Tim O'Malley (Limerick East, Progressive Democrats)

I take issue with the statement made during the debate that the Health Bill does not deal with patient safety because patient safety is at the heart of the Bill. The Bill empowers the HIQA to set nationally applicable standards in services and gives it extensive powers, set out in Part 9, to monitor compliance with standards and undertake investigations. As well as patient safety, the Bill will ensure current good practices are embedded and developed. The setting of standards for health care is, therefore, a key function of the HIQA. Regulations may be made by the Minister in respect of procedures to be followed by the HIQA in setting standards, including procedures on consultation and publication.

The chief inspector of social services will be an employee of the HIQA and have statutory independence in decisions on registration and inspection of residential centres for older people, people with disabilities and children in need of care and protection. The centres will be known as designated centres under the Bill. The chief inspector may also appear before an Oireachtas committee to give a general account of the activities of his or her office.

The regulatory arrangements for inspections will provide an objective, robust and transparent inspection and registration system for designated centres. Registration of centres is for a three-year period. It is deliberate that the Bill does not specify how often a designated centre must be inspected within a given timeframe. It is better not to be overly prescriptive in this matter, as it should be for the judgment of the chief inspector to make decisions appropriate to each centre. Deputies expressed the opinion that the inspection of designated centres should include unannounced visits. The Bill is not prescriptive in this matter, but the interim HIQA has indicated that there will be unannounced visits.

I should make it clear that the chief inspector inspects against standards set by the HIQA and regulations made by the Minister. These standards will be published. Registration information will be available to the public on the Internet. No residential centre will be able to operate if it is not registered and people can be assured that it is operating within the terms of its registration. The chief inspector must be satisfied as to the suitability of those participating in the management of a centre, an issue raised by Deputies.

Regarding standards in residential centres for older people, I take this opportunity to refer to a working group, chaired by the Department and set up with representatives from the Health Service Executive, the social services inspectorate and the Irish Accreditation Board, to develop national standards for long-term residential care settings. The draft standards produced by the working group were formally published by the Minister last month and handed over to the interim HIQA which will oversee a public consultation process. The draft standards provide the HIQA with a useful and comprehensive template for circulation with relevant parties as part of a comprehensive consultation process. The draft envisages core standards that will apply to all residential settings where older people are cared for and for which registration is required. Under the provisions of the Bill, no residential setting for older people will be allowed to operate without being registered.

The draft is set out in two parts, the first of which focuses on the standards concerning the resident as an individual and includes personal identity, social connectedness, rights and health care. The second focuses on the organisational aspects of the residential care setting and includes management, staffing, care environment and health and safety. The publication of the standards by the Minister was the first step in the process. The interim HIQA has established a working group to develop the draft standards further and oversee the public consultation process.

In debating the Bill Deputies spoke of an advocacy role and the need for a framework for complaints. By virtue of its functions, the HIQA is a patient advocate. There are other patient advocacy agencies. In addition, the Health Act 2004 (Complaints) Regulations 2006 were made in December that year and make provision for complaints by persons to the HSE and service providers and require the establishment and operation of procedures and arrangements intended to achieve a fair and reasonable resolution.

I note the importance placed by Deputies on the inclusion in the Bill of provisions regarding the protected disclosure of information or "whistleblowing". This issue will be dealt with on Committee Stage. I thank the House for facilitating the Second Reading of the Bill. We are on an important journey with the health service reform programme and, with this Bill, have taken a big step along the way.

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