Health service: People who attend A&E units as a result of alcohol-induced problems should be treated as "second class citizens", delegates attending a health sector conference in Dublin were told last week.
Jim Power, chief economist with Friends First, said the attitude towards alcohol in the State needed to change significantly. "It is one of the key reasons why there is so much pressure particularly on A&E at weekends.
"And my attitude would be that admissions for alcohol- related reasons should be treated as second class citizens within the health service and the key focus should be on those who really need it, who are really sick," he said.
He said spending on health in the State had trebled between 1997 and 2005 but the popular perception was that the investment had given poor return.
While the Minister for Health Mary Harney had referred to studies showing high satisfaction ratings among patients once they got into hospital, Mr Power said these ratings should be taken with a grain of salt.
"Presumably by definition, if you emerge alive from the health service, you are going to be reasonably satisfied. If you emerge dead, you are not going to be offering an opinion one way or the other," he said.
"The perception among the general public is that exposure to the health service, particularly in A&E, is not a very pleasant experience," he said.
He suggested much of the money pumped into the service in recent years had gone into management structures and bureaucracy.
Staffing of the public health sector had grown from about 60,000 to almost 100,000 since 1994 and it was still growing, yet the State still had just 2.6 GPs per 1,000 of the population compared with 3.4 in France. If this service was better, there would be less pressure on A&Es, he said.
And there still wasn't sufficient investment in technology. This resulted in somebody he knew having to give all their personal details three times when being admitted to a large Dublin hospital recently.
The secretary general of the Irish Hospital Consultants Association, Finbarr Fitzpatrick, told delegates the main problems in the health sector stemmed from lack of capacity. Unless this was addressed, the next generation would still be seeing patients on trolleys in A&E, he said.
Mr Fitzpatrick criticised the lack of forward planning in the health service and the length of time it took to make decisions. Planning for Tallaght Hospital began, for example, in 1981 but it didn't open until 1998, he said.
Meanwhile, the director of the National Hospital's Office of the Health Service Executive, Pat McLoughlin, said laboratory and radiology services at the State's 43 hospitals would have to be rationalised.
He said in the past hospitals had to be self sufficient for a whole range of services and tended not to look to the possibility of the same staff, particularly in urban areas, providing an on-call service for a number of hospitals at the same time.
With growth in technology, it was now possible to have much larger laboratories with hospitals sharing their services, he said.
The expenditure in this area was now being examined with a view to reorganising services. "We have just agreed internally that it needs to be done," Mr McLoughlin said.
He said the HSE would be sitting down next month with all health sector unions to discuss a whole range of issues, such as bed capacity and A&E. "While it's not going to resolve all of the issues, and some of the unions will have issues that will end up going to a third party, a whole range of issues can be dealt with in a partnership basis," he said.