Health service failing patients, says departing Hiqa chief

The health service lacks accountability, is not sufficiently patient focused, fails to learn from its mistakes and “doesn’t know how many patients it is killing and harming”, according to the outgoing head of the State’s health watchdog.

Staff sometimes tolerate levels of care they wouldn't accept for their own family members while questions about safety remain in significant areas of the service, the departing boss of the Health Information and Quality Authority (Hiqa), Tracey Cooper, says.

In an interview with The Irish Times, Ms Cooper is critical of many aspects of the health service and says Ireland has “quite a long way to go” to reach the safety levels found in the best systems internationally. After almost eight years, she finished working with Hiqa last Friday and is moving back to Wales.

“The problem is that we’ve never had any consequences, so that if there’s a systems failure or a major problem with the quality of services, nothing really happens. Where there’s a repeated problem, there should be consequences.”

'Dark corners'

She identifies the ambulance service and private healthcare providers as two “dark corners” of the health service where a greater light needs to be shone. Ms Cooper says currently “we have no idea” about safety levels in private health.

She singles out emergency departments and maternity services as the areas with greatest concern for safety. “Obstetric care is one of the most dangerous services, with one of the highest levels of claims and litigation. So you’d expect people to want to learn from incidents in their service. . .”

She says emergency departments are not being run in the integrated way they should be.

Ms Cooper says: “We still have not cracked accountability in the health service” and despite the dedication of staff “we haven’t cracked the paradigm that ‘actually, it’s about the patient, not the people working in the system’.”

A lack of high quality data across services means there’s no way of knowing how well they are being managed. “We don’t know how many people we’re killing or harming avoidably . . . It doesn’t mean that we are, but we just don’t know.”