Financial Climate: Challenges for Regulation

15 May 2009

1. 2 Case Studies:

• Republic of Ireland (Health Information and Quality Authority)

• England (Care Quality Commission)

2. General Discussion

Health Information and Quality Authority

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

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

Impact of Financial Climate

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

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

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

And how is it for you…?