Clinical governance and patient safety

Sir, – The essence of clinical governance is to mitigate risk to patients and to enhance safe care. Weak or ineffective clinical governance combined with staffing and resource deficiencies create a situation of double jeopardy for patients.

This is exactly what happened at Child and Adolescent Mental Health Services CAMHS in south Kerry. Given that staffing and resource difficulties are likely to persist for years to come in the Irish health service, investing in robust and effective clinical governance must become an urgent priority. A regional governance structure is more likely to be successful in achieving this than the current remote and monolithic HSE. – Yours, etc,

Dr TOM KEANE,

Toronto,

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Canada.

Sir, – Lack of consultant clinical supervision is correctly highlighted as a major factor in the Kerry CAMHS scandal (Letters, January 28th). The 700 vacant consultant posts in Ireland are causing harm to patients daily and result directly from political decisions.

The new entrant 30 per cent consultant pay cut imposed in 2012 was more severe than for any group. Unlike cuts for politicians, it has never been reversed.

This disparity has caused resentment and made many posts impossible to fill.

The new Sláintecare contract will impose further restrictions on new entrants’ working practices, while senior colleagues will remain unaffected. Whatever your views on consultant pay and private practice, these plans will ultimately worsen consultant recruitment and harm patients. Restoring pay without new restrictions on practice should be the starting point to mending our recruitment crisis. – Yours, etc,

STEVEN MALONEY,

Rathmines,

Dublin 6.