Nurses demand review of Hiqa impact on care standards

Nurses are demanding an independent review of the Health Information and Quality Authority as tensions between staff and the regulator increase.

Delegates at the Irish Nurses and Midwives Organisation voted unanimously for the review to establish whether Hiqa “has actually improved the quality and standard of care for patients in Ireland”.

The motion proposed by nurses in Co Donegal called for an examination into the members of the Hiqa board, their areas of expertise and the criteria for membership of the board. It sought a report on “whether Hiqa regulations actually assist those providing direct care and how they could be further improved”.

Tensions have emerged recently between the INMO and the health regulator in relation to a number of critical reports by Hiqa into the management of residential facilities.

One issue is who should have overall responsibility where problems arise, and whether the staff who are running centres on a day to day basis have legal authority for their management.

Ailish Byrne of the INMO executive council said nurses had the skillset and the knowledge but not the legal authority to act as person in charge at centres for people with intellectual disability. They had been “hung out to dry” by the HSE and Hiqa on this.

"Who watches the watchdog," asked Caroline Callaghan from Inishowen, who called for greater transparency and the inclusion of staff when standards for home are being drawn up.

Teresa Dixon, of the INMO executive council, described Hiqa's standards as "paper exercises in rubbish". "Where is Hiqa when our patients are blocking the fire exits in A&E? Where is Hiqa when patients with C Diff and ESBL are nursed side by side with frail, elderly patients? Hiqa and the HSE have to take responsibility for this. It has to stop."

Delegates also called for the opening of at least 1,000 additional public beds to tackle the trolley crisis in hospitals and said the practice of placing trolleys on corridors should cease by next October.

Health service managers are detached from labour force realities when it comes to efforts to recruit nurses, INMO general secretary Liam Doran told the conference.

While the British health service was offering enticements such as sign-up fees and free further education to potential recruits, the HSE had nothing to offer to nurses it wished to employ.

Mr Doran said he hoped the forthcoming report of the commission on nursing would recommend agreed staffing ratios related to the dependency of patients, and this would make the job more attractive to potential recruits.