Written answers

Thursday, 24 October 2019

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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173. To ask the Minister for Health when HIQA will be given powers to regulate private health care. [43919/19]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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The Health Information and Quality Authority (HIQA) was established in 2007. HIQA is an independent authority established to drive high-quality and safe care for health and social care services in Ireland. HIQA’s mandate extends across a range of public, private and voluntary sector services. Reporting to the Minister for Health and the Minister for Children and Youth Affairs, HIQA’s role is to develop standards, inspect and review health and social care services and support informed decisions on how services are delivered.

HIQA operates under the Health Act 2007, which sets out the functions which the Authority is to carry out. HIQA has responsibility for setting standards for healthcare services, and monitoring compliance with those standards. It also regulates facilities providing care for the elderly and those with disabilities, and has a role with regard to inspecting some of the social care services which are accessed by children to determine if they are meeting the relevant National Standards.  In addition, it undertakes functions in relation to Health Information and Health Technology Assessment.

Section 9 of the Act sets out the grounds under which HIQA may undertake an investigation into a particular service, or may be requested to undertake such an investigation by the Minister for Health.

The Act provides HIQA with the power to set standards for the healthcare services delivered by the HSE, and then to undertake monitoring programmes to assess compliance with these standards. In this regard, HIQA published the National Standards for Safer Better Healthcare in 2012; they represent the overarching standard which public health services are expected to meet. Flowing from these themes, HIQA have also developed standards for particular services, e.g. National Standards for the prevention and control of healthcare-associated infections in acute healthcare services. HIQA has in turn conducted a thematic inspection programme against these standards since 2012, which has resulted in the publication of over 300 reports of inspection visits to date. In addition, HIQA has also undertaken thematic inspection programmes in relation to nutrition and hydration in acute hospitals, and in relation to medication safety.

In such cases, HIQA typically undertakes both announced and unannounced inspections of healthcare facilities in order to ascertain the degree of adherence to expected standards. A report of the inspection visit will subsequently be published on HIQA’s website, and frequently attracts media attention. In cases where remedial action is required, depending on the severity of the risk identified, HIQA may draw the matter to the attention of hospital management during the inspection and request an immediate response, or in less severe cases, will raise the issue in writing. In either case, an appropriate management response would be expected.

Further standards also continue to be developed i.e. most recently the National Standards for Safer Better Maternity Services and National Standards for the Conduct of Review of Patient Safety Incidents.

The Patient Safety Licensing Bill, in line with the Sláintecare Implementation Strategy, will see HIQA become the licensing authority for all hospitals and certain designated activities. The Bill will, for the first time, introduce a licensing requirement for all hospitals, public and private, and certain designated high risk activities in the community. It was approved by Government in December 2017 and underwent pre-legislative scrutiny at the Joint Oireachtas Committee on Health on 13 June 2018.

HIQA will be the licensing body, with statutory powers to require hospitals to undertake improvements and the authority to remove a licence from a service which is failing to meet required standards.

In advance of a formal licensing regime for public and private hospitals it is proposed that the Patient Safety Bill will bring the private/independent healthcare sector within the remit of the Health Act 2007. The proposed bill will extend HIQA’s powers to set and monitor standards, and undertake investigations, where necessary, to the private acute hospital sector. The Patient Safety Bill underwent Pre-Legislative Scrutiny at the Oireachtas Health Committee on 26 September 2018.  Officials of my Department and the OPC are continuing to progress this legislation.  It is expected that the Patient Safety Bill will be brought to Cabinet next month. 

 It should also be noted that HIQA is now responsible for the regulation of medical exposure to ionising radiation. This follows my signing of the new Statutory Instrument 256/2018 on 9th January last governing the regulation of medical exposures to ionising radiation.  

HIQA was designated to take on the responsibilities of the “Competent Authority” for Medical Ionizing Radiation, as required by European Directive 2013/59/Euratom. These functions formerly resided with the HSE, however the transfer of responsibility was required in order to ensure Ireland complied with the European regulations. Such a move was also recommended by the International Atomic Agency in its review of Irish regulatory practice in this area.

I have set out above the current responsibilities of HIQA, and the additional roles it is expected to acquire in the coming period. However, I can also assure the Deputy that HIQA's role and remit will continue to be kept under review by my Department. 


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