Liam Twomey (Wexford, Fine Gael)

One of my problems with HIQA was that patient safety was not its core objective. The role of the Social Services Inspectorate is to examine standards in all institutions involved in health provision. HIQA's role does not just concern social services inspection but also the evaluation of technologies. This is a nice euphemism that slipped through in the explanatory memorandum. Another of its functions is the exact same as that of the National Institute for Health and Clinical Excellence in the United Kingdom. I have raised this on Second and Committee Stages and therefore the Minister of State will be fully aware of the role of that institute. Quite clearly, the core problem with the institute, which is supposedly built around patient care or safety, is that it decides whether one can receive treatment according to a cost-benefit analysis. If one is expected to live for so many years and one's treatment costs so much, one will receive it, but if one is expected to live only for a short time and the cost of one's treatment exceeds a certain figure, one will not receive it. This does not comprise a patient safety issue, even by the widest stretch of the imagination of a member of the Progressive Democrats. The Minister of State will agree with me in this regard.

The same problem applies to HIQA. When trying to create an ethos of patient protection, it is inappropriate to include among the functions of the organisation that deals with standards and safety issues in nursing homes and hospitals a function that would deny a person medical treatment because of its cost or because he or she will not live long enough.

We must all have an idea of costs and I would like nothing more than a cost-benefit analysis of the co-location of private hospitals on the grounds of public hospitals but unfortunately the Government cannot get around to carrying this out. Putting accountants in the same room as patient safety staff will confuse the ethos of HIQA and it will therefore not work very effectively. My first four amendments, Nos. 1 to 4, were deemed out of order because they attempted to address this.

The Social Services Inspectorate and the Mental Health Commission should have been amalgamated as part of a patient safety authority. My colleagues in the Labour Party would very much agree with this because we do not want to stigmatise those with mental illness as different from patients in the rest of the health service. Instead of breaking down barriers and destigmatising certain sectors, especially the one for which the Minister of State is supposed to be responsible, the Government is drawing in an even darker pen the line between patients with mental illness and patients in other areas of the health service.

I will not press my amendment on the basis of what I have said but I believe the Minister of State has made a mistake.

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