Joanna Tuffy (Labour)

I welcome the Bill because it improves the situation in our health system. The problem with the Bill is that it does not go far enough. It does the minimum in providing for the Health Information and Quality Authority and the Office of the Chief Inspector of Social Services However, it does not go as far as it should in terms of placing patients and their needs to the fore.

What is needed is the Labour Party-Fine Gael proposal for a patient safety authority. The Minister of State will be aware that Labour and Fine Gael recently launched a policy document, Patients First, which provides for a new approach to regulating and monitoring patient care and which calls for the establishment of an independent body — the patient safety authority — with a strong legislative base. The remit of the patient safety authority would be entirely patient-focused, which is what is needed. In addition, it would bring together the various regulatory bodies and work in conjunction with other statutory bodies or professional bodies that have a regulatory function.

No one is charged at present with ensuring patient safety in our health care facilities. The difficulty with the Bill is that it makes no provision in respect of the licensing of hospitals — this would lead to their being properly inspected — or the regulation of private hospitals. There are limited avenues through which patients can seek redress for substandard care. Labour and Fine Gael's proposal for the establishment of a patient safety authority would provide people with a much needed avenue of complaint. The authority would be the patient's watchdog, it would independently review, inspect and assess the management, provision and quality of health and social care and, most importantly, it would promote human rights.

I heard a recent edition of "Today with Pat Kenny" and I was extremely impressed by an interview given by an Irish priest who had come home to Ireland on holiday. What he said echoed much of what I hear when I knock on doors and talk to people about the health system, the issue of MRSA, etc. While the priest to whom I refer was in Ireland, his sister fell ill and had to be admitted to hospital for treatment. When in hospital, she unfortunately contracted MRSA. Following her treatment, the woman, who was only in her early 60s, passed away. The point the priest made to Pat Kenny was that there is a great deal of talk about charity in this country but he asked what is the position as regards people's fundamental rights. He stated that the most vulnerable people in society are those who require hospital treatment. These individuals have a right to receive the best care. They also have a right not to emerge from hospital with their health in a worse state than it was when they were admitted. It is not acceptable that people are dying because their health deteriorates following a stay in hospital. We must do whatever we can to eradicate MRSA from our hospitals. Other countries have done so and we have a duty to follow suit.

One of the duties of the patient safety authority proposed by Labour and Fine Gael would be to carry out regular external hygiene audits and ensure that hospitals have effective cleaning procedures and follow good hygiene practice. Members of the public are of the view that hospitals should be clean. People believe — they are right — that hospitals used to be cleaner in the past. I have not had a huge amount of experience of hospitals. However, I am aware that hospital toilets are often dirty. In fact, they are dirtier than those one would see in many other public places. I once had to visit hospital late at night and was obliged to provide a urine sample. I went into the public toilet in the hospital but there were no lights on other than those used to deter heroin users. I could not see what I was doing, it was not possible to close the door and the toilets were dirty and could not be flushed. Needless to say, I did not have a very good experience.

There has been much negative publicity about maternity units in recent times. The Evening Herald has been running stories on the matter and printed a letter from a patient in the Rotunda who had the unfortunate experience of miscarrying. I am of the opinion that if one visited any of our maternity hospitals, one would find other women with similar stories to tell. Even though quite a few people have miscarriages, many of them do not discuss their experiences with others. The woman to whom I refer who wrote to the Evening Herald did so anonymously and later others came forward with similar stories.

When one enters hospital to give birth, the overall experience, particularly if one has a healthy baby, is good. The only occasion on which I was obliged to stay in hospital was when I gave birth. I had many good experiences while there but I was also unhappy with certain aspects of my stay. Some of my disappointment related to problems with hygiene and the remainder related to how I was treated by particular members of staff, etc. Hospital authorities — particularly those in maternity hospitals — should consult patients after their stay in hospital and inquire with regard to what was good and bad about their experience and where they think improvements might be made. To my knowledge — it certainly did not happen to me — hospital authorities do not engage in such activity.

A recent study carried out by obstetricians in which maternity services were evaluated and in which patients who had experience of such services were surveyed indicated a great deal of dissatisfaction regarding the quality of care in our maternity hospitals. Issues arise in respect of how people are treated in hospital, including those who are admitted to have babies. Hospital authorities must be much more proactive with regard to discovering what is wrong with the services on offer, what needs to be improved, what are the good things, etc. I am not saying that it is all doom and gloom in our hospitals but there are problems that need to be addressed. The patient safety authority would be one forum through which this might be achieved.

I hope the Health Information and Quality Authority will carry out the type of research to which I refer. The Minister of State indicated that the authority will carry out investigations on its own initiative into safety, quality and standards of services where it believes there is a serious risk to the health or welfare of a person receiving services. In my view it should go much further than that and carry out surveys among patients who access services in different parts of the health system and discover where problems exist. People do not necessarily complain about inadequate services because they might perhaps be satisfied with the overall level of care they receive. I hope the Health Information and Quality Authority will be proactive in that regard and will try to discover what needs to be done. The most obvious avenue it should explore first is what needs to be done to improve maternity services.

The majority of those who work in the health service are good people and they do a good job and work very hard. In many instances they operate under pressure, particularly in circumstances where the proper resources and staffing levels are lacking. Such issues must be addressed. It is important that patients should be placed to the fore in the context of the health system. They should be treated with dignity and respect and should be able to have their say on how the health service should be run. This is not the case at present within the health system but provision should be made to bring about that which I am suggesting. I do not know whether it is the fault of individuals or the system but when one is admitted to hospital, one is often treated as almost sub-human. It is almost as if one does not have the same rights as one had before entering hospital. This relates to the overall focus of the health system. We introduced patient charters in the past but I do not believe we have gone far enough. We must put the patients to the forefront of the health system so that they are the primary people in the health system. It is important that all the different interests have their say, are respected and get proper resourcing, but the patient is the most important person in the health service and we must ensure that is so in future.