1. Financial Climate: Challenges for Regulation 15 May 2009

2. 1. 2 Case Studies: Republic of Ireland (Health Information and Quality Authority) England (Care Quality Commission) 2. General Discussion

3. Health Information and Quality Authority

4. National Context Republic of Ireland: 4.2m population Split health and social care provider market – monopoly state provider/commissioner Strong health insurance component Previously strong economy now significantly challenged Ongoing budgetary cuts – impacting on provision and regulation of services

5. Background (HIQA) Established May 2007 Independent – reporting directly to Minister for Health and Children Functions Setting Standards Monitoring Quality and Safety in Healthcare – moving to licensing Regulating Social Care Health Technology Assessment Health Information Driving patient safety initiatives

6. Impact of Financial Climate

7. National Challenges Significant fiscal challenges Reducing State Agencies – reviewing purpose, function Failed financial regulation – impact on regulation in other sectors Examples of poor corporate governance and public spend in State Agencies Poor decisions on quality and safety when sweeping budget cuts

8. Regulatory Challenges Delayed commencement of statutory functions Models of regulation and monitoring within reducing resources and associated risks Costing models: public to fee-based Targeting the right interventions for maximum impact Demonstrating value for money Recommending improvements associated with new resources

9. Regulatory Opportunities Creative approach to interventions Focusing on what’s important Improving informed decision-making Established 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

10. And how is it for you…?