Report shows need for change of culture

THE Health Information and Quality Authority (Hiqa) report on Portlaoise Hospital that found that managers at all levels in the HSE — local, regional, and national — were aware of patient safety risks at the hospital but failed to act on them is not unexpected.

It is, however, deeply disturbing and a challenge to our image of ourselves and our civic culture that Hiqa was unable to say it believed that the hospital was a safe place for patients. It is also a profound argument for forceful reform and greater resources for our health services.

That the report points out that hospital staff did not learn lessons from earlier clinical reviews on patient safety that might have reduced the risks faced by Portlaoise patients is shocking and unacceptable. This professional hubris must be explained and challenged with vigour.

That we have become so inured to health system failings that there is not even a suggestion that some of these managers be removed permanently to end the risk posed by their “indifference and ineptitude” — words used by the father of one of the five babies who died at the hospital shortly after birth — suggests a kind of public defeat, a defeat that can only lead to more apathy and stasis — the kind described by the report when if criticised management’s “widespread lack of urgency” to respond to risks.

The Hiqa call for an independent patient safety service to be established within a year to ensure patients’ experiences help drive reform, suggests the establishment of another quango to make up for the absence of proper oversight and accountability in the health service. Surely it would be better to insist that standards be met and impose sanctions if they are not? Hiqa is to be congratulated on publishing this report despite HSE opposition, and Health Minister Leo Varadkar’s acceptance of the report is welcome.

However, without profound cultural change, it is hard to believe that we cannot expect more of the same.

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