Bernard Durkan (Kildare North, Fine Gael)
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Question 158: To ask the Minister for Health and Children her views on whether the standard and quality of the health service is expected to improve in the foreseeable future; if so, the location at which these improvements are expected to take place; the impact that co-location plans will have on the situation; if her attention has been drawn to the public concern at the quality, availability and reliability of health services here; her proposals to address these fundamental issues; and if she will make a statement on the matter. [32334/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The fundamental objective of the Government in health policy continues to be to maximise the health status of the population. The Government is committed not only to ensuring the delivery of the best quality health services possible but to doing so in an effective and efficient way. Ensuring patient safety is of paramount importance, so that people can have confidence in the services and that the best possible patient outcomes can be achieved.

The services and targets to be provided by the Health Service Executive in 2008 are set out in the National Service Plan, which I approved in November 2007 and the addendum to the Service Plan which I approved in February 2008. Both of these documents have been laid before the Houses of the Oireachtas and published. The Annual Output statement demonstrates that substantial progress has been made in the delivery of health services. Only by continuing to push forward with and supporting an agenda of reform within the health services can we hope to deliver the kind of health service we all want to benefit from within the resources that are available to us. The gross provision for the HSE in 2008 is €14,337 million revenue and €594 million capital.

In the area of acute hospitals, the HSE is supporting the continuous improvement of the safety and quality of care in hospitals which it operates or funds. A pilot of the project for implementation of the HSE Standards for Quality and Risk Management has been completed and roll-out across hospitals will commence later this year. The Government and the Executive are also committed to ensuring that the approach to re-organisation of services is carried out in consultation with the key stakeholders and that each element is progressed incrementally. I believe that it is important to work with health professionals and other interested parties to secure an increasing set of improvements over time. This approach will, I am confident, produce the best outcome for patients.

Change is happening on a number of other fronts such as the first full modernisation in 30 years in the Medical Council and the regulation of doctors, the modernisation of the law regulating the pharmacy profession and health and social care professions, putting in place a fundamental new contract for consultants for the first time in 30 years. The Health Information and Quality Authority (HIQA) was established in 2007, as part of the restructuring of the health service under the Health Reform Programme. One of the main functions of HIQA is the setting of standards and monitoring healthcare quality. For the first time, we will have national standards across major programmes of care. Such standards in the field of symptomatic breast disease services have already been developed and are in the process of being implemented.

The Authority also has responsibility under the Health Act 2007 for undertaking investigations as to the safety, quality and standards of services where it is believed that there is serious risk to the health or welfare of a person receiving services. Recent developments have led to the commencement of a number of investigations by HIQA. In January 2007, as part of the Government's commitment to ensuring patient safety and quality in our healthcare, I established a Commission on Patient Safety and Quality Assurance to develop clear and practical recommendations to ensure that quality and safety of care for patients is paramount within the healthcare system. The Commission's Report — 'Building a Culture of Patient Safety' was published in August 2008. This is the first report of its kind and it makes far reaching recommendations which when implemented will impact very positively on patients and their families.

The most significant recommendation in the report is the introduction of a licensing system for all health services whether they are delivered publicly or privately. Other recommendations from the Commission include the participation of all licensed healthcare facilities in local and national clinical audit, a mandatory adverse event reporting system, enhanced education, training and research and improved governance structures. I am currently considering these recommendations in detail and will bring the report to Government shortly. The implementation plan endorsed by the Commission recommends the establishment of an Implementation Steering Group (ISG) with clear and regular reporting obligations to the Minister for Health and Children. It also recommends the establishment of expert sub-groups comprised of representatives of relevant stakeholders, each of which will report to the ISG on the practical and detailed implementation of the recommendations within their remit.

In July 2005 I issued a policy direction to the HSE aimed at freeing up additional beds in public hospitals for public patients. This will be achieved through the development of private hospitals on the sites of public hospitals and the transfer of private activity to those hospitals, thereby releasing substantial capacity for public patients in public hospitals. The initiative is expected to provide approximately 1,000 additional beds for public patients of the 1,500 additional acute public beds to be provided set out in the Programme for Government.

Co-location is the quickest and least expensive means of providing significant additional bed capacity for public patients. No capital outlay is required as the beds in the public hospitals are already in place, having been funded by the Exchequer. The Board of the Health Service Executive (HSE) has approved preferred bidder status for the development of co-located hospitals at six public hospital sites and two other public hospitals which are also participating in the co-location initiative, are at an earlier stage of the procurement process.