Sir, – In answer to Jonathan Irwin’s question “Has the health service gone mad” (November 8th), the answer is a resounding Yes, and it is getting madder.
In addition to what is outlined in Mr Irwin’s letter, here are a number of other symptoms of this deterioration in reason: 1. The state of many of our emergency departments during times of peak demand (more often than not) is appalling. It is very difficult for staff to assess and treat patients in any form of dignified and humane manner. In the recent words of a colleague: “If it was an animal hospital, it would be closed down”.
2. Frontline staff, including clinical secretaries, are not being replaced for enforced absences or planned leave, with a huge and potentially dangerous knock-on effect on the quality and integrity of clinical notes and communication. In addition, new clinical appointments are not receiving adequate clinical secretarial support. Again, this is “penny wise and pound foolish”, as for example test results are mislaid, and have to be repeated with further expense and further distress and delay for patients, families, and carers.
3. Economy rather than quality is driving many of the HSE’s decisions at local and regional level. Thus, for example, you have the situation where important clinical posts are being delayed regionally and nationally in key specialty areas, with a danger that the best (and sometimes the only suitably qualified clinician) will go elsewhere in the world, and in the case of many of the brightest Irish medical diaspora, will not return from the country they had emigrated to with the original goal of honing their clinical skills before hoping to return to contribute in a progressive way to Irish clinical medicine.
4. Smaller units around the country are being closed down with the mantra that patients can be treated in the next tier up “Centre of Excellence”. However, these centres are already bursting at the seams and do not have the resources or space to cater for this extra demand (I recall the late Maurice Neligan writing about this in this newspaper on more than one occasion).
That all this insanity increases under the new Government and minister is a cause of great sadness and concern. Oh, and by the way, madness rarely saves money. – Yours, etc,