‘Shocking lack of oversight’ in NI mental health provision

Although health and social care services across the board are tightly regulated by the RQIA (Regulation and Quality Improvement Authority), it has come to light that the RQIA has no remit to oversee our community and in-patient mental health services.

Following a series of negative experiences – involving both in-patient and community service providers – one Belfast resident was shocked to discover that the RQIA had no power to investigate his complaints.

“This is something that seems to be going beneath the radar. It is absolutely shocking that in Northern Ireland in 2020 there is no legal oversight of mental health services,” he said.

The complainant has been acting as an advocate for a vulnerable adult with complex needs, now aged in his 30s, for a number of years.

He does not wish to be identified as this would in turn identify the vulnerable adult in question.

“For years, the perception has been that the RQIA are the regulator when in fact they are not,” he said.

“If you take the serious allegations around the Muckamore Abbey case, the press reports refer to the RQIA as ‘the regulator,’ however, when you read the articles it was clear that the [RQIA] inspections were not really inspections in the true sense – they were recommendations rather than requirements.

“Where the RQIA has the power, they can put a facility into special measures or even close them down.”

The RQIA has confirmed to the News Letter that it has “no legal powers to inspect or regulate” community mental health provision.

A spokesman said: RQIA’s role under the Mental Health (NI) Order 1986 relates to patients in receipt of inpatient care in hospital settings.

“In order to fulfil our responsibilities we consider one of the best approaches to this is through undertaking inspections of these services. However, there is no legal requirement under the Mental Health Order for RQIA to inspect these in the manner we are required to inspect services such as residential care and nursing homes under separate legislation.

“As regards community mental health services, as these are not detailed within the Mental Health (NI) Order 1986 (they did not exist in their current form when the legislation was enacted 34 years ago), we do not have the legal powers to inspect or regulate these.”

A spokesman for the Department of Health told The Detail website in November 2019 that the department was carrying out a “fundamental review” of the situation.

When asked on Wednesday, the department confirmed that there are no further updates on the progress or otherwise of that review.

“The current legislation dealing with regulation and inspection of health and social care services dates back to 2003,” he said.

“Since that time there have been a wide range of developments in terms of what services are available and how services are delivered.”

The spokesman added: “The Department of Health is currently carrying out a fundamental review of regulation to ensure that the system of regulation of health and social care is appropriate.”