Catherine Murphy (Kildare North, Independent)

Christmas may be a distant memory but this special sitting has been called to discuss this important legislation. Reading the Bill one is struck by how exposed elderly and disabled patients have been in the health service, as manifested in a number of scandals in recent years. These elevated the importance of the Bill, which proposes to replace the informal, non-statutory arrangements currently in place. This indicates the reactive approach taken to many issues affecting the health service. One would expected the provisions of the legislation to have been introduced as matters of principle and to have formed the cornerstone of the health service.

The increasingly complicated arrangements operating in the health service are becoming difficult to fathom. If Deputies find them complex, members of the public will find them even more difficult to negotiate. While the Health Information and Quality Authority appears to be a stand-alone body, it is a sister organisation of the Health Service Executive.

I am under the impression that the HSE is little more than old health boards rebranded. As with Deputy McManus, I have noted that the replies it issues to parliamentary questions replicate those provided by the health boards.

I seek clarity on how HIQA will function. For example, the Bill allows for the transfer of HSE staff, with pension rights, to HIQA. However, HSE staff who monitor pre-schools or nursing homes may also deal with entirely different matters as part of their jobs. How will the ceiling on staff numbers be affected by these arrangements? Although it is denied that a recruitment embargo is in place, it is difficult to describe current policy as anything other than an embargo when staff numbers are not increasing in areas where more recruits are clearly needed. Will a separate funding mechanism be introduced for the new organisation? Will it have its own budget? What will be the staff complement and will it impact on the ceiling on staff numbers?

Is it necessary to provide that HIQA has a business plan, an annual report, a corporate plan and a code of governance? Is this not excessively cumbersome? The draft code of governance for the Health Service Executive announced last September has still not been finalised, yet the HSE has been in operation for several years. Timing is important. One would expect HIQA to establish principles or a code of governance before it commences its operations.

Accountability is a major issue in the health service and one of the briefs of the Opposition is to ensure it holds the Government to account. I am concerned that the provisions will have knock-on effects similar to the impact of nursing home charges on places such as the St. Raphael centre. Will the Minister examine this matter as it is causing undue concern for residents of many institutions?

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