Áine Brady (Kildare North, Fianna Fail)

Amendment No. 9 proposes that care needs assessments should be undertaken by HIQA. The function of HIQA will be to register and inspect all designated centres, including public, private and voluntary nursing homes. The undertaking of care needs assessments would be outside HIQA's role and distract from its critical function as a national regulatory authority. It would also represent an inefficient use of public resources. By maintaining the function of undertaking care needs assessments with the HSE, the legislation ensures that the applicant has access to a multi-disciplinary team of health care professionals located close to his or her place of residence. Such health care professionals will simultaneously be engaged in the provision of care, either within the acute sector as part of the primary care teams or in the community setting generally.

The transfer of this function to HIQA would require significant dedicated resources to be provided with the resulting drain on the provision of frontline health care staff from the HSE. The fact that HIQA is a centralised regulatory authority would also represent problems in terms of providing efficient and cost-effective assessments to applicants at local level. For these reasons I do not propose to accept this amendment.

Amendment No. 25 proposes that financial assessments should be undertaken by an independent third party. However, as the HSE would still be making and financing the arrangements, it is questionable how this independence could be achieved or guaranteed. This amendment is also impractical in terms of the use of public resources. It would require a dedicated budget to finance an independent third party organisation. It would also result in the existing officers who administer the subvention scheme and the public long-stay charges system, and who have received no preliminary training in relation to this new scheme, having to be redeployed by the HSE. Finally, it would result in another layer of bureaucracy, with applications being submitted to the HSE but processed by a third party. This is likely to prove inefficient and to raise issues around governance as, for example, to whom the individual would complain if the application is lost or mishandled. There are also issues regarding data protection and confidentiality for applicants to this scheme. For these reasons I cannot accept amendment No. 25.

Similarly, amendments Nos. 84 and 85 propose that reviews should be undertaken by an independent third party appointed by HIQA. For the reasons already outlined, which are that it detracts from HIQA's core functions, inefficient use of resources and the potential governance issues, I do not propose to accept these amendments.

Amendment No. 110 is related to amendment No. 9, and I do not propose to accept it.

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