Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 89: To ask the Minister for Health and Children the discussions she has had with the Health Service Executive on the stated opinion of the HSE that an over reliance on the nursing home sector to meet all of the needs of highly dependent and very ill older people is misplaced and inappropriate; the policy initiatives she proposes to ensure that very ill older people are placed in appropriate facilities; and if she will make a statement on the matter. [41406/06]

Olwyn Enright (Laois-Offaly, Fine Gael)
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Question 117: To ask the Minister for Health and Children the communications she has had with the private nursing home sector with a view to bringing about improvements in the short term in view of the public concern regarding standards in some nursing homes; her views on whether the conflict of interests prevents the Health Service Executive from being an effective independent arbiter in this matter; and if she will make a statement on the matter. [41410/06]

Olivia Mitchell (Dublin South, Fine Gael)
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Question 119: To ask the Minister for Health and Children if, in view of the current and ongoing conflict of interest within the Health Service Executive, which is contracting beds in nursing homes, has sought tenders from nursing homes to provide care for high dependency patients and which is also the regulator for nursing home standards, she will take immediate steps to ensure that the governance function in regard to inspections has sufficient autonomy, independence and competence; the steps she proposes to take on this matter; and if she will make a statement on the matter. [41407/06]

Seán Power (Kildare South, Fianna Fail)
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I propose to take Questions Nos. 89, 117 and 119 together.

The inspection of private nursing homes is the responsibility of the Health Service Executive under the Health (Nursing Homes) Act, 1990. The 1990 Act provides for the registration of private nursing homes and procedures for attaching conditions to the registration and for de-registering homes. The Nursing Homes (Care and Welfare) Regulations, 1993 set out the standards which private nursing homes owners must adhere to in the provision of nursing home services.

A Nursing Homes Inspection and Registration Working Group was established in July 2005 by the HSE and reported in July 2006. Among the recommendations of the report was the recruitment of dedicated inspection teams throughout the country, these teams to have staff with nursing, medical and mental health expertise, and other professionals available to them. The HSE is in the process of developing dedicated nursing home inspection teams and these have been developed in some areas. Standardised documentation will be used by all inspection teams throughout the HSE. An Integrated Checklist will be adopted by all Inspection Teams and completed at each inspection by team members. The HSE commenced publication of nursing home inspection reports on their website in September 2006.

Priority is being given to the appointment of dedicated multi-disciplinary inspection teams whose remit solely covers all aspects of nursing home inspections, registrations and investigations. A training programme is being developed and implemented for nursing home inspection teams which will address, in particular, report writing, elder abuse, legislation and training on appliances and clinical skills. All of the mandatory inspections of nursing homes, i.e. the six-monthly inspections, will be unannounced. Follow-up inspections may be announced or unannounced.

A Working Group was established by the Minister last year to produce draft standards for all long-term residential settings — public, private and voluntary. The Department is currently in discussion with interim Health Information and Quality Authority (iHIQA) in relation to a consultation process on these draft standards.

The Health Bill 2006 will establish the Health Information and Quality Authority, or HIQA, and will put the Social Services Inspectorate, or SSI, on a statutory basis within HIQA. The intention is that the SSI will be required to monitor residential services provided to older persons against standards adopted or set by HIQA. The Office of the Chief Inspector of Social Services will be established as an Office within HIQA. The Chief Inspector will have powers to cancel a registration or to add conditions to a registration. He or she will also be able to seek the urgent cancellation of a registration by application to the courts in situations where he or she considers the health and well-being of a person is at risk. The Health Bill will be published before the end of the year.

The Department and the HSE have progressed work on a number of initiatives as outlined above to ensure that all patients who require nursing home care are placed in appropriate settings that meet their needs. The Department will continue to work closely with the HSE to develop additional bed capacity, replace existing bed stock and to carry out necessary refurbishment and upgrading. In that context it is proposed to develop 50 Bed Units at a number of locations in Dublin and Cork and a number of other sites across the country.