Ivor Callely (Dublin North Central, Fianna Fail)

I welcome the opportunity to participate in the debate on the Health Bill. I have expressed my concerns previously about inconsistencies in standards in long-stay institutions throughout the regions. Therefore, I welcome the establishment of an authority that creates a registration and inspection system for residential services for children, people with a disability and older people in need of care and protection.

We must leave until another day the debate on the issues of a reporting structure and how Members will be able to debate and get information on the separate authorities and inspectorates that will be established. I welcome the fact that we are establishing a registration and inspection system, but I am not satisfied this should be the end of it because when we establish such systems, we are inclined to lose the connection we need to tease out issues related to the authority or service. That debate is for another day.

I am not sure all Members or the public were fully aware of the registration and inspection system we had in place or that they are aware of the new system that will now operate. I welcome the registration and inspection requirements that will apply equally to all providers of residential care centres.

The main objective of the Bill is to provide for the establishment of the Health Information and Quality Authority, HIQA, and the Office of Chief Inspector of Social Services within that authority. In reading the Bill and the explanatory memorandum, I like to think all the i's have been dotted and all the t's have been crossed. That is not my area of expertise and I trust those charged with that responsibility have ensured this is so. It seems, however, the Minister is doing her best to ensure a rigorous and robust registration and inspection system will be in place and that the relevant authority will have extensive powers to carry out its functions.

One might think the reason the Bill is before the House is because it is responding to a small number of cases given significant public attention. It is not; the picture is bigger. Thousands of people receive professional and caring services from both public and private service providers, but a difference has existed between the application of regulations in the different services.

I support the Bill as it sets good and fair standards across all providers of services. In fairness, the Bill could not be introduced or implemented in the past as some of the statutory providers might not have been able to meet the new standards. While private service providers had a system in place, there were inconsistencies. However, the House should acknowledge the dedicated and committed people involved in the provision of long-stay accommodation across the public and private area. These people have provided TLC to people in need 24 hours a day, 365 days a year.

I pay tribute to and congratulate all those involved in the provision of long-term care to people in need of such care. The welfare and happiness of children, people with a disability and older people in need of long-stay accommodation is paramount and a reflection on us as a nation. It is only right that the public should have confidence in the provision of service and that there should be no difference in the quality of care in public, private or regional services as in the past.

The new registration and inspection system meets the best international norms. I always like to set higher standards and feel we should go a bar higher. As a nation, we have the ability to set new best international standards. God knows we need change. If this truth is not recognised, all the restructuring, reform and sophisticated specialisation will be of little benefit.

As the population increases — our population is estimated to reach 7 million by 2021 — there will be greater demand for long-stay accommodation. It is only right, therefore, that all service providers will be required to meet quality standards and there will be open and transparent monitored enforcement of standards.

Other speakers raised the issue of acute hospital services. I have the height of regard for Deputy Costello, but I am disappointed that he seemed to cherry-pick certain issues relating to accident and emergency services. I can relate to what he said, but I am surprised he would not give credit to some of the success stories in our services. When I mentioned Smithfield, the Deputy seemed to be at a loss and started talking about primary care. He does not seem to know what is happening in Smithfield, which is in the heart of his constituency. What is happening there will have a significant impact and has already had an impact with regard to those who attend the Mater Hospital to which he referred. I suggest Deputy Costello should visit St. Mary's rapid access facility and see what is happening in Smithfield. I would like him to come back to the House when he has done so to say what he thinks of that service.

I am aware the leader of the Opposition, Deputy Kenny, is desperately trying to gain political support and yesterday on the Order of Business he raised the issues of the accident and emergency department at Beaumont Hospital, St. Joseph's Hospital and St. Mary's Hospital. Regretfully, as is normal with Deputy Kenny, he got it all wrong. That is no surprise. He is dedicated to too much comment on his incorrect diagnosis and not enough on a proposed solution to problems in the services. I am not alone in saying this; it is being said on the ground and the Fine Gael Party knows that is the case.

I have a great knowledge and understanding of the services emanating from Beaumont, St. Joseph's and St. Mary's hospitals. I have worked with these authorities along with other service providers in the area to enhance and develop services. I salute all the personnel in these hospitals, who provide tremendous care and give of their best in the delivery of services.

Beaumont Hospital undertakes tremendous work as part of its regional and national specialty. Just as Deputy Kenny challenged people on the Government side of the House, I challenge him to come with me and visit the neuro-surgery ward at Beaumont Hospital to see the good work being carried out there. He should also visit all the other wards in the hospital to meet the dedicated personnel, in particular, a geriatrician named Dr. Ciaran Donegan who is doing extraordinary work.

I agree, that like busy stations, Beaumont Hospital has some pressure points that are a source of concern. There is a bottleneck in accident and emergency departments and I am concerned about delays in the accident and emergency department. Like Deputy Costello, I share the concern about the figures being presented to us by the HSE. I stated previously on the public record that the jury is out in the case of the HSE.

I concur with what Deputy Costello stated about the figures being presented. I know well their source, Ms Helen Stokes, because I worked with her, but I do not know who is asking her to provide the figures as they are being presented. Figures in my possession indicate that on 10 January eight out the 33 accident and emergency departments — 24% — had nobody waiting for admission and 16 out of 33 accident and emergency departments — 48% — had nobody waiting, and that, as late as 21 February, eight out of 34 accident and emergency departments — 23% — had nobody waiting for admission and 15 out of 34 accident and emergency departments — 44% — had nobody waiting, and then one sees a phrase, "from the time they had been referred by the accident and emergency team for admission", under the latter figures which gives the distorted picture on which I concur with Deputy Costello.

What surprises me is this. When I was in the Department of Health and Children I initiated the Rapid Access Clinic, which avoids entry through accident and emergency. It has proved so successful that the Department is now providing special funding to set up a new centre in Smithfield, not alone to accommodate the Mater Misericordiae Hospital's accident and emergency department but also Beaumont Hospital's accident and emergency department. Deputies Kenny and Costello do not seem to understand this. They are looking at their own political, general election orientated diagnosis of a situation, but there is much good work taking place.

Deputy Kenny got the geography of St. Joseph's incorrect. I am delighted that I, when in the Department, allocated the first funding to St. Joseph's for a special rehabilitation unit for stroke patients, which heretofore we had not got in the services.

See this speech in context