Health and care services report

Review ordered into RQIA resignations

An independent review has been ordered after the entire board of the Regulation and Quality Improvement Authority (RQIA) resigned following a disagreement over the handling of the Covid-19 pandemic.

All nine board members of the health watchdog resigned in protest in June, saying that they had not been consulted on a number of decisions taken by the Department of Health. The moves made that are believed to have triggered the resignations include the reduction in the number of inspections in care homes, the redeployment of RQIA staff, Chief Executive Olive Macleod among them, to other agencies and RQIA inspectors being put to work in different roles in care homes.

The RQIA is responsible for monitoring the quality of health and social care in Northern Ireland, including the carrying out of inspections of care homes, which were so heavily impacted during Covid-19. In a statement to the BBC, the resigned board members said that they “couldn’t stand over” the decisions, which they said “diluted the RQIA’s independence and critical function as a regulator to maintain the protection of vulnerable adults in residential and nursing homes during the Covid-19 crisis”.

The Department of Health defended itself against the criticism, saying that the frequency of inspections was lowered in an attempt to lower the risk of infection; official figures show that more than half of the Covid-19 deaths in Northern Ireland occurred among care home residents.

After calling the resignations a “matter of regret”, Health Minister Robin Swann ordered an independent review. The Minister said that the resignations would have “no impact” on the daily operations of the RQIA. At a press briefing, Swann defended the Department of Health, saying that they had to make decisions quickly as they were in the “teeth of a full-scale emergency”.

Swann appointed Christine Collins as interim chair of the RQIA and further defended the actions of the Department by saying that other parts of the UK had done similar. The Minister said that he was aware of “tensions” between the RQIA board and Department officials since the beginning of May, but that he was still surprised by what came after and “didn’t expect it to culminate in the resignation of the board”.

Chief Medical Officer Michael McBride has said that he will fully cooperate with the review and that he believes that the decisions of the Department had saved lives as the pandemic began to spread. McBride said: “The decision was to reduce the frequency of visits to care homes, not stop them. It was designed to protect individuals in care homes, reduce footfall and the risk of infection.”

Restrictions on the frequency of care home inspections were lifted on the same week that the resignations were announced, but the damage had been done as far as the RQIA board’s relationship with the Department is concerned. Questions were asked about the announcement of a review coming so quickly on the heels of the resignation announcement, but Swann said that he would rather act quickly than slowly.

Department of Health permanent secretary Richard Pengelly has written the terms of reference for the review, although other details have not been announced as of yet.

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