Time to progress Tallaght recommendations
“The Challenge…for all other acute hospitals in Ireland will be to drive, inject and embed strong patient-centred leadership in order to establish and sustain a strong culture of patient safety…”
The above quotation is from the HIQA statement which was issued to accompany the publication on May 8 last of the Tallaght Hospital Report. As health service managers we welcome this Report, as indeed we welcome all such reports that strive to make our health delivery systems safer for our patients. The issue of patient safety is paramount and should hold sway over all other concerns. It behoves the manager, in all circumstances, internal and external, and difficult as they may be, to ensure that our systems and processes are such that the safety and well-being of our patients is paramount. The time-honoured maxim “First, do no harm” is as relevant today as ever.
The sense of recurring themes is hard to avoid in this Report. Culture, corporate governance, clinical governance, leadership, accountability, planning etc. to name but some. Some of the sub-themes may not be presented as prominently but nonetheless come across as significant factors which play into the overall melee of issues with which our management systems have to contend. One such issue is the difficulty in controlling the range of clinical service provided. This is understandable in a political system which, by and large, has failed to define which hospital services should be delivered where, and which has unwittingly allowed professional elites compete with each other for ‘primus inter pares’, for pole position as it were, the hospital with the biggest and the most, and at all costs.
It is heartening to note the urgent emphasis on governance, including clinical governance. It is important now for meaningful discussion, at national and local level to inform the development and composition of boards of governance, including those ‘Boards’ which will be instituted on an administrative basis pending enabling legislation. In the context of ‘Tallaght’ and the development of interim Hospital Groups such discussions are fundamental in arriving at foundation principles in which local governance for hospital trusts will be built.
The recommendations in Executive Management are equally instructive. Again, the theme is very familiar and one which the Health Management Institute holds as a core mission; the need for a clear career progression for leaders and managers to ensure that individuals receive the appropriate vocational training and development and human factor skills required for a senior management role. This is something for which the HMI has long advocated and has often written about.
It is now time to progress on all these fronts.