Seán Ardagh (Dublin South Central, Fianna Fail)

I am delighted to have the opportunity to contribute to the Health Bill 2006 which provides for the establishment of the Health Information and Quality Authority and the Office of the Chief Inspector of Social Services. The area that concerns me is the form of governance that will apply. I hope to be convinced that, as a result of this, there will be separation of responsibility and that the bodies responsible for these important areas will be accountable in a proper governance way to the Minister and to the board of the HSE.

It is not good enough that the Office of the Chief Inspector of Social Services should report to HIQA. Similarly, it is not good enough that HIQA should just report to executives within the HSE. What is being done by these bodies is so important that there must be a degree of independence for the executives that they can, if they see something that needs to be changed, report that to the board of the HSE directly in some way without fear of offending an executive of the HSE. If the Health Information and Quality Authority is to set the standards of quality and safety in many areas, it should not be constrained. It should ensure that those standards of quality and safety are world class. The head or chief executive of HIQA should on occasion, whether it be quarterly or twice yearly, report to the board of the HSE without the executives of the HSE being present.

The HSE, effectively, would have responsibility for HIQA. Normally, on an administrative basis, the chief executive of the HSE would have that responsibility. However, we must ensure that the authority is not in any way prevented from ensuring that the highest professional standards that apply throughout the world also apply in this country. The Office of the Chief Inspector of Social Services is under HIQA and will assess whether these standards are being applied and adopted. It might be better if that body was separate from HIQA, although still reporting in the same way to the HSE. It could have the same governance with regard to reporting to the board as I have suggested for HIQA.

There are times when the Office of Chief Inspector of Social Services might see instances where the standards are being applied but where it is obvious that those standards could be improved. The inspectors must be in a position, without offending anybody in HIQA, to recommend that standards be improved, whether it be in nursing homes, the provision of occupational therapy or chiropody services or other home care services. They should be able to report, without fear, directly to the board of the HSE or a committee of that board on a quarterly or semi-annual basis, just as an internal audit committee within the HSE probably reports to another committee of the HSE board without the presence of the chief executive or other higher executives of the HSE.

This already happens in State organisations. The National Pensions Reserve Fund Commission and the National Treasury Management Agency work together and Dr. Michael Somers is still the chief executive. The two bodies work hand in glove very effectively. A more independent HIQA and chief inspector of social services should be considered so there would be a separation of responsibility and greater independence. It would result in a greater degree of double check within the system. One body would be able to balance the other body and improve the service rather than have it in a position where it would just carry on in a certain fashion because that is the way it was done last year.

There are many other things I could say about the board but as this is a health matter and I am a representative for the Dublin South-Central constituency where Our Lady's Hospital for Sick Children is located, this is an opportunity for me to state that I fully support the national children's hospital being located on the site of the Mater hospital. It should be proceeded with. Any further delay will be to the detriment of the many children who need the world class tertiary services that can best be provided by a single hospital in a single location.

However, the team in the Crumlin hospital have spent much time exploring the design of a world class tertiary facility in that location and, as a result, has developed a valuable body of work and a good knowledge base. It would be an awful pity if that is not used and developed with the other methods being applied. There is a stand-off at present and this is not the time for it. Hopefully, wiser counsel will prevail.

The question of location should be put to bed at this point. I cannot understand how access can be a problem. Consider Dundrum Shopping Centre where ten times, if not 100 times, the number of cars enter and exit on a regular basis. It means there are three entrances to the car park but it is not beyond the imagination of the designers to have at least two entrances to the multi-storey car park at the Mater hospital. That should not be a problem.

The knowledge available from the Crumlin team should be recognised, brought on board and used with the knowledge provided by the Temple Street hospital and Tallaght hospital personnel. The new hospital should be put in place as soon as possible.

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