Sir, – The revelation by the boss of the Health Information and Quality Authority that the health service lacks accountability and "doesn't know how many patients it is killing and harming" is shocking, true and not surprising ("Health service failing patients, says departing Hiqa chief", May 26th).
In Paul Cullen’s interview with Dr Tracey Cooper, departing chief executive of Hiqa, she tells us “We’re not the kind of country where people who provide services can demonstrate how good they are in terms of performance, outcomes and safety. They’re not making this information publicly available.” But Hiqa is the authority which was established to set standards and then evaluate and publish information on the delivery and performance of our health service. After eight years we are left with promises.
Dr Cooper’s comment, in relation to lack of accountability and withholding of health information, is interesting. Hiqa, although advised in 2008, has still not put in place a standard to monitor and publish the outcome for patients who suffer a brain haemorrhage – subarachnoid haemorrhage (SAH) – and are denied access to emergency neurosurgical treatment in Beaumont Hospital. SAH patients are left untreated in hospitals which have no neurosurgical expertise and we still don’t know how many, if any, survive.
“The hospital does not have the resources to retrospectively review” is the answer from the HSE, on behalf of the Minister for Health, to a parliamentary question requesting this information.
Lack of accountability is often a cover for poor leadership and corporate governance. In the case of Hiqa there is no clear separation of roles and responsibility between Hiqa and the HSE. Hiqa claims that it is not responsible for the safety of patients unable to access neurosurgical treatment and claims that Beaumont Hospital is responsible and required to provide assurances to the HSE. Beaumont claims that it is not responsible for patients it does not admit for treatment. These assurances are no substitute for independent clinical audits benchmarked against international best practice.
The role of investigating authority (Hiqa) and the body which allocates funds (HSE) to healthcare providers needs to be clearly defined. Government needs to revisit the Health Act 2007 and clear up this ambiguity.
To be fair, Dr Cooper has made a significant contribution to our health service and can take credit for a number of initiatives which undoubtedly save many lives. I wish her well. – Yours,etc,
JIM LAWLESS, MBA
Cypress Downs,
Templeogue,
Dublin 6W.