clinical indemnity scheme brings together valuable information on incidents and valuable lessons can be learned from this.

The Department put considerable effort into developing standards of care for older persons and the HSE implemented new management structures to facilitate safety. Through the Health Information and Quality Authority, the Government will put in place another major element of an independent standards regime. All of the elements I mentioned will combine to form a robust and effective patient safety infrastructure.

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