Margaret Conlon (Cavan-Monaghan, Fianna Fail)

I thank Deputy Reilly for introducing this necessary Bill. I respect the Minister for Health and Children's leadership in not taking a partisan stance on this issue. I also welcome the establishment of a group to examine the issues raised, with a view to returning to the matter by the end of January 2010.

The Minister for Health and Children proposes the Bill be re-examined fully. Its stated purpose is "to regulate doctors so that they must have appropriate insurance in order to practice medicine in Ireland". This needs to be done to update legislation so it moves and adapts with the changing nature of medical law. The public needs to have confidence in the medical services. The relationship between a patient and their general practitioner is personal and intimate. It is important patients treated in an improper manner are fully compensated.

The State, under the clinical indemnity scheme, takes responsibility for the indemnification and management of clinical negligence claims arising from the diagnosis, treatment and care of patients. The scheme was established because commercial insurers were not interested in continuing with many medical practitioners or were not in a position to provide cover at affordable rates due to ever growing court costs and high awards.

The State Claims Agency, established in July 2002, manages the clinical indemnity scheme. It was imperative that it would rationalise the many and varied indemnity arrangements which applied up until then. The scheme allows legal liability for various health centre's employees' alleged clinical negligence.

While this Bill is needed, we need to analyse further its implications from legal, administrative and other angles. As the indemnity scheme is not an insurance-based scheme, it would, therefore, fall outside the current drafting of this initial Bill. I agree with the Minister's desire to re-examine this Bill in its entirety so as to ensure further add-on amendments are not needed to cover provisions that may have been missed.

In January 2007, the Commission on Patient Safety and Quality Assurance was established to develop clear and practical recommendations to ensure that safety and quality of care for patients existed across the health care system. The commission's report, Building a Culture of Patient Safety, was published in August 2008 and approved by the Government in January 2009. It contained 134 wide-ranging recommendations. The implementation steering group, chaired by the Department's chief medical officer, was established in June this year. The group's initial report is due presently and I look forward to its publication.

HIQA is already well advanced on the development of national standards of patient care. We need the highest levels of quality and safety across all health care sectors. Patients and their families demand and deserve nothing less. HIQA has developed a model for quality and safety based on research and analysis of international and national literature on safety, quality and standard development. There has been wide consultation with stakeholders which is to be welcomed.

I commend the Minister for Health and Children and her Department as she aims to restore the confidence of the public in the health services. This is being achieved through the establishment and continued strengthening of HIQA and the Office of the Chief Inspector of Social Services. The significant developments in patient safety including quality and risk, complaints management, incident reporting and learning in the HSE, particularly in the past two years, are also acknowledged as is similar work in the regulatory bodies.

It is important we continue to create a culture of openness in the health system. A patient's dignity must always be respected. Many are often vulnerable who must believe they are protected from malpractice. Members on this side of the House recognise several issues raised in the draft Bill need further analysis. This will allow the space, time and expertise to deliver more fully fledged legislation. I acknowledge Deputy Reilly's efforts in introducing this Bill.

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