Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I move: "That the Bill be now read a Second Time."

I warmly welcome the opportunity to address the House today on Second Stage of the Health (Amendment) Bill 2016 which is a technical amendment to the Health Act 2007 and has the sole purpose of extending by two years an existing transitional period in respect of the registration of centres for people with disabilities. I will also take this opportunity to say a few words about the broader issue of the safety and protection of vulnerable people in the care of the State which is of paramount importance to me and this Government. There have been a number of cases coming to light in recent weeks and months which have given me significant cause for concern. I am joined in this reaction by other Deputies in the House today. Unacceptable events and practices, mainly historical but also more recent, are coming to light following the RTE Prime Time programme. It reflects an attitude in the past to people with a disability. I have major, urgent concerns and during my watch I will protect and guarantee the rights of all people with physical and intellectual disabilities. It is important.

Let me make it clear today, I am determined that the utmost priority will be given to the full protection of people with a disability in the care of the State. Furthermore, I am determined that historical issues will be comprehensively examined and addressed. The cases in recent media reports are of serious concern but it is important to note they are now coming to light because the system has changed. Things are far from perfect but in recent years we have introduced new policies and regulation to attempt to prevent this kind of event from happening again. Since 2013, all residential centres for children and adults with disabilities must be inspected by HIQA. The regulator is a shining a light into every corner of every centre where our most vulnerable citizens live. Notwithstanding the reports we read in the media, most of these centres are providing very good person-centred care and support.

The inaugural annual report by HIQA on the regulation of centres for people with disabilities published last week found evidence of a high standard of care and a focus on individual residents' needs and preferences in many cases. It stated that regulation has brought a cultural change to the sector and has steadily led to improvements in the standard of care provided to residents. My objective will be to ensure that residents are protected from all kinds of abuse. There are exceptions to this and some HIQA inspection reports do not make for easy reading. I totally endorse the work of HIQA. There have been cases where massive improvements have been demanded by HIQA and there have been cases where HIQA has cancelled the registration of centres that are unable to meet the standards required. I emphasise that regulation is a work in progress and it takes time to bed down these new systems. The Bill before the House today is a small component in this system. I will return to its specific provisions shortly.

On Monday of this week, the Minister, Deputy Harris, and I met with HSE officials. We made very clear and outlined our serious concerns about the recent allegations in the Prime Time programme and we listened to the HSE on a range of measures that are being implemented and have progressed in recent years to improve these matters. The meeting on Monday was very tough and difficult but we had to put it on the line to ensure the safety of all residents. This includes the Transforming Lives agenda, which is driving the move towards person-centred, community-based care and the roll-out of the critical policy of safeguarding vulnerable persons at risk of abuse. In addition, the HSE confidential recipient, Ms Leigh Gath, is working diligently to assist people who need to approach a person in confidence to have a concern addressed. The confidential recipient is another key part of improving safety for residents. Ms Gath’s first annual report set out a range of cases in which she has been involved and was able to assist people with concerns.

I urge all Deputies, if they have any concerns or issues, to contact Ms Gath.

Regarding some of the allegations, I expect to receive shortly from Mr. Conor Dignam, SC, the report which will feed into the terms of reference for a statutory commission of investigation. This will be established as a priority following agreement on the terms of reference and the approval of the Oireachtas. When this happens, I will be looking for cross-party support in regard to the commission of inquiry and the terms of reference.

I will also receive shortly the independently chaired inter-agency review in regard to the case of "Mary", who lived in a former foster home in the Cork-Kerry region. As soon as the facts are established, I am determined that every required action will be taken.

Actions and developments are in progress. It is important that everybody is reassured regarding these matters. None of these vital changes can take effect overnight; all are works in progress.

I am committed to developing the framework of regulation and investigation to safeguard and protect people with a disability in the care of the State and one part of this Health (Amendment) Bill 2016 which I will now discuss.

The Health Act 2007 provided for the establishment of the Health Information and Quality Authority, HIQA, its inspection and regulation of designated centres and the framework for registration of these designated centres. The measures provided for in the Health (Amendment) Bill 2016 relate exclusively to residential centres for people with disabilities. It was planned that all such designated centres for people with disabilities would be inspected and registered by HIQA, or be refused registration, within a three-year period of the relevant section of the Health Act 2007 coming into effect. This period is now due to expire on 31 October 2016. Due to the complexities of the disability sector and, in some cases, the significant quality and safety issues identified by HIQA in the first two years of regulation, HIQA alerted the Department of Health in 2015 that it would not be possible to complete a final registration decision for all designated centres which had been deemed to be registered in this way by the end of the transitional period on 31 October 2016. There are 1,000 residential centres for people with disabilities throughout the country and by June 2016, 556 had been registered. HIQA estimates that more than 350 centres will not be registered by the end of October 2016.

It is important to understand the very serious consequences if the deadline is not extended. Under the existing legislation, HIQA would be obliged to cancel the transitional registration of a large number of centres. The Health Service Executive, HSE, would be required to take over the running of these centres and to make alternative arrangements for residents of the centres taken over. This would have major implications for the affected residents but also significant budgetary, administrative and staffing implications for the HSE and Department of Health.

The Health (Amendment) Bill 2016 is simply a technical amendment to the 2007 Act with the sole purpose of extending by two years the transitional period which sets out the final deadline for registration of centres for people with disabilities. The Bill has no impact on the registration or regulation of residential centres for older people or children. The exact same standards of safeguarding and protection will continue to exist for residents of the centres for people with disabilities.

The proposed two-year extension will not limit or diminish the responsibility of providers to manage and operate the services under their control, nor will it limit HIQA in the application of its sanctions and powers of enforcement. HIQA is in full agreement with the extension of the transitional period proposed in the Bill and that is why I ask the House for its support today. Furthermore, there is no additional cost to the State involved in extending the timeframe for registration by HIQA of centres for people with disabilities.

The Health (Amendment) Bill 2016 is relatively short legislation, providing only a minor technical amendment to section 69 of the Health Act 2007.

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