Sir, – The Health Information and Quality Authority (Hiqa) has done a huge amount of valuable work in continually exposing serious flaws in our health system. However, there is a fundamental problem in the way that Hiqa is set up in that its primary function is focused on standards, accreditation and inspection and it has no role in solving the problems it detects in the course of its inspections. That role is nominally allocated to the HSE.
This splitting of the inspection and problem-solving roles makes it very unlikely that the problems will actually be solved. This structure is what was traditionally deployed in industry where production and quality control operated as separate functions and were frequently at loggerheads with the result that, while lack of quality was detected, it was not improved. This kind of culture clash was vividly illustrated by the threat of senior HSE executives to seek a court order stalling the publication of the Hiqa report on Portlaoise Hospital.
The modern approach is to have an overarching improvement culture in which problem-solving through team work results in continuous improvement. Suggestions have been made that the terminally dysfunctional HSE should be abandoned and replaced with an organisation better equipped to run our health services. As part of this, Hiqa, as a standalone body, should also be abandoned and the opportunity taken to establish a single organisation with a focus on continuous improvement.
This is not a new idea. For a quick and easy outline of what is involved, take a look at the About Us page of the website of the NHS Healthcare Improvement Scotland.
The contrast between the ethos of support for healthcare providers outlined there and the command-and-control approach in the Irish healthcare system could not be more glaring. – Yours, etc,
MICHAEL STUART,
Malahide,
Co Dublin.