Root-and-branch reform of hospital services and medical staffing has been agreed by the Coalition Government as part of a comprehensive restructuring of the health system.
The Hanly report, published yesterday, is the third element in a package of reforms designed to improve the efficiency and quality of patient care. The Minister for Health and Children, Mr Martin, said he was "confident enough" the necessary funding will be made available.
The Government's recent record in funding extra hospital beds and other services has been abysmal. But the need for change in the hospital system is so acute - and the demands of EU law so compelling - that action can no longer be postponed. By August of next year, the long working hours of so-called 'junior doctors' must be reduced significantly in order to comply with EU law. If that is to happen, new working procedures will have to be put in place and, in the longer term, a greater number of hospital consultants employed.
Yesterday's report proposed that the number of consultants should more than double over a ten-year period, while the number of junior doctors should decline. At the same time, acute hospital services will be reorganised on a regional basis - as already planned for the Mid-West and East Coast regions - and employ large teams of consultants, working flexible and longer hours.
In this new system, local hospitals will provide elective medical and surgical procedures, out-patient clinics and other procedures, but a 24-hour service will not be provided.
Mr Martin said the proposals offered very good value for money on acute hospital spending and in the reform of the hospital system. And the cost of extra consultants, estimated at €100 million, was not considered exorbitant.
The pay of consultants, however, is just one element in this package. Even there, pressures on the Government to complete negotiations on a new common contract with consultants before next August will place it in a weak negotiating position. The capital costs of the new acute hospitals will be considerable. And the up-grading and development of the entire ambulance service has to become a vital element in the proposed reforms.
Opposition by some communities to the "downgrading" of their hospitals can be expected. For this reason, a second report by Mr David Hanly on the restructuring of hospital services in the remaining regions will not be published until after next June's local elections. Government Ministers talk about the need for tough decisions. They should get on with the job.