Inadequate communication, breakdowns in working relationships and deficiencies in governance were behind the mass resignation of Northern Ireland’s health watchdog, a probe has found.
An independent review into the scandal involving the Regulation and Quality Improvement Authority (RQIA) has issued an excoriating assessment of the relationship between the RQIA’s executive team and the Department of Health.
It has found the relationship between the RQIA executive team and the Department of Health was “too close”.
It also said “the lack of any real relationship” between the Health Minister and Department of Health and the RQIA Board meant that only Dermot Parsons, the interim chief executive, “had the ear” of senior departmental officials.
As a result, the RQIA board was effectively “invisible” to the Department of Health, while Mr Parsons was “eager to please” and the Department “was persuaded” the board “was a nuisance and getting in the way”.
It continued: “The Department appears to have been comfortable with the dysfunctional, one-sided relationship with the RQIA executive team and supported the interim chief executive in his disagreements with the RQIA Board even when he was clearly in the wrong or was not giving a full and accurate account to the officials in the Department.”
The review also found Mr Parsons was “thrown in at the deep end” when he was appointed interim chief executive of the organisation in March 2020.
He was appointed to the role when Olive Macleod was seconded to run the Public Health Agency as part of the pandemic response.
In June 2020, the entire RQIA board resigned after a row over the handling of the pandemic.
The board was concerned that a range of steps were taken, including moving senior officials from the RQIA to other organisations within the health service, without consulting them first.
The long-awaited review into the resignation was published on Monday morning and found Mr Parsons was “provided with no proper induction training or any other preparation for the role”.
It continued: “It is the opinion of the review team, and several others during this review, that he failed to understand the roles and responsibilities of a chief executive and his accountability to his own board.
“Nevertheless, the review team notes that departmental officials must have believed that he was of sufficient calibre and had adequate experience to perform this role fully and effectively as they appointed him to the position.
“Some departmental officials acknowledged that, with the benefit of hindsight, its decision to redeploy several senior members of the RQIA’s Executive Team at the end of March had left the interim chief executive with very limited management support.”
However, the review, led by David Nicholl, also found Mr Parsons “did not seek to use the extensive experience and expertise of his board to help him understand his role and perform his functions”.
It continued: This was especially important during the pandemic when he most needed the support and backing of his board.”
The report said there were “several occasions” when Mr Parsons “sought to exclude or override the board”, which it said was “wrong”.
It has now emerged that Mr Parsons has resigned from his post running a Northern Ireland care home firm.
A statement from Kathryn Homes – which was renamed following a series of high-profile scandals – said Dermot Parsons resigned last week.
Mr Parsons took up the post of managing director of Runwood Homes at the start of this year.
The company was subsequently rebranded as Kathryn Homes, with Theresa Nixon, former RQIA director of assurance, appointed to lead the board of the company's Northern Ireland branch.
Mr Swann has welcomed the conclusion of the report.
"I deeply regret that the board members did not come to me and say they were on the brink of resigning. I would have taken that very seriously and I believe we could have worked together to resolve the difficulties," he said in a written statement to the Assembly on Monday.
However, he said the review team was "also clear that the Department of Health cannot escape its share of responsibility for what occurred".
"It believes that, if better governance had been applied between the department and RQIA, this event may have been averted," he said.
"The recommendations put forward, therefore, are aimed at providing the necessary clarity on roles and responsibilities and relationships for a minister, for his or her officials, and for the department's arm's-length body (ALB) boards, along with their executive teams, in accordance with legislation and best practice."
Welcoming the report, the RQIA said of the many recommendations - those that are within the authority’s control - will be taken forward as quickly as possible.
Interim chair of the RQIA, Christine Collins, said: “Since appointment by the minister in autumn 2020, the authority has been committed to working closely with the minister, departmental officials and other partner organisations to make sure that health and social care services in Northern Ireland are safe, effective, and of a high quality. RQIA’s independence and expertise are fundamental to success in this essential work.
"The authority and RQIA’s senior staff appreciate the support provided by the minister and departmental officials during this unprecedented period.
"The RQIA’s priority is always to safeguard patients and service users, especially as Covid and other pressures on HSC systems increase.
"RQIA’s objectives, as agreed with the department, set out what we are aiming to achieve. We are grateful for and acknowledge, the dedication and effort of our staff, who continue to place service users at the centre of our work.”