Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 298: To ask the Minister for Health and Children if she will establish an office independent of the Health Service Executive to which shortcomings and dangerous practice in care can be referred as addressed. [12559/10]

Mary Harney (Dublin Mid West, Independent)
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The health sector is one of the most complex areas of activity in every country and it must, by its very nature, command the confidence of those who use it. While I am confident that the majority of patients in Ireland receive effective and safe treatment, unfortunately, errors do occur in any health service. It is important therefore, that we have systems in place to minimize risk of occurrence and to detect and respond appropriately to them when they do occur. Patient safety has always been high on my agenda and on the agenda of this Government as is evident from various initiatives I have taken in this regard.

I established the Health Information and Quality Authority (HIQA) in 2007. One of the main functions of the Authority is the setting of standards and monitoring healthcare quality. The Authority also has the power to undertake investigations as to the safety, quality and standards of services where it is believed that there is a serious risk to the health and welfare of a person receiving services. The Authority has carried out a number of investigations in recent years and there is acknowledged to be public confidence in the work of HIQA.

In January 2007, I established a Commission on Patient Safety and Quality Assurance to develop clear and practical recommendations to ensure that quality and safety for patients is paramount within the healthcare system. The Commission did consider the option of creating a new, stand-alone agency for Patient Safety. However, after much deliberation, the Commission concluded that it would be better to continue the momentum already built up through the working of the Commission and the improvements in patient safety that had already been made by the existing regulatory bodies. It was the Commission's view that a new patient safety agency, with a very broad remit, would require major legislative, structural and organisational changes which would take some years to put in place, thereby delaying the effective implementation of the recommendations in the Report. The Commission's Report - Building a Culture of Patient Safety was published in August 2008 and approved by Government in January 2009. The report contains 134 recommendations spanning almost every area of the health service. The most significant recommendation of the report is the introduction of a licensing system for all health services whether they are delivered publicly or privately based on standards to be set by HIQA. The Commission also proposed that the licensing scheme should be operated by HIQA. HIQA's role in the licensing process, its overall remit in setting standards and monitoring health care quality and its achievements in this area to date, reinforces the Commission's strong emphasis on patient safety and quality and further obviates the need for a new agency.

An Implementation Steering Group (ISG), chaired by my Department's Chief Medical Officer, was established in June 2009 with clear and regular reporting obligations to me regarding progress on the implementation of all the recommendations; this Implementation process is well advanced. The overall approach to the implementation plan endorsed by the Commission was to avoid short-term structural changes and, instead, to build on the structures already in place. The Commission considered that this was the best way of delivering results quickly. Finally, in March 2009 the provisions of the Health Act 2007 on protected disclosures were commenced. This facilitates all healthcare staff to disclose matters of concern to them to an authorised person and to provide statutory protection against penalisation in their workplace and against civil liability.

All the above measures are paving the way for a new culture of patient safety, openness, transparency, learning and accountability. On this basis, I do not see a need for, and am not proposing, the establishment of a separate office to which shortcomings can be referred.