John Curran (Dublin Mid West, Fianna Fail)

——but the various sections are not enacted in a timely fashion. With specific reference to this Bill it is worth noting the comments of the Minister for Health and Children yesterday when she assured the House the preparatory work has been carried out by the interim HIQA, so that as soon as the legislation is enacted, the authority will be ready to use its powers. That is important and it should be put in context. It is too easy to stand back and say the Bill is late and that nothing is being done. It is exactly the opposite in this case and that point should have been acknowledged by the previous speaker.

I welcome the Bill which provides for the establishment of the Health Information and Quality Authority and the office of the chief inspector of social services. Section 7 sets out of the functions of the authority. It provides for setting and monitoring standards on safety and quality in health and personal social services provided by the HSE or service providers and advising the Minister and the HSE on the level of compliance with those standards, carrying out reviews to ensure the best outcomes for resources are available to the HSE, carrying out assessments of health technologies, evaluating information on health and personal social services and so on.

It is important to realise this is not just an inspection regime, that standards will be set and there will be criteria for measuring performance. The families and relatives of those in nursing homes, private or otherwise, need to know that their relatives and friends are adequately and properly taken care of. We have seen examples in the past where that has not been the case. Our public service provider, RTE, has adequately shown the case. For many of us who did not have a day to day experience we were shocked with what we found. This specific legislation goes a long way to addressing the concerns raised. Inspection on its own is simply not enough; setting standards is the key. In that regard I refer to the point the Minister made yesterday that work is well under way in advance of the legislation being passed.

That means that shortly after the passing of the Bill the independent inspectorate will be operational for all nursing homes for older people, public and private, as well as for centres for people with disabilities and children. The Bill provides for registration and inspection and tough powers for the new authority which will allow for urgent closure in cases of non-compliance. The public must have absolute confidence in these facilities be they public or private. That the ultimate sanction can be immediate closure helps compliance.

I wish to mention a particular aspect because it arose recently at the Joint Committee on Health and Children. One of the functions of the new authority is to evaluate the clinical and cost effectiveness of health technologies, including drugs, and provide advice arising out of the evaluation to the Minister and the executive. While it may appear to be a small item in the legislation it is timely and important. Recently we have had a debate on the provision of generic drugs where those who were involved in dealing with epilepsy, in particular, were concerned about the effectiveness of generic drugs versus the traditional branded drug, particularly where it had been prescribed for an extended period. In that regard it is important that the Minister has independent advice to evaluate that type of decision making because the implications are profound for those who may use it. There are similar type aspects included in the Bill that need to be acknowledged.

One of the Minister's final comments in her contribution yesterday was that she intends to introduce an amendment to provide protection for what is commonly called whistleblowing, that is, those engaged in the health service professions who come forward with information.

While slightly outside the remit, I wish to make a comment. Much debate has taken place recently on the National Children's Hospital. This time two years ago I spent every day in Our Lady's Hospital in Crumlin. Since then I have met and spoken with a number of the consultants. Much debate has taken place on the location, the Mater Hospital site, transport problems and so on. Others have argued that it should be co-located, one on the northside and one on the southside. From my personal experience a single location is paramount. I saw my daughter in Our Lady's Hospital in a critical condition where an effort was made to transfer her to Beaumont Hospital for particular tests and it simply was not possible. The illnesses that children suffer cannot be clearly categorised where one is suitable to hospital A or hospital B. There is a cross-over of services and if there are two hospitals the services are duplicated.

For parents of very sick children or children who have long-term illnesses, location comes second to medical expertise and professionalism. We want the best outcomes, the best technologies and the best staff. I am not convinced that co-location can provide the best outcome. That is not just my experience in regard to my daughter. If one goes to Crumlin hospital any day and looks at patients who would be transferred to another location for a test or procedure, it is clear that a single location with world-class services is what is required. The debate should refocus on the provision of services within that hospital rather than where the hospital is located. Like any politician I would like it located in my constituency. From a medical point of view for a national facility I do not support co-location. We duplicate services and we do not have the world-class service in a single site that parents of sick children want. I defy any Member who is dealing with a person with a serious illness, adult or child, to say their first concern is not where to get the best medical attention. Whether the person is from rural Ireland or wherever, travel is an inconvenience, but the best medical outcome is the paramount concern. Somewhere in the debate about the Mater Hospital and the National Children's Hospital as possible locations that aspect is missing.

I have deviated slightly from the Bill but having had personal experience I cannot stress strongly enough my view that a single site is what people want, need and deserve and the sooner we can deliver that the better.

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