Pat Carey (Dublin North West, Fianna Fail)

I appreciate the opportunity to comment on the Bill. I compliment the Minister on her courageous programme of reform, which has not always received the support of everybody in this House or across the country. This legislation is part of that reform programme. What the Government is doing in this and other areas will stand the test of time.

I commend the Minister on her steadfastness on the new tertiary paediatric hospital on the Mater Misericordiae Hospital site. Although some might say I do this because I live on the north side of the city, it has little to do with that. I want to debunk a number of issues that have arisen from time to time. Deputy Ardagh mentioned the question of access. A great deal of our time on the north side of the city is spent discussing with the Railway Procurement Agency the alignment of metro north and the type of stations there will be. It escapes some people that Mountjoy Prison will be gone to a site on the outskirts of Dublin long before the hospital is built. It might not be perfect, but it is the site that has been chosen for it. That will free much space for expansion and redevelopment of that part of the city. The specialties in Temple Street, the Mater, Beaumont, St. James's and Tallaght hospitals will complement each other.

I support the thrust of this Bill. As other speakers have said, there is a culture here of avoiding inspections if we can get away with it. I come from a profession where, at my level, we were regularly inspected. As time went on pressure mounted to ensure we were warned of inspections well in advance. I cannot say I complained overly about that. As Deputy Crawford said, sometimes the best china is brought out and a lick of paint might be applied to smarten up a place that might not otherwise look its best. I see the same arising in farm inspections. There must sometimes be unannounced inspections. We have examples of best and worst practice in supervision, inspection, monitoring and the implementation of legislation. One of the best examples I know is the Office of the Director of Corporate Enforcement because it is built on robust legislation and has independence and resources. We need to ensure this Bill has the same strength. If what happens in this city is any guide, the planning enforcement legislation is almost a laughing stock. It is not strong enough to force offenders to comply, penalties are inadequate and resources are not granted to it.

Even when the most rigorous measures are in place some people will always find ways to avoid complying. For example, the Police Ombudsman for Northern Ireland, Mrs. Nuala O'Loan did not get complete co-operation from all of those she was trying to question for her recent report. Let us hope the Garda Inspectorate does not fall into the same trap of becoming part of the system. The proposed inspectorate we are discussing here must be at arm's length from the HSE and maybe the House will tease that out on Committee Stage. A degree of independence and distance is important. In education, with which I am reasonably familiar, we have the National Qualifications Authority of Ireland, which, in the short period of time it has been there, is respected. It monitors the quality of courses, the environment in which courses are delivered and, to a certain extent, teaching. A good example of an organisation with teeth is the Food Safety Authority of Ireland. Sometimes authority is built around the personality of the chief executive or the chairman of the board, but the FSAI is built on good legislation. I do not know which Government was in power when it was established, but whoever was responsible for it deserves credit as it is robust.

This proposal to establish the HIQA is important and good. Its role needs to be sharpened and defined further. The roles it is designated to carry out are clear and wide ranging, and my only reservation, as articulated by Deputy Ardagh, is its governance, reporting role and independent functioning. There is a danger that an overarching body such as the HSE can squeeze uncomfortable parts of its operations if HIQA becomes a thorn in its side. We have seen bodies that were originally established as independent being emasculated, being subsumed into Departments and their powers and effectiveness being reduced further.

The public health system stands rigorous examination by any authority or inspectorate. Over Christmas I visited a number of public hospitals such as Blanchardstown Hospital and St. Mary's Hospital in the Phoenix Park, and smaller operations such as Seanchara in my constituency, where there was a warm, welcoming atmosphere. As Deputy Burton knows, St. Mary's will never win prizes for architecture but it will win prizes for quality of care. Although it is not right to say this, people are almost killing each other to get into it and that is a testimony to the staff who work there and the quality of provision there. On the other hand we have seen private nursing homes where the quality of care is less than satisfactory. I am also a great believer in day care centres. The HSE has recently opened two such centres in my constituency, Nether Cross and Odin's Wood. Before Christmas, a time when people may not feel at their best, I was impressed by the quality of care, the delivery of services and the happiness of the people there.

The office of the chief inspector of social services has operated on an administrative basis since the late 1990s. There are convincing arguments for setting the HIQA and the inspectorate of social services apart from each other. There is potential for confusion and the organisations working at cross purposes. I am not certain the functions of the social service inspectorate in monitoring the delivery of foster care, the quality of provision in pre-school centres, crèches and detention centres, of which there is one in my constituency, under the Criminal Justice Act 2006, and the monitoring of standards, care, staffing and resources can sit easily with the functions of the HIQA. I am open to persuasion and the thinking may be that one may complement the other. There is at best the possibility of duplication of inspections, registrations and monitoring of standards. At worst there is the possibility of deliberate confusion between the roles of the two authorities. It needs to be clarified whether they will be separate sub-committees of a HSE executive or just administrative units with some joint reporting role. The Minister in her reply may be able to satisfy some of our concerns.

Like Deputy Glennon I welcome the commitment to the provision regarding whistleblowers from within the health service as this is necessary in light of experience. The Bill has the potential to be effective legislation but its functions and operations need to be teased out.

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