What’s in store for health in 2016?

Liam Doran

General secretary of the INMO

What were the biggest wins in healthcare in 2015? A significant development on paper was the recommencement of recruitment across the health service after five years but we're running to stand still. We're losing experienced people; we're very short of nurses, we're short of doctors in certain specialisms, we're short of allied health professionals. The health service is still not seen as an employer of first choice. It's really up against it due to the perception that it's a hard place to work with limited career options.

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Tadhg Daly, chief executive, Nursing Homes Ireland. Photograph: Cyril Byrne

And the biggest disappointment? Trolleys. We had record numbers of admitted patients on trolleys in 2015, almost 80,000 in the first 11 months. It is just not big enough to cater for the demand.

What are your hopes for this year? I'm just very concerned that our health service has been so badly ravaged over the past five or six years, in an unplanned manner, that it'll be a number of years of sustained investment before it's fit for purpose. One of my main concerns is that no political party will commit to fund the public health service to the level it needs to meet the demand in the State.

What are this year's biggest challenges? Capacity in terms of staff, capacity in terms of beds and capacity in terms of services as a whole and I mean that right across the spectrum: intellectual disability, mental health, primary care, elder care. The system is just not fit for a population of 4.6 million and growing with our particular demographics.

What election promises do you want to hear? That any political party will commit 10 per cent of GDP as a minimum for at least a period of five years towards public health spend. We're currently at 8.2 per cent.

Who are you tipping to be the next Minister for Health? My best guestimate is it's likely Fine Gael will be re-elected as the biggest party so I'd expect Leo Varadkar.

Shakya Bhattacharjee

General secretary of Overseas Medics of Ireland

What were the biggest wins in healthcare in 2015? The Alcohol Bill – it will have a big impact on families. And the biggest disappointment? The migration and exodus of doctors. We have buildings where there are plenty of instruments and equipment, but there are no doctors. A lot of people feel when they've finished their training, there aren't enough consultant posts. A lot of junior doctors also feel overworked and there are a lot of problems with career satisfaction.

What are your hopes for this year? We're fighting for transparency in the medical exam system. We should have full access to how many people are applying for exams, how many are passing, how the standards and criteria have been set by the Medical Council and royal colleges. People should have full access, like in the UK. What are this year's biggest challenges? The beds crisis, waiting lists and trolley crisis. Also, this migration of talented, local doctors will go on unless there's a dramatic change in the way the system is run.

What election promises do you want to hear? Obviously they will all talk about the bed crisis, the trolleys, the long waiting lists for patients, but I think the actual problem is much more complex. We need more doctors.

You can’t tell two A&E doctors to run the whole department and you can’t tell them about speed. If you try to make them do [their work] faster, it will be compromised. The manpower issue should be urgently addressed.

Who are you tipping to be the next Minister for Health? I think Varadkar did a good job, so more of that.

Stephen McMahon

Irish Patients Association

What were the biggest wins in healthcare in 2015? The Minister actively attending the ED (emergency department) taskforce meetings. I wonder how much progress could be made in his absence.

And the biggest disappointment? The photograph of the late Gerry Feeney sitting in a soiled open nappy and his food- stained shirt. This showed so much of what's wrong with the system. The reports of some of our elderly patients, who were treated in undignified ways at some of our ED departments and the lack of accountability for such occurrences. The failure to tackle the long list of outpatient appointments – almost 15 per cent of all people with a medical card are waiting for a first consultant-led appointment.

What are your hopes for this year? That there is industrial relations peace. That the forthcoming election is not used as an excuse by some to take the pedal off the reform process. That the proposed Independent Patient Advocacy service is truly independent and driven by patients and their representatives.

What are this year's biggest challenges? Management accountability. Hospitals will now be fined in relation to overcrowding and the duration a patient is waiting on a trolley. But how will management be held to account? What election promises do you want to hear? In the patient's best interests I want to see deeds not words. Again it's about accountable management. Tackle this everywhere.

Who are you tipping to be the next Minister for Health? I've no tip but whoever gets the post will have their work cut out for them.

Tadhg Daly

Chief executive, Nursing Homes Ireland

What were the biggest wins in healthcare in 2015? Putting more resources into Fair Deal was a good strategy – it took pressure off the acute hospital system and ensured people could get timely access to nursing home care.

And the biggest disappointment? The State continuing to abuse its dominant position within the nursing home sector, threatening the sustainability of current bed provision. Its actions are repressing development of additional beds required. At the heart of this is a failure to introduce an independent appeals process that would provide recourse for key healthcare providers – nursing home operators.

What are your hopes for this year? The State must bring stakeholders together to plan properly for our older persons' care requirements – a continuum of care. Our older population is increasing rapidly, and a proper plan and strategy are imperative. A key hope is for a forum to be finally established by the Minister for Health to plan for nursing home care and older person care requirements. We must plan now for the health and social care requirements of Ireland's ageing demographic.

What are this year's biggest challenges? We must start recognising true reality of providing care to persons with very complex care requirements. If we fail to do so, we are looking at closure of beds within our sector, and this will have very grave consequences for our health services and older persons' care. There is a real, real crisis in the recruitment and retention of nurses that is not just confined to the HSE. The HSE is taking nurses from our sector and this has very serious implications for providing care for older persons. Failure by the State to recognise the real cost of care that we provide significantly hinders our ability to retain nurses.

What election promises do you want to hear? The need to address the cost pressures in the nursing home sector is imperative, with uneconomic fee rates presently being provided under the Fair Deal threatening the viability of nursing homes. Increased funding for nursing homes to ensure sustainability of current provision would be an important step in redressing the balance in equality of treatment between private and public.

Who are you tipping to be the next Minister for Health? The current Minister has had too short a term and if he was to have 2½ years more and allowed money to follow the patient, he could be good . . . If not him, Simon Coveney, as he is rising and would need that health experience to better understand the challenges.