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'The Tanaiste isn't listening'
By Niall Hunter-Editor
Health Minister Mary Harney needs to listen more to those who are providing healthcare in Ireland, according to Dr Christine O'Malley, President of the Irish Medical Organisation.
She claims the Tanaiste does not want to speak to or be informed by health professionals in drawing up her policies.
Dr O'Malley is firmly against the Tanaiste's plan to involve the private health sector in resolving the public health service crisis.
In a video interview with irishhealth.com, Dr O'Malley a consultant geriatrician, says if the Tanaiste had consulted with doctors on the ground about her plan for building private hospitals on public hospital sites she would have been told it could not work.
IMO President Dr Christine O’Malley
"She does not seem to wish to speak to, engage with or be informed by health professionals. For example, on the co-location of private hospitals on public sites-if the Tanaiste had spoken to doctors we would have said to her that it is an interesting idea but it will not solve the health crisis in A&E. Anyone who works in the system knows that private hospitals do not take sick patientsthey take stable elective people and they treat them very well."
Asked if too much consultation would not simply lead to stagnation and no action, Dr O'’Malley agreed that you can have too much consultation, but some consultation is needed. "I think you have to consult, then think about it and know what to do."
Asked if the Tanaiste's policy of involving the private sector in trying to ease the health crisis could be because she feels that the public system has failed to provide a solution, Dr O'Malley strongly disagrees.
"I believe the public system has worked extremely well. There are five million patient contacts every year in the public system; that is a phenomenal workload and is double what we were doing 20 years ago. We are victims of our own success. The reason why we face a queue in A&E is because we are so busy, so hardworking, so effective in the public system. The problem is that we have not been given the wards…actual physical space to put the patients into."
Dr O'Malley believes private hospitals cannot really take the pressure off the public system because they are 'niche' specialist centres."They are very good at looking after stable, elective patients, especially patients who require procedures. But I know that when a patient suffers a complication after their operation and they phone the private hospital they will be told to phone their local doctor, which is code for 'go to A&E' because we don't deal with the complications of operations. A person who thinks he is having a heart attack and rings a private hospital will also be told to phone their local doctor; again, code for: 'please go to A&E'."
Asked if the private system did not have an important role in taking pressure off the public system, Dr O'Malley said the private system does not deal with the difficult and expensive component of patient care.
"What happens at the moment is that if you have a private wing in a hospital a person goes into the A&E with a heart attack and is stabilised at the expense of the public purse; that cost is carried by the public system. When they are stabilised they may then be well enough to transfer to the private system; but the private system does not deal with the expensive and difficult part of care; the 24/7 part of care; the emergency care. Three-quarters of all patients admitted as in-patient to our public hospitals are emergency cases."
So what is Dr O'Malley's solution to the A&E/hospital admissions crisis?
She believes the answer is as simple as abc.
"The answer is abc-acute bed capacity .in the public system. We also need elderly care beds. It is an outrage that elderly people should have to live out their lives in an acute hospital when they should be in another location. The number of elderly beds in the system has fallen over the years. The number of elderly beds has fallen in the lifetime of this Government and continues to fall. We also need more GPs and support for GPs."
Dr O'Malley says if you expand the GP service in a country you will end up with a definite pay-off in terms of the general health of the population. She feels however, that far too much weight is being put on the shoulders of GPs as regards solving the A&E crisis.
"I do not think
that patients are being sent unnecessarily to hospital care by GPs. Our
problem is we have a lack of capacity across the system-not enough GPs,
not enough acute
hospital beds, elderly care beds etc. Prof Drumm recently made a statement
to the effect that if he provided acute beds people will think the problem
is solved. Well I would think: 'in that case Prof Drumm-do it!' Provide
the beds and then maybe the problem is solved. And when the problem is
solved we can work out the efficiencies afterwards. Because when you are
running at 100% capacity in a hospital, when you are so overcrowded that
people are overflowing into your corridors, people are distressed on trolleys
in A&E…that it not a time to try to harness the goodwill and morale
of the people working in the hospital in trying to find efficiencies."
Dr O'Malley said that while innovation and reform are welcome, a stop-gap solution of increased capacity is required now.
Dr O'Malley, who works in Nenagh Hospital in Co. Tipperary, said that if the Hanly plan was implemented, her hospital would probably become a long stay unit and would carry out day surgery etc.
"The acute service would move to a bigger acute hospital but what Hanly did not do is look at the consequences of that. There are 4,500 admissions to Nenagh hospital each year; they would all have to go to Limerick under the Hanly plan. We were on the phone yesterday trying to transfer a sick patient from Nenagh to Limerick and they said: 'sorry we have a problem-we have 15 trolleys in A&E.' This was in summer 2006. We also had six patients in the corridor in Nenagh. If you were to shut down the acute service in Nenagh and transfer it to Limerick where do the patients go? There has been no 'how-to' put into the implementation of Hanly."
View the video interview at:
|Anonymous Posted: 14/07/2006 00:04|
|It's crazy for Mary Harney to suggest that there are inefficiencies in areas such as A+E and then go and put an incentive to be inefficient on site. Is she going to ban the staff working in the public area from having a vested interest/practice in the private area. If not who's going to look after the public needs whilst private clients are being seen? It looks like another cosy arrangement that will benefit a few. If she put the same amount of resources into ensuring the public sector was able to function, and provided some modern public facilites(with some of the grants given to private providers) wouldn't we all have a great service? Do we want a health service that lines the pockets of a few and leaves the rest of us with service providers that are permitted to cherry-pick, decide when and who they're going to treat, and most importantly are there to make a profit, not necessarily because they care. Why won't Mary sit down with FRONT LINE Public SERVICE PROVIDERS who DO NOT have a vested interest in privatisation, she may be pleasantly surprised-the answers might not be so expensive.|
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