Mutiny in the Ranks

March 20, 2009

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The Irish Nurses Organisation (INO) is escalating it’s campaign against the proposed spending cuts in the health service. It has launched a new website Stop Health Cutbacks to monitor the level of cutbacks proposed by the Health Service Executive (HSE). Hospital staff and members of the public are invited to post comments online on what their experience of cutbacks has been and to air their views on how the services could be improved. All material will be validated before publishing and patient confidentiality will be protected at all times. Liam Doran, General Secretary (INO), has stressed that the overriding aim of this initiative is to demonstrate in detail where the system is failing patients.

The non-consultant hospitals doctors (NCHD) are also up in arms with the latest decision by the HSE, to cut their overtime and allowances.

Six junior doctors have begun a High Court challenge, along with the Irish Medical Organisation (IMO), against the HSE. The IMO and the doctors claim that the HSE’s proposals are a breach of contract. They further claim that the proposed changes are impractical and will damage the functioning of the various departments in the hospitals where they work.

Next month’s emergency budget will radically affect healthcare in this country and it will be patients who bare the brunt of the further cutbacks. It is essential that everyone plays their part to ensure the highest possible standards of patient care in the difficult times ahead. Make your views known before it is too late.


A Balancing Act

April 19, 2008

I listened with interest to Prof John Crown on the Late Late show last night as he outlined the failings within our health service. John Crown is a leading consultant oncologist working in the front line of the Irish health service and he doesn’t mince his words. He believes that the consultant’s contract as currently presented by the HSE, is a fiasco. He described it as an apartheid contract for an apartheid system of healthcare. Today, I heard that the Irish Hospital Consultant’s Association (IHCA) has accepted the HSE’s proposals and will be recommending the contract to it’s members in a ballot later this month. Meanwhile, the Irish Medical Organisation (IMO) is still refusing to come on board and has today requested third party mediation to resolve the problems. On one side, we have a government that insists on perpetuating a 2-tier system of healthcare despite the consensus of opinion which believes that a single tier health service is the way forward. On the other side, we have doctors who don’t like being put under the thumb by administrators who will decide their working hours. This contract has already been four years under discussion and I have to agree with Prof Crown, it has the potential to be a fiasco.

We have a health service in Ireland that offers a high standard of care but the care is not optimal. According to John Crown, this is due to ‘mal’ funding rather than underfunding. When the allocation of money from the HSE runs out, services are cutback at the expense of patient care. Treating patients costs money but It costs the system nothing to have patients on waiting lists. We have a health service run by civil servants instead of having a medical leadership structure in place. The policy of co-located hospitals as proposed by the Progressive Democrat (PD) health policy, is set to cause an even wider divide between the public and private systems. Each system will be differently funded, further adding to the complications. The concept of co-location ultimately means that services are duplicated in the one location. This is neither efficient nor cost effective . The co-located private hospitals already in existence, tend to be small and have sub-optimal expertise in place. As a holder of private health insurance, I can personally testify to this having once faced the decision of having to choose between standard of accommodation and standard of medical care. I was very unwell in A&E at the time and required admission for investigation. As I was known to be infected with MRSA , I required isolation facilities in order to be admitted to the hospital. There were single rooms available in the co-located private hospital but the physician under whose care I was to be admitted, worked only in the public hospital where no isolation facilities were available at that time. This dilemma typifies all that is wrong with the plans for co-location and the divisive nature of the consultant’s contract. I had no problem choosing medical expertise over comfort but I should never have had to make that choice. Why does healthcare have to so divisive? If you’re sick and in need of hospitalization, the type of care you receive shouldn’t be dictated by your ability to pay.

John Crown is in no doubt that the way forward for our health service is a single-tier, not for profit system of healthcare based on a universal system of social insurance. He makes no apology for speaking out about the deficiencies within our health service. As long as there continues to be vested interests and a burgeoning bureaucracy in control of our health service, the system is doomed to fail. The future of the consultant’s contract remains in the balance.


A Force for Change

March 30, 2008

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If you’ve read this blog before you’ll know that I’m continually harping on about the crisis in the Irish health service. Put simply, the public health system in is melt-down. When the HSE was first set up, we were promised better services – we got patients on trolleys. We were promised better conditions for health staff – and we got a jobs freeze. We were promised value for money – we got mismanagement and dictat. Yesterday, I was given reason to believe that this health crisis will not end in catastrophe.

An estimated crowd of over 4,000 people turned out in Dublin to demand a better public health service. People travelled from all over the country to take part in the rally. It was the first time that patients, consultants, hospital staff, unions and patient pressure groups all came together to declare “Enough is Enough” and demand a decent public health service. The Irish Nurses Organisation (INO) and Irish Medical Organisation (IMO) gave their support. Eamonn Gilmore (leader of the Labour Party), James Reilly (Fine Gael health spokesman) and the Lord Mayor of Dublin all participated in the rally. The march was well-organised with the Gardaí providing an escort of outriders to facilitate movement of the large crowd through the city centre to Government buildings where the rally was addressed by speakers representing each of the groups.

ConorMacLiam, gave a very moving address to honour the wishes of his late wife, Susie Long. Susie’s untimely death last year was brought about by the direct failure of this government to provide an equitable health service for all. Conor claimed that as many as 5,000 people are dying each year as a result of cutbacks and delays in the health service. He also told us that the government has plans to privatise hospice care in this country. This government is determined to pursue against all advice, a policy of privatising the public health service and now we hear that it also plans to develop a 2-tier hospice service. How nauseating is that?

For me personally, there were many highlights to the day. I thoroughly enjoyed the camaraderie of the crowd as I walked alongside young and old, from all walks of life but all united in determination to fight for a better health service. They all had stories to tell of their travails with the health service. I was also encouraged to see two emminent hospital consultants join the rally and take to the stage to give their views on the health service. Prof. John Crown, a consultant oncologist, confirmed that we have been sold a ‘pup’ by this government in terms of healthcare and very soon when we enter a hospital it’ll be a case of “Turn Left” if you’ve health insurance and, “Turn Right” if you’ve not. Prof. Orla Hardiman, a consultant neurologist and spokeswoman for Doctors Alliance (a lobby group formed in 2007 that advocates for better public healthcare), warned that we should be careful to support and protect those elements of the public health service which work well in serving the sick. Otherwise, the government will use the constant whining from the public as further reason to privatise healthcare in this country. I thought this was an excellent point. There are lots of good aspects to our health service and we need to preserve and protect them from government interference.

Susie Long went public in the final year of her illness to highlight the inequities in the system. She turned her own personal tragedy into a force for positive change. She helped to motivate me and many others, to do more to highlight the failures within the health service. I was determined to be there yesterday to honour Susie’s memory and I can honestly say that for the first time in a long while, I felt the tide may be turning. Hopefully, this rally will prove to be the catalyst for change.


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