A MANDATORY licensing system for both public and private healthcare providers, including family doctors, has been recommended in a Government-commissioned report published yesterday. DR MUIRIS HOUSTON, Medical Correspondent reports
The report, by the Commission on Patient Safety and Quality Assurance, highlights failures in the system including a lack of accountability structures. It makes a range of far-reaching recommendations designed to make the Republic's health system safer for patients.
The 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.
Its report, Building a Culture of Patient Safety, was welcomed yesterday by Minister for Health Mary Harney, who promised to bring it to Government next month.
Asked about the provision of funding to implement the commission's recommendations, a spokesman for the Minister said: "Patient safety will be a priority in the allocation of resources."
The commission, chaired by Dr Deirdre Madden, senior law lecturer at University College Cork, stopped short of recommending the formation of a single patient-safety body.
But it highlighted specific failures in the health system, including poor leadership and organisational deficiencies that create barriers to the development of a patient-safety culture.
Among the key recommendations is the need for a mandatory licensing system in the State to cover both public and private healthcare providers. This would mean that all hospitals, family doctors and community-care providers must obtain a licence before they could offer a service to patients. The Health Information and Quality Authority would become the licensing agency. And private health insurers such as the VHI would be required to ensure that all private healthcare facilities adhere to the authority's standards.
Chief executives of healthcare organisations should be formally held accountable for patient safety and managers in the health service will be subject to the same ethical and disciplinary systems as other healthcare professionals, the report recommends.
Following concerns about the role of locums in the recent breast cancer-care scandals, employers would be obliged to exchange information concerning doctors, nurses and others whose work has raised concerns for patient safety.
Doctors and other professionals would have to seek privileges to practise in hospitals and will be required to update their credentials to show they are competent to undertake specific procedures and treatments. A system of open disclosure of adverse events to patients is recommended.
A national network of patient advocates which would work in partnership with healthcare organisations has been suggested, while information should be provided to patients and carers to enable them deal with illness. The report also identifies the need for a visible patient advocate within the Department of Health.
The report was welcomed by both Fine Gael and Labour. Fine Gael health spokesman Dr James Reilly called on the Minister to bring forward legislation to enable implementation of the commission's recommendations.