A MAJOR row has broken out between the Health Information and Quality Authority (Hiqa) and the Health Service Executive (HSE) over implementation of a number of key elements of a recent report on patient safety at Ennis General Hospital.
The Irish Times understands that Hiqa’s chief executive Dr Tracey Cooper was so concerned at the lack of urgency being shown by top management in the HSE in moving on key recommendations in the report that she raised the matter with Minister for Health Mary Harney.
The report on safety issues at the Ennis hospital was carried out by Hiqa upon the revelation last year that at least two cancer patients – Ann Moriarty and Edel Kelly – had been misdiagnosed at the hospital. Its investigation, published in April, made a host of recommendations in relation to the types of conditions that should in future be treated at Ennis, about integrated care in the midwest, and on leadership and governance of hospitals in the region.
It is understood it is the perceived lack of speed in tackling the governance issues that is especially of concern to Hiqa, which claims patient safety could be compromised as a result.
Its report had recommended all the hospitals contributing to the midwest region acute care system should form a hospital group under an integrated operational governance and management structure, based at the Mid-Western Regional Hospital in Limerick. It said this group should be led by a management board and a chief executive.
And it said the HSE should “as a priority” undertake a review of the clinical and non-clinical management, leadership and governance arrangements at the Mid-Western Regional Hospital to ensure clinicians and managers in key positions had the capacity and capability to manage the new role of the hospital as the main acute hospital in the midwest region.
Furthermore, it called on the HSE to nominate a director who would ensure a plan was drawn up for the implementation of the report within a clear timeframe.
It is understood the HSE is reluctant to move on some of the specific appointments suggested in the report, as it has its own plans to make a number of other appointments under its transformation programme in the coming months. However, Hiqa believes this is not good enough.
Asked how it was progressing with the appointment of a chief executive to the midwest hospital group and whether an implementation plan had been drawn up yet to implement Hiqa’s report on Ennis hospital, the HSE yesterday issued a statement that did not say specifically if an implementation plan had been drawn up or not.
It said: “As part of its integrated services programme, the HSE is in the process of redesigning its organisation and management structures and processes in order to provide a more integrated health service for patients and clients and to ensure that clinicians have a greater management and leadership role within the health services.” It said a new directorate of quality and clinical care headed by Dr Barry White had been created and 42 clinical directors had been appointed around the country.
It also said interviews would be held in coming months for the appointment of four regional directors and an integrated services directorate was being created.
It added that a range of reports, including the Hiqa report on Ennis, “have provided a clear direction for how we should organise our services optimally for our patients and clients”.
The HSE also stressed that a significant reconfiguration of hospital services had been initiated in the midwest. “The finalisation of new regional and local governance and management structures over the next number of months will be another major advance in this context,” it said, adding that the appointment of a chief executive to the midwest hospital group “will be progressed in the context of this ongoing work”.
Asked to comment, Hiqa said it was part of its “normal business” to ensure reports it published were followed up on.