Mary Harney (Dublin Mid West, Progressive Democrats)

I accept that. We must prioritise the services we provide, irrespective of whether resources are made available from general taxation or a combination of social insurance and taxation or private insurance and taxation.

It is our priority to ensure terminally ill people are provided with the highest possible quality of service. I am proud that in the mid 1990s, Ireland became the second country in Europe to introduce consultant cover for palliative care. While the system still has gaps and deficiencies, we are rapidly moving to provide appropriate services for people who are terminally ill. The cancer programme is very much about reducing the incidence of death from cancer and so on.

Regardless of how they are made, one must always bear in mind the regulatory impact of regulations. This would also be the case if Deputy Reilly or Deputy O'Sullivan were in my position. When Governments are introducing regulations, they must consider their economic impact and cost as well as wider impacts. Many worthwhile Government programmes are phased in over a medium to long-term timeframe because of the various impacts arising from making the transition from a traditional way of doing things to a new model of care. This is also the case in many areas other than health.

On standards and giving HIQA teeth, I agree that we must have a licensing regime for public and private providers. We have an authorisation regime for nursing homes and HIQA will inspect nursing homes from next year onwards when it will be in a position to close down nursing homes which do not meet standards.

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