DONAL DUFFY,
Sir, - Dr Diane Browne (September 20th) shows a lack of understanding of how our acute health service is managed and developed when she says that "the appointment of new consultants is in the hands of a group of seniors who fear they may lose their private fees". Those familiar with the acute health service will know:
1. The Irish Hospital Consultants Association, which represents more than 85 per cent of consultants in this State, has repeatedly called for a substantial increase in consultant numbers since its inception.
More recently it proposed the appointment of an additional 1,000 consultants in its submission to the Medical Manpower Forum. This is a matter of public record.
2. Hospital consultants are working actively with the Medical Staffing Taskforce in developing pilot projects to test various models of service delivery, which should ultimately lead to the provision of extra consultant posts.
3. Comhairle na nOspideal, the statutory body with responsibility in such matters, has structured a total of 340 new consultant appointments between January 1997 and December 2001. This represents a 26 per cent increase in public consultant posts during that period.
4. Comhairle na nOspideal, the majority of whose members are hospital consultants, must have financial clearance from the Department of Health before it may structure a post.
It is ultimately a matter for the Department of Health to determine the type of acute health service that this country will have. It is not in the hands of "a group of seniors who fear they may lose private fees".
The provision of extra consultants will not in itself resolve the fundamental difficulties in our creaking public health service. There are currently consultants employed in the service who do not have access to beds in which to accommodate their patients, do not have access to theatres in which to operate on their patients, do not have outpatient facilities in which to see those in need of care, do not have the use of offices in which they can see and discuss with patients their concerns in confidence. These facilities must be provided also. Debate about the conditions of non-consultant hospital doctors is welcome, but let it be based on fact.
It is clearly not in patients' interest to restrict consultant numbers. If Dr Browne has evidence that this is happening she should produce it. Otherwise her view can only be considered as another wild allegation which serves to obscure rather than inform the discussion. - Yours, etc.,
DONAL DUFFY, Assistant Secretary General, Irish Hospital Consultants Association, Dundrum, Dublin 14.