The future of health and social care regulation

To be effective, regulation must respond to people’s needs and must adapt to changing circumstances or risk becoming defunct and meaningless, HIQA CEO Mr. Phelim Quinn told the Oireachtas Health Committee.

Phelim Quinn
Phelim Quinn

He said HIQA constantly sought to improve regulatory practice and explore how care could potentially be regulated into the future.

As such, it had recently developed a series of discussion papers exploring the regulation of health and social care services.

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The paper on disability services considered the current care and support models for people with disabilities and looked at future potential models of regulation.

It looked at the current legal definition of a designated centre for people with disabilities in Ireland, as set out in the Health Act. “This definition relates to the physical location where care and support is provided. It is also based on a model which delivers care and accommodation, primarily in a long-term residential setting.

“Increasingly, HIQA inspectors are finding that some emerging models of care, particularly in relation to people with disabilities, do not fall under the definition of a designated centre and are therefore unregulated. One example of this is where people are moved out of a congregated setting to services that have no regulatory oversight.

“Other examples include homecare, sheltered housing, assisted living, convalescence or step-down care and personal assistants. Again, as these services do not come under the definition of a designated centre they are not subject to regulation.

“It is important to note that service users in these unregulated sectors may be just as vulnerable as those being cared for in designated centres. They also have the same right to high-quality care. As such there is a need to review and expand regulation to have oversight and provide public assurance on the different models of care and service delivery.

“Ireland is behind the curve internationally and must re-evaluate the current approach to regulation in order to protect and promote the rights of all people assessing health and social care services. The Disability (Miscellaneous Provisions) Bill 2016 must be passed to address the remaining legislative barriers to Ireland’s ratification of the UN Convention on the Rights of Persons with Disabilities. Similarly, resources must be made available to allow for the full commencement of the Assisted Decision-Making (Capacity) Act 2015, which will strengthen the rights of vulnerable people to live lives free from abuse.”