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Hiqa blames lack of powers for not acting
14 March 2010 By Susan Mitchell
The independent body responsible for monitoring safety and accountability in the health service said its failure to intervene at Tallaght Hospital could be explained by its lack of statutory inspection powers.
The Health Information Quality Authority (Hiqa)has statutory powers to inspect residential care for older people.
This effectively gives Hiqa the legal right to enter private property without the owner’s permission. But those statutory powers do not extend to public or private hospitals and clinics.
Jon Billings, director of healthcare, quality and safety at Hiqa, said: ‘‘In the absence of statutory inspection powers, the authority has to draw a balance between an interventional response, such as an investigation, and expecting healthcare providers to take responsibility and accountability for addressing issues of concern.
‘‘This balance is a judgement call based on an assessment of the risk to patients and the robustness and progress of the provider response."
It emerged last week that Hiqa was informed in April 2009 that there was a problem with unopened GP referral letters and a backlog of radiology reporting at Tallaght Hospital.
Hiqa raised those concerns with the hospital and met management at Tallaght in June. At that meeting, Hiqa was told that there were about 4,000 unreported x rays and that these were primarily check and repeat x-rays or x-rays that would not normally be reported by a radiologist, such as dental x-rays.
It has subsequently emerged that almost 58,000 x-rays had not been reviewed by a consultant radiologist.
Hiqa also raised concerns about delays in GP referrals to the hospital at the June meeting. In September, Hiqa requested a written report. A number of letters from Hiqa subsequently went unanswered and meetings were cancelled.
‘‘In relation to Tallaght, our staff were given assurances at the most senior level that the issues raised by us over a period from last April were being addressed in an appropriate manner and that the hospital was putting in extra resources to deal with the backlog," said Billings.
He said Hiqa would have been in a much stronger position if legislation that was recommended by a group on patient safety had been enacted.
This group, the Commission on Patient Safety, was established by health minister Mary Harney in 2007.
Its objective was to provide a comprehensive roadmap for improvements in safety and quality across the health service.
The commission reported back to the minister in August 2008 and recommended the introduction of statutory licensing for all health services, whether delivered publicly or privately.
An implementation steering group was subsequently set up, but it is unclear when the necessary legislation will be enacted.
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