The Seeing Eye

national | consumer issues | opinion/analysis Thursday July 30, 2009 12:38 by Sean Crudden - impero sean at impero dot iol dot ie Jenkinstown, Dundalk, Co Louth 0879739945

HIQA

"We will set the standards for delivering health and social care services and we will continuously inspect to ensure that these standards are being met."

"We will help deliver value for your money by monitoring that the resources in our health and social services are used in a way which delivers the best outcome for the patient or service user."

The above lines taken from the front page of HIQA’s web site strike me as being rather gung-ho. It appears that HIQA is setting itself up like some martinet intent on squeezing performance out of unwilling minions.

"There's a one-eyed yellow idol
To the north of Kathmandu;
There's a little marble cross below the town;
And a brokenhearted woman
Tends the grave of 'Mad' Carew,
While the yellow god for ever gazes down."

The Green Eye of the Little Yellow God

"We will set the standards for delivering health and social care services and we will continuously inspect to ensure that these standards are being met."

"We will help deliver value for your money by monitoring that the resources in our health and social services are used in a way which delivers the best outcome for the patient or service user."

The above lines taken from the front page of HIQA’s web site strike me as being rather gung-ho. It appears that HIQA is setting itself up like some martinet intent on squeezing performance out of unwilling minions. Obviously there is, at least, an implied disrespect for the thousands of trained professional experienced staff in the health service. And a disregard for their supervisors and managers?

It seems to me that excellence and high standards are better guaranteed by an internal synergy within the system rather than by the dictates of external direction. And we are all familiar with the concept of "eye-service" where those adept at pleasing the boss present an angelic appearance while the genuine worker who is putting her shoulder to the wheel pays less attention to appearances and may ironically earn disfavor and disregard from the upper echelons.

Of course a more gentlemanly regime of inspection was the order of the day in the banks and it appears it was a catastrophic failure. Would a more aggressive system of inspection have prevented the economic collapse of the past year? I really don’t think so. It requires the utmost in democratic leadership especially within organizations which may be operating in a less than ideal way to listen to the calm voice of protest within which may be coming from those who are rooted in the reality of the situation rather than the hype of those cocooned in ivory towers further up the line. If the genuine internal ferment within is absent that is the real indicator and harbinger of failure coming down the tracks.

The Mental Health Commission is in charge of standards in the area of mental health. A quick glance through their website - and there is a lot of reading in it - shows refreshing concern for the patient’s point of view. My only caveat is that consultation with patients seems to be formalized at the level of academic research. Why was no-one listening to the patient on a day-to-day basis over the years? And is the patient really being listened to now?