Hospitals face closure under new targets law

Public and private hospitals will be shut if they put patients lives at risk or fail to meet key targets under controversial new licensing plans.

Health Minister Simon Harris

The legislation, which also gives officials the power to impose heavy fines, is set to come into force by the end of next year after a string of crises in the health sector.

The Irish Examiner understands that, under a bill to be brought to cabinet this morning by Health Minister Simon Harris, hospitals will be told they must sign up to a licensing system by the end of 2018.

The new laws will give the Health Information Quality Authority (Hiqa) beefed-up powers to investigate both public and private hospitals.

While Hiqa already examines facilities, the fact no hospital licensing system exists means the health watchdog has been limited in what action it can take to address serious problems.

However, under the Government plan, all hospitals will be ordered to apply for licences to operate, which will provide for fines, short-term closures and potentially being shut completely if key standards are not met.

The initial stages of the Patient Safety (Licensing) Bill will be signed off on by Cabinet this morning, before being sent to the cross-party Oireachtas health committee and to the Dáil and Seanad. And, if the plans are backed by opposition parties, the new system will be in place by the end of 2018.

The Government move — which mirrors previous beefing up of Hiqa powers to inspect and sanction nursing homes — comes after a series of controversies to hit the public and private hospital sectors. These include record hospital waiting lists, excessive trolley counts and the Portlaoise maternity services scandal in the public sector and serious concerns about plastic surgery services in the private sector.

Meanwhile, the much-maligned public hospitals have been largely given the thumbs up in the most extensive patient survey ever undertaken in Ireland.

Minister for Health Simon Harris TD chatting with Sheila O’Connor from Patient Focus

However, while 84% of those surveyed reported their inpatient experience as “good” to “very good”, no hospital met or was close to reaching the national target of either admitting or discharging 95% of emergency department (ED) attendees within six hours.

That is according to Rachel Flynn, Hiqa’s programme director for the National Patient Experience Survey, who said just 30% of patients were admitted within the six hour timeframe. In fact, 241 patients waited more than two days — and that was just in May.

“Our expectations are that we now expect to have to wait in the ED despite research showing the longer you are there, the poorer the outcome,” said Ms Flynn. “This is not the norm and we shouldn’t expect it.”

On a more positive note, 82% of patients said they were always treated with respect and dignity in the ED, and similarly throughout their stay in hospital.

Patients were also largely positive about receiving clear answers from nurses and doctors on the ward but, almost half (49%) said they could not always find a staff member to talk to about their worries and fears.

More than a third said they were not always involved enough in decisions about their care, while thousands said they were not informed about the potential side effects of medications or the danger signals to watch out for after discharge.

Patients made over 21,500 comments in response to three open-ended questions. In total, 13,706 people took part in the survey, which was open to adults who spent more than 24 hours in an acute public hospital in May.

Taoiseach Leo Varadkar, who attended the survey launch, said it provided “hard evidence about personal experiences of the Irish health service...warts and all”. He said the survey will be expanded next year to include maternity services.

“I think, therefore, it’s only a beginning on a longer journey, a journey to what we all believe in, which is a truly patient-centred health service,” said Mr Varadkar.

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