A ‘whistleblower’ law coming into force next month will protect people working in the health service who report matters of concern to the authorities. The measure forms part of a number of initiatives to improve patient safety announced by Minister for Health Mary Harney today.
The Minister also confirmed the Government would bring in legislation providing for the licensing of all healthcare providers, including public and private hospitals, nursing homes and doctors.
She said the new measures would pave the way for “the new culture of patient safety, openness, transparency, learning and accountability”. All service providers, including nursing homes, will have to pay a licence fee to cover administration and the State’s inspection regime.
This was a key recommendation of the report of the Commission on Patient Safety and Quality Assurance published last year. That commission was established by the Government in January 2007 in response to health system failures, including those highlighted by the Lourdes hospital inquiry into the activities of obstetrician Dr Michael Neary.
Commission chair Dr Deirdre Madden made a range of far-reaching recommendations designed to make the State’s health system safer for patients. Her report was brought to Government by the Minister recently.
“The Government place great importance on the policies and practical reforms we are implementing to ensure patient safety and quality-assured health services,” Ms Harney said today.
"I am pleased to announce today that the Government, having considered the Report of the Commission on Patient Safety and Quality Assurance, have decided to draw up legislation to give effect to its central recommendation on the licensing of both public and private healthcare providers."
She said the licensing system would establish !objective, mandatory standards” and compliance with standards would be “legally required for every hospital or healthcare provider”.
“The legislation will be complex, and it is important that we start out on the legislative path now.”
Ms Harney said that in relation to long-term care and nursing homes, the Government was “already a very long way down this legislative road”.
This year, she said, a new system of mandatory standards, inspections and licensing for both public and private providers would come into operation.
“As we prepare more legislation, patient safety and quality-assurance will continue to drive our current reforms in cancer care and the re-organisation of services, for example, in the mid-western region.”
Ms Harney said the Government also strongly supported improved governance in hospitals, and, in particular, the introduction of systematic audit of clinical practice and outcomes for patients.
“Had such a system been in place, practices which have had catastrophic effects for patients, for example, the pattern of interventions by Dr Neary at Our Lady of Lourdes Hospital in Drogheda in the 1990s, would have been picked up and stopped earlier.”
Ms Harney said the commission had underlined that the culture of patient safety required “openness, transparency, facing facts and a blame-free culture”.
“Accordingly, on January 30th last, I signed into law the commencement of the protected disclosures provisions of the Health Act 2007.
“This will facilitate all healthcare staff making such disclosures in an environment where they are protected from penalisation in the workplace and from civil liability and will come into effect from March 1st next,” the Minister said.
The Minister said the changes would require “time and resources” and that they would pose “considerable challenges to service providers in both the public and private sectors”.
All health service providers will have to pay a licence fee to cover the cost of the administration and inspection regime for the new system. Nursing home registration and inspections will begin later this year.
“This will involve substantial costs on the Exchequer and it is only right that these costs should be met by the service providers,” Ms Harney said.
The Minister said the Government had supported the immediate establishment of a Steering Group to drive implementation of the commission’s recommendations.
“The safety of patients must always be at the heart of what we do. I strongly encourage health service managers and the leaders of the medical, nursing and other professions to take on leadership roles to achieve real and lasting improvements in safety and quality care.”
The office of the Chief Medical Officer has been assigned responsibility for all matters relating to patient safety.
HSE chief executive Prof Brendan Drumm said delivering higher quality and safer care in every part of the health service was a priority for the organisation.
“Any programme that can support this objective is most welcome. Today’s announcement will further support the advances HSE staff are making in raising quality and safety standards through initiatives such as reconfiguring primary and hospital care, streamlining our reporting structures, reducing healthcare associated infection, developing designated cancer centres, promoting multidisciplinary team working and appointing clinical directors.
“While we continue with this work, developments in areas including licensing, regulation of healthcare professionals and legislative change to support clinical audit and adverse event reporting will be beneficial in our collective pursuit of first class quality and safety standards.
“We look forward to continuing to work with everyone involved, including patients and their families, to ensure the potential of the commission’s work is maximised.”
Independent Hospital Association of Ireland (IHAI) chairman Dr Danny O’Hare said: “Licensing of all healthcare services is a vital step to ensuring consistent and acceptable patient safety across the entire health service.”
“The IHAI looks forward to working with both the Department of Health and Children and the National Steering Committee on the implementation of the Commission’s recommendations."