Dáil debates

Tuesday, 25 November 2008

Other Questions

Nursing Home Standards.

2:35 pm

Photo of Jim O'KeeffeJim O'Keeffe (Cork South West, Fine Gael)
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Question 72: To ask the Minister for Health and Children when the standards for nursing home care, recently approved by the board of the Health Information and Quality Authority, will be published; when the standards will come into force; if the standards will be compulsory; and if she will make a statement on the matter. [42548/08]

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Labour)
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Question 138: To ask the Minister for Health and Children when she expects that the nursing home standards being developed by the Health Information and Quality Authority will be in place; and if she will make a statement on the matter. [42454/08]

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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I propose to take Questions Nos. 72 and 138 together.

The Health Information and Quality Authority submitted its draft national quality standards for residential care settings for older people to the Minister for Health and Children on 29 February 2008. The draft standards have been published and copies are available on the authority's website. In line with best practice, the draft standards, and the regulations required to underpin them, are currently the subject of a regulatory impact assessment. As part of this assessment, a consultation session with key stakeholders was hosted by the Minister and me on 23 October. Further details are available on the Department's website.

I expect the assessment to be finalised by the end of the year and the approved standards and regulations to be in place by the end of the first quarter of 2009. At that stage, and once the relevant part of the Health Act 2007 has been commenced, all residential centres for older people, including public and private nursing homes, will be subject to inspection and registration by HIQA and its chief inspector of social services. The standards involved will be compulsory. In the meantime, discussions are taking place between my Department, HIQA and the HSE about the administrative and other arrangements required to move from the existing system to the new system of inspection.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I thank the Minister of State for her reply. I am very pleased that HIQA will be doing this and there will be some independence in the inspection of public nursing homes. The major deficit to date is that the HSE has been inspecting itself, which is neither tolerable nor sustainable.

Have the necessary staff been appointed and trained up to begin inspections, since we must assume that they must be in a position to start by the first quarter of 2009? Have funds been allocated accordingly?

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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Some staff have been transferred over, and more staff will follow. There is ongoing negotiation between the HSE and HIQA to finalise the arrangement to sign over the standards and put them in place.

Photo of Jan O'SullivanJan O'Sullivan (Limerick East, Labour)
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I wish to pursue that specific aspect too. We all welcome the fact that the standards will be in place for both public and private institutions, but they will not be of any use unless the relevant inspectorate is in place to carry out the inspections. The Minister of State referred to the fact that staff will be transferred. Will any new staff be recruited or will it be solely a matter of transferring staff within the system? How often is it intended to visit each nursing home or public long-stay institution?

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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While there will be some new staff, we anticipate that the vast majority will be transferred over from the HSE. It would not make sense to let people go from the HSE and take on new staff. Therefore, the vast majority of the inspectorate will be transferred directly over, with the possibility of some new staff also being hired.

On the issue of the regularity or frequency of inspections, we do not want to be too prescriptive. As the Deputy is aware, private nursing home inspections take place twice a year, unannounced, which is a good guideline but we have not made a definitive decision on the matter as of yet.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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In her introduction to the National Quality Standards for Residential Care Settings for Older People report, the HIQA chief executive, Dr. Tracey Cooper, stated that:

Once the necessary regulations are in place, the Authority's inspectors will carry out inspections across the public, private and voluntary sectors to ensure that the standards detailed in this report are being met and that residents are receiving the highest quality of care.

The Minister of State has indicated that the draft regulations have been published but the critical question is when they will be implemented. I ask the Minister of State to give a more exact indication of when she expects the draft regulations to become regulations which are in situ and being implemented.

The question of additional personnel has already been posed but what additional resources, across all of the needs that HIQA will identify, will be provided in order to carry out what must be a very extensive and comprehensive programme of inspections in all nursing home settings? What additional resources can we expect HIQA to be given to carry out its functions in the most effective and comprehensive manner?

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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We have engaged in extensive consultations with the key stakeholders on the regulations and agreement has been reached. We hope to finalise the regulations early in the new year, at which stage we will be ready to move forward.

The Deputy also asked about costs and expectations that may emerge.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I asked about additional resources.

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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A regulatory impact assessment is being undertaken at the moment, which will determine the costs and benefits. When the assessment is finalised we will know what additional costs, if any, will be involved. At present, however, I cannot give the Deputy a definitive answer on the matter.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I am less concerned about costs and more concerned about the quality of the changes that will take place. I seek information on the additional resources that will be given to HIQA to enable it to carry out its function. I must say, with respect, that Deputy Hoctor and the Minister for Health and Children, Deputy Harney, can worry about the costs. I want to know what resources will be provided to HIQA to ensure the best quality of care for older people in the various care settings.

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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The vast bulk of additional resources will be transferred from the HSE and, as I have stated, some new staff may also be hired.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I am sure Deputy Ó Caoláin is no clearer than I am on the matter. I hope the regulations are not as woolly as the Minister of State's answers, with respect.

I have already asked whether training has taken place and whether staff have been trained up. In order to make the question easier to answer, I will be more specific. Has any additional training of staff taken place? How many staff does the Minister of State envisage will be involved, including transferred and new staff? What grades are involved? What types of staff will be involved; will they include doctors, nurses and occupational therapists, for example?

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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The staff resources will come from a variety of areas and specialisms, including those mentioned by the Deputy. We envisage that the inspectorate will comprise between 60 and 70 people. Many of the staff involved have already received training and any additional training requirements will be met in due course to ensure the smooth operation of the inspection service.