‘There’s good practice and appalling practice’ in health service, says outgoing Hiqa chief

Accountability and learning from mistakes key challenges for health service, says Tracey Cooper

Outgoing Hiqa chief executive Tracey Cooper: “I wouldn’t say we were the safest [health service]. We still have quite a long way to go.” Photograph: Eric Luke

Outgoing Hiqa chief executive Tracey Cooper: “I wouldn’t say we were the safest [health service]. We still have quite a long way to go.” Photograph: Eric Luke

Mon, May 26, 2014, 01:00

After eight years running a rule over the Irish health service, the head of the State’s health watchdog has some good things to say about the system.

“We’ve got some very good pockets, some phenomenally experienced people, a capable and skilled workforce on the whole and some appetite for innovation.”

That, however, is about as good as it gets. The Health Information and Quality Authority (Hiqa) has been called in to too many disasters in the Irish health service for outgoing chief executive Tracey Cooper not to be aware of its shortcomings.

While she believes the system “is in a better place now than it was a few years ago” she tells The Irish Times this progress needs to be sustained.

Every health system makes mistakes but Cooper says the key challenges for the Irish health service are to learn from its mistakes and to ensure there is accountability on the part of those responsible.

In other countries, support is given to people having difficulty doing their job. “It’s a serious business, healthcare. If you’re having persistent problems and you’re not able to do that role, something should happen.”

“If you’re a consultant, you should be supported to do a different role. If you’re a manager accountable for services and you’re not able to do that job, then you shouldn’t stay in it.”

There is too much emphasis on the technical aspects of providing healthcare and not enough on the need to modernise the focus around “the humanity, the dignity, the communication and empathy with the patient,” she says. And when things go wrong, the quality of response varies greatly. “There’s good practice, and there’s appalling practice – and that’s inexcusable.”

Trenchant criticism

Asked whether Ireland has a safe health service, the Welsh woman says it is “difficult to say” because of a lack of the kind of data collected in other countries. “I think we provide really good services in some areas and in other areas we’re not quite sure because we don’t have the data.”

“I wouldn’t say we were the safest. We still have quite a long way to go.”

Hiqa’s trenchant criticism of safety standards in small hospitals has led to the closure of many emergency departments, often in the teeth of local opposition. But Cooper says it’s not just about the emergency department. “It’s about the totality of services a hospital can safely provide that support what an emergency department is or isn’t. If there aren’t sufficiently qualified people to treat what you’re admitted for, you’re in the wrong place.”

Groundbreaking report

Hiqa got off to a flying start back in 2006, as Cooper recalls. “I remember the first challenge very well. We were five days after being established and I got a call from [