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Editorial - Quality care is the priority

Reports on the activities, discussions and debates that took place at the INMO’s recent 93rd Annual Delegate Conference in Killarney are covered in a special section this month (see page 13).

The theme of this year’s conference, Safe Care – Safe Practice – No Compromise, ran through almost every debate and discussion over the three days.

Almost 75% of the motions tabled for discussion centred on the pivotal issues of practice, quality, advocacy and the environment in which patients are placed and INMO members are expected to work. Many of the delegates gave graphic examples of the very challenging dilemmas they face as they struggle to maintain safe practice and quality care, despite shortages of staff and increased acuity within their patient/client population.

Perhaps one of the most striking contributions was when one delegate detailed the 14 hour shift they had to put in earlier that week, because of a shortage of staff in an intensive high dependency unit. She described the very real risks that were at play and her efforts to maintain quality and address the urgent needs of her patients. When she came to the end of her contribution, as she strove to control her emotions, she uttered the words “this cannot go on, I am broken”.

In a later contribution to that debate, I said that this Organisation will never allow any of its members to be broken by the pressures of work. We will never stand quietly by when safe practice or quality care are being compromised by the decisions of those who never see a patient.

Shortly after the ADC, the Health Information and Quality Authority (HIQA) published its report into the management of patients in the emergency department of Tallaght Hospital. This report found that no hospital should keep patients on corridors, that clinical governance must be improved, and that the overall management of Tallaght Hospital must be greatly enhanced. But why did it take so long to produce this report? And why has HIQA been silent for so many years about overcrowding in EDs and the resulting pressures on all departments in so many hospitals?

It was also striking that, in this report and in the media coverage afterwards, the INMO’s Trolley Watch scarcely received mention. There was no reference to the numerous press releases that the INMO has issued with regard to the overcrowding in the ED of Tallaght and other hospitals over the past eight years. It was as if HIQA had discovered the problem, when a terrible tragedy occurred nine months ago. HIQA offered no explanation for why it had not initiated investigations earlier, in the face of the overwhelming evidence of overcrowding, which could have prevented the tragedy occurring in the first place.

The silence of HIQA and the Department of Health regarding the INMO Trolley Watch was in stark contrast to the words of Tony O’Brien, director of the Special Delivery Unit, at the recent ADC. He said that a great debt of gratitude is owed to the INMO for shining a bright light for many years on the nationwide problem of ED overcrowding.

Ultimately, whether it be our Trolley Watch, our safe practice campaign or simply our support for members, this is about the provision of quality care.

The INMO will never rest or be diverted from highlighting the twin issues of safe practice and quality care. Everything in any health service revolves around these fundamental issues.

In that context, HIQA, the Department, the HSE and all healthcare providers need to join us in this campaign, so that safe practice and safe quality are always put before finances and budgets.

Liam Doran
General Secretary, INMO

Editorial - Quality care is the priority
June 2012 Vol 20 (5)
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