Hiqa says it cannot adopt softer line on standards for facilities under fiscal strain

Health service watchdog Hiqa has indicated that it cannot adopt a softer line in inspecting or setting standards for facilities and institutions operated by State bodies due to the financial and staffing pressures they are experiencing as a result of Health Service Executive spending controls.

HSE chief executive Paul Reid told members of the organisation's board in recent weeks that his target to limit a financial overrun in hospital and disability services to €100 million this year was, in part, dependent on statutory regulators having "due regard for the resources available to the HSE".

Some service operators, particularly in the disability sector, are concerned that taking measures to live within their budget, as demanded by the HSE, would clash with their obligations to meet standards set by Hiqa.

Hiqa said on Monday that its main priority was to ensure the safety and care of vulnerable persons in receipt of these services. It said it had received and shared with the Department of Health legal opinion regarding a section of the Health Act 2007 that specified it must have regard to the resources available to the HSE when carrying out regulatory work.

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Legal opinion

Minutes of Hiqa board meetings from early last year reveal the legal opinion, which stated that, under legislation, it was functions carried out by the organisation corporately as distinct from those carried out by its chief inspector that should have regard to the HSE’s resources, “for example when setting standards”.

“For the chief inspector to have regard to the resources of the HSE would give rise to potential inequity as the regulatory function could be interpreted as being applied differently to public and private providers and therefore open to legal challenge from a number of quarters.”

Hiqa said in a statement on Monday that through its inspections and monitoring of services “we strive to ensure people receiving these services are treated with respect and dignity”.

“Hiqa believes that there needs to be continual improvement in the quality of services and for the people who live in residential services.”

Spending

Meanwhile, The Irish Times has learned that the new board of the HSE has told management that its first priority should be to get a grip on spending in the health service.

In a letter sent to Mr Reid earlier this month, the chairman of the board Ciaran Devane said: "in the short term, the board is clear that we expect the executive to exercise the necessary financial grip to ensure we get the best health care for the available money, do not spend money we do not have and deliver the savings promised in the national service plan".

The board’s second priority was to support the highest standards of clinical governance while the third was to understand strategic human resource and staff-related issues.

Mr Reid had already told health service mangers on his appointment in May that none of them had the authority to overspend their budgets and that they would be held to account where this took place.