Louise O'Reilly (Dublin Fingal, Sinn Fein)
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20. To ask the Minister for Health further to Parliamentary Question Nos. 213 to 215, inclusive, of 23 June 2015, the actions he is taking to ensure patient safety in terms of investigating why certain hospitals have higher than average death rates; if he will undertake any investigations or follow-up action following the publication of the second annual report of the national health care quality reporting system; and if he will make a statement on the matter. [20917/16]

Catherine Murphy (Kildare North, Social Democrats)
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114. To ask the Minister for Health if he is satisfied that hospitals are required to trigger inquiries themselves before action can be taken where statistics show an anomaly in patient outcomes, given the findings of the national health care quality reporting system annual report. [20952/16]

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 20 and 114 together.

The Second annual National Healthcare Quality Reporting System (NHQRS) Report was published on Thursday 16 June 2016, and included data on a wide range of indicators. The purpose of the annual NHQRS Report is to use easily accessible information to develop a better understanding of whole health system performance. The mechanism was established to provide a broad overall picture of the quality of our health services. It is intended to demonstrate to individual hospitals and other health service providers the importance of examining their own data in order to improve the services they provide. It must however, be understood that the performance and quality of a service cannot be measured by one indicator alone. This is why the report presents an analysis of a range of indicators that reflect different parts of the services and allows progress and priorities in the health system to be identified.

It is important to note that the NHQRS is not intended to act, and was not designed to act, as a performance measurement tool. There are already a variety of existing measures in the broad healthcare sphere that have been put in place to drive improvements in patient safety, including the work undertaken by the Health Information and Quality Authority. Similarly, it is not intended to provide detailed comparative analysis for particular health questions. In relation to the particular figures provided in the NHQRS report, I would note that care must be exercised when considering them given the variation in the numbers of cases that individual hospitals, in particular smaller units, may deal with. Other issues, for example the quality of the data collected, or patients attending one service being more unwell and consequently presenting with more complex needs than those attending other services, can also influence the final outcome.

However, I recognise that there are areas identified where further room for improvement exists. In particular, considerable variation can be seen between counties in rates of hospitalisation for common chronic diseases such as chronic obstructive pulmonary disease, asthma, diabetes and heart failure. Identifying this variation is a first step to addressing the reasons why this variation exists and to improving it. For example, the information on chronic obstructive pulmonary disease is already informing requirements in Primary Care and the National Clinical Effectiveness Committee Guideline being developed by the HSE Clinical Programme for the management of this disease.

Nevertheless, rather than initiating enquiries, the intent of the report would be for any apparent anomalies which come to light to prompt further research into their possible causes; in the first instance, that is the responsibility of individual hospitals which are required, under the National Standards for Safer Better Healthcare, to provide safe and effective care and treatment to patients.