Paul Coghlan (Fine Gael)

I welcome the Minister of State and his officials to the House, but I cannot welcome the Bill, which is regarded by this side as a belated response to the criminal and systematic abuse of senior citizens in need of continuous care. While I welcome the establishment of an inspectorate of residential services for older people, people with disabilities and children in care, the Bill is flawed and does not meet the standards set out in my party's policies. The Government could have gone much further in this legislation, but has failed to do so.

According to the Government, this Health Bill addresses patient protection, but it does not put the patient at the centre of health services. How could we possibly support it? After the recent disastrous failures in the health service, such as the scandal at Leas Cross, the MRSA crisis, deficiencies in hospital hygiene and people left waiting on trolleys in accident and emergency departments, patient protection should be our number one priority, but that is not the case in this legislation.

People have had hospital procedures cancelled more than once and, as a result, have been condemned to die by the failures of the health system. Elsewhere, a post mortem ascertained severe burns sustained from a radiator while in the care of a nursing home in County Kilkenny. These issues in the health care system should be corrected by the Minister for Health and Children and addressed by the legislation.

At Leas Cross, the HSE allowed elderly people to live in neglect and danger. That is where this legislation originated. Every day in accident and emergency departments, people are left waiting in Third World conditions. When patients leave such departments for wards, their lives are continually threatened by the Government's failure to deal with matters of hygiene, MRSA and all the bugs found in our hospitals each week.

Nothing in this legislation deals with the MRSA scourge. It is strange that, as MRSA has grown more prevalent in our health care system, other European countries have addressed the issue, in some cases successfully, while all we get is the same old bluster and bylines to the effect that the Minister is interested in patient safety, when that is not the case. For this reason, the legislation fails. If this legislation had been in place for the Leas Cross matter, I wonder whether the person who complained would have been ostracised by the HSE.

The only way to protect patients is to establish a patient safety authority with full responsibility in this area, as Fine Gael and the Labour Party proposed. People would trust such an independent body to inquire into their complaints. Even if there is a failure to establish an independent patient safety authority, one would at least expect the Minister to regard Members of the Oireachtas as suitable authorising persons on condition that they make inquiries in a discreet manner through the appropriate Minister. Members do not abuse parliamentary privilege and they respect the institution of the Oireachtas.

The Bill does not recognise or protect patients residing in centres registered by the Mental Health Commission or patients residing in acute hospitals. We need strong legislation to protect the vulnerable people who must use one of our health care institutions. The Social Services Inspectorate and the commission should have been amalgamated as part of a patient safety authority. It is vital that we do not stigmatise those with mental illness as being different from patients in the rest of the health service. Instead of breaking down barriers and destigmatising certain sectors, the Government is drawing in an even darker pen the line between patients with mental illness and patients in other areas of the health service.

There is a crisis concerning children, particularly refugee children, who were trafficked into this country and escaped the protection of the HSE. For example, the Minister is well aware that children went missing from a child care facility in Dublin. We have no idea where they have gone or what happened. Such an institution is not covered by this legislation. It covers nursing homes and other specific institutions that have made media headlines rather than those to whom protection should be offered.

Those suffering mental illness will remain stigmatised because the Government sees fit to protect mental health patients under a different body. The commission is good and I wish to apply its principles to the entire health service. We should not continue to marginalise and stigmatise people with mental health difficulties.

The Bill proposes too many distinct roles for HIQA, which take from the original and sole purpose of the legislation. The immediate role relates to the setting and monitoring of standards of residential care. Subsequent roles for HIQA relate to the evaluation of information concerning the health and welfare of the population and setting information standards to ensure best outcomes for resources available to the HSE. The scope of HIQA's role is too broad in its current form.

One of the problems with HIQA is that patient safety is not its core objective. The role of the inspectorate is to examine standards in all institutions involved in health provision. HIQA's role does not just concern social services inspection, but also the evaluation of technologies. This is a nice euphemism that slipped through in the explanatory memorandum. Another of HIQA's functions resembles that of the National Institute for Health and Clinical Excellence in the United Kingdom.

Patients in other countries have been given power in that they are placed at the centre of their respective heath services. Too much confusion is evident within the processes and systems here. It is unnecessary for the Minister to make all of the changes she has proposed. The establishment of a patient safety authority would give power to patients. Once the Minister moves the power base in the health service more towards patients, the changes she is having difficulty getting through will follow automatically.

I hope the Minister of State will take on board some of the facts we have highlighted. HIQA is not a patient safety protection agency, its remit is too broad and it will not work. The Minister must separate the inspectorate and combine it with the commission to set up a proper patient safety authority. Perhaps the Minister should not dismiss what the Fine Gael and Labour parties are doing, given that the WHO believes it is correct.