A HEALTH board chief executive has warned that the Freedom of Information Bill will have major implications for Irish health services, and they are not prepared
Mr Denis Doherty, director of the Office for Health Management, which has a co-ordinating role over all the health boards, said yesterday hospitals and health boards will have to recognise their obligations and responsibilities to Irish citizens. He explained that from October 1st, 1998, people will have the right of access to medical records and other matters on file.
Mr Doherty said systems will have to be put in place to cope with this. "As of now I do not think we have the skills for this. You could take a negative view and say it will be very bureaucratic or you can look on it as a body of entitlement of the citizen. We must be much more open, much more transparent and put the citizen first."
Speaking in Limerick at the conference of HOPE, an organisation which involves 15,000 European hospitals, Mr Doherty said it would be necessary for hospitals and health boards to employ more people, including legal staff, to cope with the demand.
"How can we afford the citizen what he is entitled to if we do not understand it ourselves? We need to prepare for this rather than be beaten into it by the Ombudsman, the freedom of information commissioner or the press, when the time comes," said Mr Doherty, who is president of HOPE.
People would be able to question decisions and how they were arrived at. `Medical cards are a fairly subjective area and people will now be able to ask what criteria were used to decide whether or not to give a medical card. If we do not explain it then it can be appealed to the freedom of information commissioner. There are also implications for people being able to look at their own medical records and what they discover," said Mr Doherty, who is chief executive of the Midland Health Board.
He urged the 300 delegates at the conference to welcome the new consumer revolution sweeping European_hospitals and not to regard it as a threat to professional standards. The theme of the conference is "Improving the Quality of Hospital Services".
Mr Kai Essinger, director of the Federation of County Councils in Sweden, spoke about how to shorten hospital waiting lists. In Sweden, he said, a commitment had been given by the local councils that there would be only a three month waiting period for 10 of the more common procedures, including hip replacements, cataracts and heart surgery.
They managed to increase the numbers of patients being treated and reduce the waiting time without increasing the cost. There were problems with the system at present because of a decline in the Swedish economy but he expected this would "balance out" within a year.
Mr Essinger, who deals with international public health issues, spoke about a quality improvement programme set up to improve patient satisfaction for people with lung cancer. It resulted in a 20 per cent increase in satisfaction levels.
"The idea is to analyse who are your customers, who you are working for the patient and the referring doctor. We devoted a lot of time to discussing this. A questionnaire asked what an acceptable waiting time was for diagnosis and for treatment after the diagnosis is made. We then looked at what the waiting time actually was."
Then the reason for the waiting time was analysed and a system was set up whereby each case was followed through and a nurse was made responsible for most of the "paper flow" and authorised to make certain decisions.
Goals for waiting times were introduced. "As a result patient satisfaction has been measured and increased," said Mr Essinger.
There were many ways of dealing with waiting lists, he said, and this was one particularly effective way. But he pointed out that a lot of work was involved and it took up to 3 per cent of the personnel budget for two years while it was being set up.