THIS WEEK, HIQA is marking its 10th anniversary. Since establishment in 2007, our core focus has been on achieving better, safer health and social care for the people of Ireland.
HIQA began regulating services for vulnerable people in 2009, starting with residential services for older people (nursing homes). By tasking an independent body such as HIQA to carry out this function on its behalf, the State acknowledged the crucial need to protect its vulnerable citizens.
HIQA now not only regulates designated centres for older people, but also for adults and children with disabilities and will shortly commence full regulation of all children’s social services.
Those who remain outside the system
However, we believe that there are still groups of vulnerable people in Ireland who remain outside of this system and are thus at risk of abuse or neglect.
A major national Red C Poll commissioned by HIQA shows that there is widespread misunderstanding of which areas of health and social care are currently independently regulated and monitored.
There may be some surprise among the public to discover that there is currently no independent regulation of private hospitals, homecare services, or health and social care provision in residential centres for asylum seekers or homeless shelters. Indeed the poll showed that there is strong support for the independent regulation of homecare services, public hospitals and community-based services for people with disabilities.
Everyone is entitled to safe care
Everyone in Irish society has an entitlement to safe care and to be protected from abuse, and yet HIQA does not yet have the legal mandate to assess the quality and safety of the services being provided to some of the most vulnerable people in the country. This situation has the potential to create new, hidden populations in Ireland.
To be effective, regulation must respond to people’s needs and adapt to changing circumstances. HIQA constantly seeks to improve regulatory practice and explores how care could potentially be regulated into the future.
Legislators have demonstrated a commitment to the promotion of the rights of vulnerable and disempowered individuals in the passing of the Assisted Decision Making (Capacity) Act in 2015 and in the progress of the Disability Miscellaneous Provisions) Bill 2016 through the Oireachtas.
These pieces of legislation are aimed at ratifying the UN Convention on the Rights of People with a Disability and dealing with issues surrounding the deprivation of liberty. However, we remain concerned at the lack of legislation that identifies the State’s responsibility to protect adults who may be vulnerable or subject to exploitation.
The recent Red C opinion poll found that 63% of people in Ireland have witnessed poor provision of health and social care services. Particularly distressing is the large number of people who have witnessed physical or emotional abuse, including in home care services.
Significantly, many of the areas where poor provision is witnessed are currently not independently regulated, despite broad public support for same. It is only through the extension of regulation that we will achieve the safe and effective services that the public desires and deserves.
Legislation urgently needed
But what other steps are necessary to protect the most vulnerable people in our society? HIQA strongly believes that statutory measures to protect the health, human rights and wellbeing of individuals are urgently necessary, and advocate for the introduction of national safeguarding legislation for adults.
Such legislation would set out clear definitions of offences in respect of the abuse of vulnerable adults. It would also give statutory powers of enforcement and prosecution, currently only enjoyed by HIQA in the regulation of nursing homes and disability centres, to other health authorities in Ireland. HIQA will continue its work as part of the National Inter-Sectoral Safeguarding Committee and with the Department of Health and the Oireachtas to accelerate safeguarding legislation.
The poll commissioned by HIQA highlights the fact that there is broad support amongst the Irish people for the type of health and social care that HIQA has long supported, whereby the rights of vulnerable people are pivotal and where there is clear accountability when something goes wrong.
What we need now is strong political will and the collaboration of all of stakeholders to achieve a health service that we in Ireland can be proud of.
Phelim Quinn is HIQA CEO.
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