Is the HSE the right model for health care in Ireland?

'There is, quite simply, no argument against the city needing a much larger emergency department'

UHG.

UHG.

How can we speak coherently about Galway's health services at a time where our media's daily diet is composed of negative stories concerning Government failure to properly ensure medical care for its own citizens?

Media reporting is today focused on storylines about scandals, such as ministerial mis-management of the CervicalCheck screening programme and the cost overruns of the National Children’s Hospital. Public concern is also extending to the excessive cost of new cancer treatments, and the socially divisive idea that if you do not subscribe to VHI, you may, as a public patient not have the same access to life saving cancer treatments, as those who do.

Why is it that, with so much of Ireland's annual tax income now devoted to paying for healthcare - which today is costing €18 billion a year - public healthcare is still such a shambles in "one of the worlds wealthiest countries", as Vincent Browne describes the State.

Yet many voters will still put their local party Government supporting FG/FF councillors back in come May 24, instead of recognising their failures, and voting instead to get them out.

health injection

The current intricacies surrounding the development of the National Children’s Hospital, with its cost overruns now said to leave tax-payers with a final bill likely to breach €2 billion, and doubts remaining about its choice of location, confound any rational explanation. Insider thinks that some of its floors will remain empty and be unused, because it will be too expensive to equip and fully staff them.

Such issues are becoming more typical of a Government that is seemingly unable to advance any form of infrastructural development, similar to the failure to build Dublin's Metro North, or to advance the National Rural Broadband Plan, without a public row emerging over its design, purpose, funding, project commencement/or completion dates.

We know all about such issues in Galway where you only have to look at the 20 years of planning and the two attempts to advance the building of an outer city bypass (now known as the N6 Ring Road ), that is already costing €30 million in planning without a single brick being laid. The Harbour extension, which has been spoken about for decades, but yet is still no nearer commencement, is languishing in a file with An Bord Pleanala for the past five years.

health merlin park

Recent history of hospital service and healthcare provision in the west of Ireland is perhaps no different to that in many other regions. The continuing row over Waterford's 24 hour Cath-Lab rages on where Tánaiste Simon Coveney has pledged in the Dáil that a second cath lab in that city will be given the go-ahead, despite fears it could be just one of the projects delayed, a casualty of the enormous cost overruns at the National Children’s Hospital. Meanwhile, the Irish Examiner reported: “Children with acute mental health problems are increasingly presenting to emergency departments because they cannot access an appropriate bed, leading to costly hospital admissions."

'In Galway we have a long running saga surrounding our urgent need for a new ED building, replacing the present emergency department at UCHG - which must be the third or fourth new or extended exmanation of A&E facilities ordered in the past 40 years that Insider remembers'

Our own Saolta Hospital Group's failure to promptly deal with a leaking roof at Merlin Park Hospital's orthopaedic theatres, is a scandal. Ten highly trained surgeons are left with hands hanging and to manage a waiting list with 2,000 patients on it - all needing various orthopaedic procedures that would ensure some comfort from painful conditions.

Hip and knee replacements and life-enhancing spinal surgeries are all being held back, while hospital managers argue over contract difficulty with suppliers of new modular operating theatres. Insider knows a little about such things, as in the 1970s he trained and was among those first qualified to become an operating theatre technician, working with the NHS more than 40 years ago. He knows this is not rocket science.

Health maternity services

In Galway we also have a long running saga surrounding our urgent need for a new ED building, replacing the present emergency department at UCHG. Which must be the third or fourth new or extended exmanation of A&E facilities ordered in the past 40 years that Insider remembers. There is, quite simply, no argument against the city needing a much larger emergency department. Working conditions must be intolerable for staff working therein, but predominantly, and most importantly, it is intolerable for the many patients who are at present left waiting on a trolley (when one is available ) or are left on a chair in the waiting room or in a corridor when not.

Insider has had his own experience of being in such a situation a few years back. He well remembers it was not a pleasant experience, despite the care of all staff present on that night. Once in a bed upstairs, the care was exceptional. Though Joe Duffy’s Liveline a few weeks back tells a different story for the many women who have suffered poor maternity care.

We must then be sure to ask the current crop of aspiring councillors calling to our doors this single question; Why is it that, in Galway, which we have been told many times is among the fastest growing cities in Europe, we cannot have a hospital with an A&E built to a scale which matches this growth, and is capable of dealing with a rapidly increasing public need?

Simple answer you will perhaps be given is of course, that public needs of voters in Dublin overrides all of us who live beyond the Pale, and whose voices are not heard! British citizens who live north of Watford must feel much the same I am sure. As their English parliament similarly treats its regions with as much disdain.

One is then left to wonder if our Galway TDs are ever listened to? We know they have asked questions. Certainly Galway's star TD, Independent Catherine Connolly [pictured above], is pulling as hard as she alone can. Dep Connolly is well able to get answers of sorts. You only have to glance at her Facebook page which shows that she is articulate, always knows her stuff, and is well prepared with her questions. Judging by the amount of papers spread out on the desk in front of her in the Dail, she has done her research.

'Insider is minded to ask if the HSE is yet capable, or is it even the right model, to successfully manage health care in Ireland, but he takes hope from those political rumblings, seeking a change'

Certainly Dep Connolly was well able for Robert Watt, secretary general of the Department of Finance, when, a few weeks ago, he appeared in front of the PAC to answer questions about how we ended up with these enormous cost overruns at the struggling NCH. His demeanour was less than might have been termed respectful or helpful, as he too sought to evade answering Dep Connolly's questions. The Journal.ie reported that Secretary General Watt was later accused of 'playing games' with Oireachtas committees.

On the brighter side; in the time Insider has lived in Galway, ambulance services in the city have multiplied from a dozen or so vehicles to the increased number of high quality advanced paramedics and the range of other qualified personnel now specialising in emergency medical care; including the many new vehicles and modern equipment, all working together with linked helicopter rescue services that are unrecognisable from just a few years ago.

Insider knows personally the first two nurses who were seconded to work full-time with Galway's ambulance service in the early 1980s onwards. At that time they had no access to separate female changing facilities at the old Fever Hospital ambulance control, nor did they always receive the respect from their male colleagues – or get much help from union reps either when representing their case to management.

Just look now at how much all that has changed with so many qualified female EMTs working alongside their male counterparts, both in driving and who are also very capable of engaging in all the work this valuable service provides us when urgently needed. And yet Insider hears there are now rumblings of discontent emerging here too. Insider is minded to ask if the HSE is yet capable, or is it even the right model, to successfully manage health care in Ireland, but he takes hope from those political rumblings, seeking a change, which are beginning to emerge.

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