John Carty (Mayo, Fianna Fail)

I welcome the opportunity to speak on the Bill which continues the health reform programme begun by the then Minister for Health and Children, Deputy Martin, in 2003, and carried on by the Minister, Deputy Harney, since she took over the Department of Health and Children in 2004.

A central priority of the health reform programme is to deliver high quality services based on evidence-supported best practice. The Health Information and Quality Authority is the means by which this objective will be achieved. The functions of HIQA will be as follows: setting and monitoring standards, safety and quality in health and personal social services provided by the Health Service Executive or on its behalf; advising the Minister and the HSE on the level of compliance with those standards; carrying out reviews to ensure the best outcomes for resources available to the HSE; carrying out assessments of health technologies, evaluating information on health and social services and the health and welfare of the population; advising the Minister and the HSE on deficiencies identified; setting information standards and monitoring those standards; and undertaking investigations as to the safety, quality and standard of services where the Minister believes there is serious risk to the health or welfare of a person receiving services.

We all know health information is a valuable resource. Many advances in health and health care during the past two centuries have depended on the increasing availability and application of useful health information. Discoveries in genetics and breakthroughs in bioengineering, health informatics and other fields are likely to transform our information base and provide more effective means to protect health, combat chronic disease and plan and deliver health care. Information is generated at such a pace there is a serious risk of information gaps opening up between the public, clients-patients, professionals, planners, policy makers and the research community. Keeping abreast of new information and applying it on a daily basis will remain an ongoing challenge. The national health information strategy will support the achievements of the vision, goals and objectives set out in the health service reform programme by ensuring health information becomes more readily available and appropriately used throughout the sector. HIQA will play a pivotal role in the implementation of the strategy. The potential of modern information and communications technology will be exploited to help health professionals provide safer and more integrated care to their clients-patients and to achieve value for money.

At its core, the strategy is about fostering a change of culture with respect to the development and application of health information at all levels. In the hands of people with the expertise and incentive to use it, data which is defined and understood in a shared way is transformed into information. This information, set in the context of previous action, becomes evidence, and evidence that is analysed and researched becomes knowledge. The potential of applied health information to transform all aspects of health care delivery and to effect major improvements in population health is clear and, with consistent effort, attainable. The implementation of this strategy will contribute in a very significant and fundamental way towards achieving that goal.

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. The Bill also establishes the office of the chief inspector of social services within HIQA, with specific statutory functions. The chief inspector will be responsible for inspecting residential services for children in need of care and protection, people with disabilities and older people, including in private nursing homes. Inspections will be carried out against standards set by HIQA and regulations made by the Minister. The chief inspector will also be responsible for registering these residential services, inspecting special care units and monitoring the delivery by the HSE of foster care services, the scheme for boarding out of older people and the HSE's preschool inspection system.

I was delighted the Minister assured the House that the preparatory work has been carried out by the interim HIQA so that, as soon as this Bill is enacted, it will be ready to use its powers. It is reassuring to know that very soon there will be a fully independent inspectorate for all nursing homes for older people, public and private, as well as centres for people with disabilities and for children.

It is vital HIQA has strong powers. It will set national standards and the chief inspector will inspect residential facilities against these standards. Where necessary, the Bill provides for action to be taken quickly to protect health service users. It also includes provisions for the urgent closure of centres. No longer will there be any issue about the legal capacity to urgently shut down a nursing home or residential care centre that is clearly failing in its duties and obligations.

There is no doubt a rigorous and robust inspection system is being set in place. Centres will be inspected against standards set by HIQA and regulations made by the Minister. The chief inspector of social services will have extensive powers in carrying out inspections and may enter a centre, examine any records, take copies of documents and inspect and remove other relevant items. The chief inspector can also interview staff in private and interview residents. Residential centres may not operate unless they have been registered by the chief inspector and it will be an offence to operate without registration. A centre must be in compliance with the conditions of its registration. Registration details will be available to the public on the Internet. The chief inspector can cancel a registration if the residential centre fails to meet standards. An urgent cancellation of registration can be sought by the chief inspector from the District Court if the chief inspector believes there is a risk to the life or a serious risk to the health or welfare of people resident in a centre.

I welcome the Minister's pledge to set up a commission on patient safety and quality assurance to examine and make recommendations on a system of licensing for all public and private providers of health care, which includes public, private and voluntary hospitals. It is the direction we must take to give patients the greatest possible assurances of safety and quality care.

I am certain HIQA will bring efficiency, quality and effectiveness to the health sector to inform and assist decision-making at all levels — national, local and individual. It will be a guarantor for the public and taxpayers that the highest and toughest standards of safety and systems are in force in our health services and that value for money in the delivery of health and personal social services is guaranteed.

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