Speaking note for Minister James Reilly at the Leadership Seminar on Patient Safety

In welcoming our International speakers and guests, I figure I should point out that Croke Park hosted her Majesty, Queen Elizabeth II last week. Fortunately, she didn’t make a speech when she was here. The comparisons might not have been helpful to some of us…

I do hope you’ll get the chance to explore at least a little of our wonderful city while you’re here, as the Queen did. It’s a marvelous mixture of history, culture, hospitality and fun.

The alliance between Joint Commission International and Health Care Informed of Ireland will undoubtedly have a positive impact on safety and quality in our healthcare system.

You heard from my Department’s Chief Nursing Officer earlier this morning.

I endorse her comprehensive briefing on the Patient Safety First Initiative, and commend the signatories on their ongoing commitment and support to Patient Safety.

Which brings me to the fact that this seminar is dedicated exclusively to the Patient Safety agenda.

That wouldn’t have happened ten years ago. But now, we recognise that patient safety relates to:

  • Public confidence and reputation;
  • Efficiency
  • More integrated service provision
  • Patient experiences and outcomes; and
  • Staff morale.

This is a very timely and forward-looking initiative in an era of great change.

Great change brings great challenge. But it also brings the opportunity for strong and dynamic leadership, in public and private healthcare alike.

What’s needed are people who have a depth of experience and distilled wisdom — and the courage to give leadership.

That sounds obvious, but it isn’t. Too often, experience can generate caution and self-protection, rather than leadership in the interests of the patient.

High calibre management and leadership are the key skills that will bring healthcare through the current economic difficulties.

They’re the skills that will ensure we’re well prepared to take advantage of the new opportunities which will emerge. And they will emerge.

If ever there was a time for sound strategic leadership and for excellence in management, this is it.

You’re going to hear about many strands of the patient safety agenda today, but I want to focus on a few vital elements with the potential to drive significant change.

HIQA’s Standards for Better, Safer Healthcare is the beginning. It’ll be followed by a rake of other advances designed to strengthen patient safety. It’ll be followed by a rolling series of new standards and legislation.

Once adopted, the application of the Standards will be reinforced by legislation for the mandatory licensing of public and private healthcare providers.

More immediately, I’ll be introducing legal protection (in the context of health service provision) around open disclosure, adverse event reporting and clinical audit. This will be included in the Health Information Bill this year.

Late last year, a National Framework for Clinical Effectiveness was established to mandate the development of national clinical guidelines in key service areas, and promote the widespread use of clinical audit. What we’re trying to achieve is to marshal the extensive knowledge and experience already in the system.

It’s sometimes believed that if you talk about reforming a system, it means you want to reform the people within the system. That’s not what I mean by reforming our health system.

What I mean is fixing the system so it makes the best use of the wisdom, experience, insight and initiative located within.

Sometimes hidden within.

Sometimes, let’s be honest, buried within the system.

You know the phrase “the fifth column”? During the Spanish civil war, a general who was about to besiege the city of Madrid said that he had four army columns outside the city and a fifth inside – made up of his supporters behind the lines.

In the most positive sense, reform has a fifth column within the health service and particularly within the HSE, where energetic, committed professionals are champing at the bit to take the system by the scruff of the neck and make it work better.

The great thing about that fifth column for good within the healthcare system is that their energy – allied to new legislation and regulation – will make healthcare in Ireland safer and more effective for the patients, while at the same time making it a much better sector to work in: a magnet sector, I hope, in the not too distant future.

The point I’m making is that we have the brightest and best within the system already. Reform means making better use of their capabilities. It means catching ourselves doing something right and applying that right across the board.

But it also requires that we constantly remind ourselves about the central objective.

The old saying has it that when you’re neck-deep in alligators, it’s hard to remember your objective was to clean up the swamp.

My primary goal is equal access.

That simple.

That difficult.

It can be achieved only through a single-tier system that gives access based on need – not on ability to pay. That’s why I’ll be introducing Universal Health Insurance.

One other point about reform that’s important is this. In setting out to reform a system that serves patients, we must involve patients and put them at the centre of care provision. We’ll do that through the National Strategy for service user involvement, so that patients become active participants in their care and to the safety of that care.

We’re facing massive change. And it’s not just Ireland that faces massive change.

Across the globe, governments are facing enormous financial pressures to maintain, let alone develop, their health services. Ageing populations, the growing burden of chronic disease, lifestyle-related risk factors, rising costs, increasing public expectations and medical and technological advances all contribute to the challenge.

The temptation is to be overwhelmed by the nature and scale of the challenges we face at any given time.

But it all boils down to two aspects of healthcare: its effectiveness (outcome) and its humanity (experience). We all want to receive, and indeed deliver, effective care in a humane way.

To make sure that happens, we’re well on the way to the establishment of a Patient Safety Authority (PSA) to incorporate HIQA.

Quality management is not the preserve of one manager but of all managers. Quality is achieved through a chain of processes, each of which has to be under control and subject to continual improvement. However, while processes support the quality of services, it is the commitment, leadership and contribution of people which ultimately ensures delivery. The power of one professional is immeasurable.

This event gives us all the chance to hear from others so that best practice can be shared. Good care can make the difference between enduring life and enjoying life. And that instinct to offer care is one of our finest and noblest human attributes.

Working together we can, (over a relatively short time), develop a healthcare system and culture distinguished by the highest level of commitment to patient safety and quality.

That’d be good, right? Right. So let’s do it.

Thank you.