Tony Dempsey (Wexford, Fianna Fail)

Déanaim comhghairdeachas leis an Aire Sláinte agus Leanaí agus na hAirí Stáit as ucht an Bille seo a chur os ár gcomhair. Roghnaíodh mar Theachta Dála mé ceithre bliana ó shin. Gach uile lá ó shin, léighim trácht sna nuachtáin agus cloisim daoine ag gearán ar an raidió agus teilifís. Go minic, bíonn cúis cheart acu gearán a dhéanamh faoi chúrsaí leighis sa tír. Tharla rudaí uafásacha go minic sa tír seo. Déanaim comhghairdeachas leis na hAirí éagsúla agus an HSE toisc go raibh siad cróga go leor dul i gcoinne na rudaí seo agus céimeanna a ghlacadh ionas go mbeidís ábalta na deacrachtaí a scrúdú agus a bheith cinnte nach dtarlódh a leithéid arís.

From the time of my election a few years ago, somebody has often made a statement on the radio nó sa páipeír or on television about the awful events in places such as Leas Cross. I congratulate the Minister, Deputy Harney, and the Ministers of State, including Deputy Tim O'Malley, who is in the House tonight, for being brave enough to put before us a scheme which will guarantee to the ordinary person that there will be no repeat of such disasters.

The components of the name Health Information and Quality Authority are resonant of what has been wrong. There is nothing more important than the health of the individual in a nation. There is no guarantee more necessary in a democracy than equality of health care. Deputy Enright mentioned standards of information and I agree with her points in that it is very important that rigid standards are put before us.

It is also imperative that quality, which has sadly been lacking, will be addressed through this new authority. I would go so far as to suggest a league table. Such a table would be abhorrent in education but not in the health sphere as people should know the standards available before registering in a nursing home.

The vulnerable sectors of society are referred to specifically in the Bill. The quality and standards which this Bill will implement have been commonplace in industry and for Deputies. Every four or five years, Deputies go before the public, are scrutinised and their performances are judged in the most critically analytical manner. It is time the standards applying to industry are applied to public and private services in the provision of health care.

I note the Bill will implement an independent inspectorate for public and private services, which is very important. For too long inspectorates and their inspectors have not been independent. Although I use the education system as an example, rather than criticising it, inspectors there usually come from a pool of teachers. The Garda is inspected by peers. The saying in Latin is "Quis custodiet ipsos custodes?" or "who will guard the guards?" The guardians of this new approach, implementable through HIQA, will be independent and I commend the Ministers involved and the HSE on this independence.

The power of enforcement is also needed. I am delighted HIQA can close a nursing home or section of a hospital if it does not meet justifiable and acceptable standards. In the past, the legal process required to do this rendered it is impossible to achieve closure.

Registration requirements are also important. I believe that anybody could have opened a private nursing home until now, although I am not completely sure about that. Standards were very limp if they existed. This board will in future oversee registration and I am confident there will be serious scrutiny of those who wish to provide care for our most vulnerable sector.

It will be a single national agency and if no other benefit flows from the HSE, this will be one. There could be no single independent inspectorate under the various health boards but under the HSE, we can have a unified approach. The standards maintained in Wexford will be similar to those in Limerick, Galway etc. It is very important to have a single authority scrutinising these issues.

Enforcement is important and there should be no compunction in closing those facilities that do not deserve to remain open. I was interviewed this morning on South East Radio about the national development plan, particularly with regard to education. I was delighted to note that it is hoped to bring 50,000 people out of the poverty trap through second chance education. The Christian Brothers did this for me and many others when they provided education at no cost to the taxpayer and little cost to the consumer.

Listening to various Deputies discussing MRSA, I am reminded that nuns in the past voluntarily rendered a service to the public that ensured cleanliness unequalled anywhere else in Europe. Those days of voluntary service, within or without the various churches, are gone and voluntary effort is no longer available at the scale it was when the Christian Brothers worked in education and nuns worked in hospitals.

It is therefore important that this board will have representatives of the consumer. I believe Lord Denning described the ordinary man as the man on the Clapham omnibus, and this man often suffers in the hospitals. If one has enough money, it is sometimes possible to get a service that is otherwise unavailable. There will be equality of service. The gaps in the scope of enforcement that have existed for too long and allowed too many unscrupulous people to escape ordinary moral standards are being closed by this Bill.

I am glad the Minister has mentioned the standards in the care of children in pre-school and foster care as well as old people being cared for in types of boarding houses. These people will also be protected through HIQA.

I will refer to the Minister's speech in which she briefly mentioned the functions of the authority. I will not go through all of them because her speech contains too many and I prefer to speak off the cuff rather than read.

The first functions mentioned are to "set standards on safety and quality for all services provided by the HSE and service providers on behalf of the HSE, and private nursing homes, with the exception of mental health services which are covered by the Mental Health Commission and the Inspector of Mental Health" and "monitor compliance with the standards it sets and advise the Minister and the HSE on the level of compliance".

It is hoped inspections will take place unannounced and someone will drop in and see what is happening on that day. The ultimate mistake in the past was to announce inspections. If one knows an inspector is coming, it is easy to prepare. I hope HIQA will send people without notice.

The functions also include to "undertake investigations as to the safety, quality and standards of services where the Minister believes there is serious risk to the health or welfare of a person receiving services". I hope a need for such an investigation will not arise. From my reading of the Bill, if HIQA operates with the vigour the Minister intends, we will not have investigations because the standards of registration will automatically ensure we do not have rogue traders.

Another function will be to "carry out reviews to ensure best outcomes and value for money for the resources available to the HSE". During my interview this morning, I was asked what was in the national development plan for the current health budget. I stated that in 2005 approximately €4 billion was taken in income tax from ordinary taxpayers and €13 billion, more than three times the total income tax take, was spent on health services. To me, that is enough. It is now time we saw value for money. I hope the inspectorate will also scrutinise HSE resources. We have had too many failures in the past.

The next function mentioned is to "operate accreditation programmes of health and personal social services in both the private and public health sectors" and "carry out assessments of health technologies, including drugs and medical devices". It has always amazed me that one can buy a ventolin inhaler in Spain for approximately 20% of what it costs in Ireland. From my association with sport, I know many athletes who must take ventolin. It is one of the drugs banned by the new authority and one can only take it with the authority of a doctor.

Having been in Lanzarote with the Wexford hurling team and seeing the number of young men entering shops to buy inhalers, I recommend to the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, that the cost of drugs be taken into the remit of HIQA. It is a scandal that although we are in a common market we do not have a common price for drugs. Not only do we not have a common price but the price in Ireland is extortionate when compared with the countries with which we trade on a daily basis.

The authority will also "evaluate information available on services provided by the HSE and other service providers and the health and welfare of the population". I congratulate the Minister and the Ministers of State for their courage in seeking standards which have been commonplace in industry for many years.

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