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Financial Climate: Challenges for Regulation
15 May 2009
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1. 2 Case Studies:
• Republic of Ireland (Health Information and Quality Authority)
• England (Care Quality Commission)
2. General Discussion
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Health Information and Quality Authority
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National Context
Republic of Ireland: 4.2m populationSplit health and social care provider market – monopoly state provider/commissionerStrong health insurance componentPreviously strong economy now significantly challengedOngoing budgetary cuts – impacting on provision and regulation of services
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Background (HIQA)
Established May 2007Independent – reporting directly to Minister for Health and Children
FunctionsSetting Standards Monitoring Quality and Safety in Healthcare – moving to licensing Regulating Social CareHealth Technology AssessmentHealth InformationDriving patient safety initiatives
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Impact of Financial Climate
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National Challenges
Significant fiscal challengesReducing State Agencies – reviewing purpose, functionFailed financial regulation – impact on regulation in other sectorsExamples of poor corporate governance and public spend in State AgenciesPoor decisions on quality and safety when sweeping budget cuts
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Regulatory Challenges
Delayed commencement of statutory functionsModels of regulation and monitoring within reducing resources and associated risksCosting models: public to fee-basedTargeting the right interventions for maximum impactDemonstrating value for moneyRecommending improvements associated with new resources
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Regulatory Opportunities
Creative approach to interventionsFocusing on what’s importantImproving informed decision-makingEstablished Forum for Chief Executive’s of all Health and Social Care Regulators in Ireland (14) – collaboration in business processes, reducing burden of inspection, information exchange, informing policy – national and international networks
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And how is it for you…?