Billy Kelleher (Cork North Central, Fianna Fail)
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10. To ask the Minister for Health the reason the programme for Government commitment to establish a Patient Safety Authority has not been honoured; and if he will make a statement on the matter. [20782/15]

Billy Kelleher (Cork North Central, Fianna Fail)
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I wish to ask the Minister for Health the reason the programme for Government commitment to establish a patient safety authority has not been honoured and if he will make a statement on the matter. In view of the HIQA report into the infant deaths in Portlaoise hospital and its recommendations and the testimony given to us at the Oireachtas Joint Committee on Health and Children in recent weeks, there is an urgent need for us to address that failed commitment and ensure we have a patient safety authority of standing.

Leo Varadkar (Dublin West, Fine Gael)
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I am strongly of the view that any new patient advocacy service should be set up independent of the HSE from the outset. For this reason I removed reference to the establishment of an interim patient advocacy agency from the service plan for 2015.

My view has been supported by the recent recommendation made in the HIQA investigation report on services at Portlaoise hospital on the need to establish an independent patient advocacy service. The HIQA recommendation is that an independent patient advocacy service should be in place by May 2016. I fully agree with the recommendation and intend to see it implemented well in advance of the timeline provided by HIQA.

The scope, role and functions of the independent advocacy service will be considered along with the appropriate structural, governance and funding arrangements that need to be put in place. My Department will be consulting widely on the best way to get the service up and running in the shortest possible timeframe.

The role of the independent patient advocacy service will be to support and advocate for patients in their dealings with the health service. Regrettably, the health service has not been as responsive to patients who have had bad experiences as is required. I believe the patient advocacy service can assist in redressing the balance in the relationship between patients and service providers.

The proposed establishment of a number of new statutory bodies is something that I have given consideration to in the context of the immediate priorities associated with the overall health reform programme. I believe there are some functions associated with the patient safety agency that are currently carried out to an independent high standard already by HIQA. I do not propose at this stage to interfere with these arrangements and instead intend to address the major gap in advocacy and support to patients through the new independent service.

I also intend to improve the advice available to me on patient safety through the enhancement of my own Department's patient safety function under the leadership of the chief medical officer.

This will allow such advice to be incorporated within the existing accountability arrangements between the Minister for Health and the HSE, HIQA and other regulators and health bodies.

Billy Kelleher (Cork North Central, Fianna Fail)
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It is welcome that the Minister will establish an independent advocacy agency. The best way we can address the issue of advocacy for patients and those who use the heath service is to try to ensure we have accountability. The best form of accountability is to have information available to the public, including on the performance of hospitals and individuals within hospitals in terms of outcomes, assessments and comparators across health services, in order that people can scrutinise hospitals and see how good their performance is. While HIQA is very much into the quality side, there is a gap evolving in the information flow in ensuring full information and accountability across the health service. The patient safety authority should have a role in ensuring people are aware of the performance of hospitals in orer that they can make informed choices.

Leo Varadkar (Dublin West, Fine Gael)
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The Deputy makes a very valid point. Information that is available, provided it is collected accurately, should be made public in order that patients can see it and if there are discrepancies between hospitals and services, they can at least ask probing questions as to why. That is why a few months ago, for the first time, my Department published data by hospital for all sorts of issues, including caesarean section rates in maternity services and in-hospital mortality rates for heart attacks and strokes. This was replicated at community level. We intend to expand the report next year and include more information into it, including perinatal mortality statistics. Information on certain complications is already included. It will be produced by my Department and published annually. It is very important that we include patient experience data. An external survey will be conducted of patients' experiences of hospitals and it will be reported on. A satisfaction survey was conducted in the past and will be carried out again and will be published annually.

While the Deputy does not do this, others abuse the statistics. Medical statistics are produced within competence intervals and have a margin of error, plus or minus 5% or even 25%, particularly when dealing with low numbers. We all need to stand together against vested interests and some in the media who turn data into league tables that are not statistically significant. We need to be united against that misinformation and sensationalism.

Billy Kelleher (Cork North Central, Fianna Fail)
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"Lies, damned lies and statistics" comes to mind.

Kathleen Lynch (Cork North Central, Labour)
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We do the statistics.

Leo Varadkar (Dublin West, Fine Gael)
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Others do the damned lies.

Billy Kelleher (Cork North Central, Fianna Fail)
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The damned lies would not be done over here either. Some days ago I referred to the perinatal pathology services in the context of the debate on Portlaoise hospital. It is critically important that people have confidence in the statistics and that the statistics cannot be massaged and manipulated for various, sometimes nefarious, reasons such as when it is tried to suggest there is a deficiency in a service when it is just a statistical blip due to small numbers. I understand all of this.

On the issue of MRSA in hospitals and trying to get hospitals to be cleaner, only when the information was being published did hospitals across the service become motivated and concentrate on making an effort to encourage staff, clinicians and management to work together to address it. When information is available, people can make informed decisions on whether a hospital is run well and whether the clinical outcomes are correct. It should be part and parcel of the agency if HIQA is unable or incapable of doing it.

Leo Varadkar (Dublin West, Fine Gael)
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I agree in principle and if HIQA wants to start publishing hospital by hospital data for MRSA, it is free to do so and there will be no objection from me. However, it is important that the data are reliable. Unreliable data are no good to anybody and can be harmful. The role of the patient advocacy service will be to advocate for patients generally and individually. I do not intend it to gather and publish statistics, which can best be done by the patient safety unit in my Department or HIQA. We do not need to duplicate another agency to collect and publish statistics. We should just do it. It does not require a statutory agency to do something that can already be done. The patient advocacy service will do something that is done by NGOs but is not resourced and supported to the extent it should be.