Ruairi Quinn (Dublin South East, Labour)
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Question 69: To ask the Minister for Health and Children if she has plans to ensure safe practices, including throughput of patients to maintain expertise in specific specialties; and if she will make a statement on the matter. [20474/09]

Bernard Durkan (Kildare North, Fine Gael)
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Question 134: To ask the Minister for Health and Children her views on the principle of the need to ensure that all hospitals and health centres or institutions are operated to the level of a centre of excellence in each case and that the patients' needs are at all times paramount in the determination of the layout and delivery of hospital and health services; and if she will make a statement on the matter. [20905/09]

Bernard Durkan (Kildare North, Fine Gael)
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Question 138: To ask the Minister for Health and Children the standards intended to apply in terms of procedures, practices and equipment at hospitals or health institutions not identified as suitable centres of excellence in the future; the way this is expected to affect the quality and standard of services to patients; and if she will make a statement on the matter. [20909/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 69, 134 and 138 together.

The fundamental objective of Government health policy continues to be to maximise the health status of the population. The Government is committed to ensuring quality health services delivered efficiently and effectively. Ensuring patient safety is paramount so that people can have confidence in the services and that the best possible patient outcomes are achieved.

It is widely recognised that treating a low volume of cases in higher-volume specialties is not conducive to optimal patient care. In order to ensure the best possible outcomes for patients, clinicians must be able to maintain their specialist skills by treating a sufficient number of cases. It is more difficult for specialists to maintain their skills in smaller hospitals when treating a low volume of patients. This has implications for how we organise acute services generally.

The HSE has commissioned a number of reviews in relation to how acute hospital services should be organised in particular regions. These reviews have highlighted the need for changes to be made in the provision and organisation of acute hospital services in the regions concerned, particularly in relation to accident and emergency services, critical care, acute surgery and medicine. Importantly, the programme also involves developing smaller hospitals to provide a much greater proportion of less complex care, especially in day surgery, medicine and diagnostics. This underlines the fact that smaller hospitals can be reconfigured to provide important services for their local community.

A recent example of reconfiguration in relation to the delivery of specialist services is the development of designated centres for cancer care. A Strategy for Cancer Control in Ireland 2006 identified an evidence-based requirement for specialist cancer centres each serving a population of 500,000 – meaning that eight would be required - and recommended, inter alia, that all cancer care should be provided through a system of four Managed Cancer Control Networks. The restructured National Cancer Control Programme will deliver real improvements in cancer care based on best international practice.

In 2007, I established the Health Information and Quality Authority (HIQA) as part of the Health Reform Programme. A core function of HIQA is to set standards on safety and quality of health services and to monitor enforcement of those standards in an open and transparent way. HIQA has already developed national quality standards in areas such as Symptomatic Breast Disease Standards, National Hygiene Standards and National Standards for Infection Prevention and Control. Work has also commenced on the development of National Quality Standards for acute hospitals in the public sector. HIQA standards will apply to all public health services wherever appropriate.

There has also been considerable progress made in recent years in reforming the regulation of health professionals in Ireland. The Medical Practitioners Act 2007 and the Pharmacy Act 2007 provide for new, modern systems of regulation for Medical Practitioners and Pharmacists. New legislation is in preparation for the reform of the regulation of Nurses and Midwives. Part 11 of the Medical Practitioners Act 2007, once commenced, will place duties and responsibilities on individual medical practitioners, their employers and the Medical Council regarding the maintenance of professional competence. Preparations are ongoing for the implementation of these provisions, which will be commenced in due course.

In January 2007, I established the Commission on Patient Safety and Quality Assurance and it reported to me in July 2008. The Government recently accepted the Commission's report and approved the commencement of work on the drawing up of legislation to give effect to its central recommendation on the licensing of both public and private healthcare providers. Other recommendations to be implemented include the introduction of a programme of clinical audit across all health services, adverse event reporting, learning dissemination and a system of credentialing for healthcare professionals. Both the Government and the HSE are committed to a process of change which is incremental and which involves appropriate consultation and discussion with those affected.

I believe that all of these measures are contributing to an improvement in the quality and standard of our health service.