Johnny Brady (Meath, Fianna Fail)

I welcome the opportunity to speak on this new Health Bill. As we all know, the Bill is a fundamental part of the health reform programme begun by the former Minister for Health and Children, Deputy Martin, in 2003 and continued by his successor, Deputy Harney, since she took over the Department in 2004. Coming from the north-east, a Cheann Comhairle, you and I know the problems that have existed in that region over the years. We all welcome the commitment from the HSE that a new regional hospital will be built in that area. I compliment colleagues in my town, including the members of Kells Town Council and in particular Councillor Brian Reilly. The council has made land available if the health area executive needs it to build a hospital there. If not in Kells, I hope it will be built in Navan or elsewhere in County Meath. It would be a suitable location for a regional hospital. When the announcement is made, I hope County Meath will be the location.

The programme currently being undertaken includes the most extensive reform of the health system in more than 30 years. The programme's priority focuses on improved patient care, better value for taxpayers' money and improved health care management. The development of a world class public health service is a core objective for everyone in this House. We want to expand quality and access, which we will achieve through greater investment and system reform. No-one can claim there has not been investment in our health services in the past ten years. As a share of national income, non-capital public expenditure on health has increased from 5.8% of GNP in 1997 to 7.6%. We are matching this with reform. The HSE has been established under the reform programme. It is up and running and while it is facing many challenges, I am confident of its success.

A key policy aim of the health reform programme is to deliver high quality services based on evidence-supported best practice. The Health Information and Quality Authority, which this Bill establishes, is central to advancing this aim. The mandate of HIQA is to ensure that world class, quality standards are applied in Ireland's health and personal social services across the public, private and voluntary sectors; to monitor and inspect against these standards; to provide information in regard to the services; and to undertake health technology assessments. HIQA will play a crucial role in promoting delivery of the highest quality and most efficient health services to people in every part of the country. It will provide the common thread of efficiency, quality and effectiveness for the health sector, to help inform and assist decision-making at all levels — national, local and individual0

It is the job of HIQA to ensure that best practice is rapidly, effectively and consistently advanced nationwide, while acting as a resource for planners, health care professionals, patients and their carers to help them make decisions about treatment and health care. HIQA will provide a stamp of assurance for the public and taxpayers that the highest possible standards of safety and best systems are adopted by and embedded within the sector, and that value for money in the delivery of health and personal social services is guaranteed.

Much of the focus on this Bill arises from the fact HIQA will incorporate a new and independent inspectorate and registration authority for residential services. In other words, the Bill provides the means by which we will get tough on setting standards and tough on enforcing standards. Make no mistake, an independent organisation with real power is being created. With this Bill, we are placing the Social Services Inspectorate, SSI, on a statutory basis and providing for its expansion to inspect and register residential services for people with disabilities and older people.

The SSI was established in 1999 on an administrative basis to inspect the social services. The priority at that time was the inspection of children's residential centres run by the HSE and, more recently, the inspection of foster care services. Inspections are conducted against the National Standards for Children's Residential Centres of 2001, the National Standards for Special Care Units of 2002 and the National Standards for Foster Care of 2003, which were produced by the Department of Health and Children. These were the first nationally agreed standards in this area.

The SSI publishes its inspection reports, which include findings and recommendations under standards for best practice. In 2005 the first full round of inspections of all statutory children's residential centres in the country was completed. The SSI uses unique insights gained through inspection to support developments that improve quality in the sectors in which it operates. Annual reports provide an overview of findings in the sector, prioritise areas for improvement and offer a national summary of service provision.

The SSI will now be established as an office within HIQA. It will continue its work in respect of child welfare and protection services. This replaces and strengthens current inspection and registration arrangements. For the first time, there will be a fully independent inspectorate for all nursing homes, public and private, as well as for centres for people with disabilities and children. There will also be clearer procedures to close a centre if its continued operation poses a risk to the health or welfare of residents, including an explicit procedure for an immediate or urgent closure of a centre.

The purpose must be to make sure that the standards set are applied consistently and on a national basis, and that, where necessary, action can be taken quickly and effectively to protect service users. In monitoring standards, HIQA will have strong powers, including the power to enter and inspect premises, access documents and interview staff. HIQA will review and inspect to ensure services are being provided and to investigate serious concerns in health or social services. It will evaluate and provide information to staff and the public in regard to how well services are performing, which will inform the planning of future services. The authority will also assess new and existing drugs and equipment to ensure they impact positively on the quality of life for patients and represent value for money.

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