Madam, - In his opinion piece (Oct 31st) Prof Mark Redmond promotes private solutions to Irish healthcare woes. Many of his assertions are open to challenge but a small number warrant an immediate response.
He cites the Joint Commission on Accreditation of Healthcare Organisations as a valid assurance of care standards in the eight affiliated Irish private hospitals. The joint commission is a private US agency which has been adopted (only) by private hospitals in Ireland as an umbrella quality assurance mechanism. It has no Irish foundations and is not linked to any of the statutory regulators of healthcare in the State.
It offers a convenient, generic and non-intrusive quality assurance label to private hospitals in Ireland who do not wish to engage with the far more robust and relevant regulatory structures which exist here; these include the Irish Health Services Accreditation Body for global standards and the postgraduate colleges of medicine and Medical Council for training standards for doctors.
Prof Redmond says that: "Private hospitals perform similar procedures and care for a similar patient profile as public hospitals." How can we tell, without information from the private sector? Private healthcare agencies in Ireland publish virtually no information about their operations. It is not possible to identify the numbers of patients seen, what those contacts were for, what procedures were undertaken, what outcomes resulted, or what costs were generated. Private agencies and insurers decide what problems they will address (and more importantly what problems are excluded) and do not participate in the planning, audit or funding of community level care. They cherry pick the profitable items of once-off or episodic care and exclude most chronic care responsibilities.
Prof Redmond raises the Minister for Health's initiative to "free up 1,000 beds in public hospitals within five years". This is surely the clearest marker that we live in a policy world gone mad.
At present, approximately 20 per cent of all bed-days in Irish public hospitals are taken up by private patients - hospitals are encouraged to pursue this policy to supplement their statutory budgets. This "cuckoo in the nest" arrangement should be dispensed with immediately, and without cost to the public purse.
If the private insurers were required within six months to fulfil their responsibilities to their clients by arranging their own hospital facilities, I suspect that our A&E crisis and most waiting list problems would vanish in the subsequent six months. Government has encouraged a bizarre situation in which private companies make their profits by usurping public facilities. To now give them five years and further public funding support to build their own facilities while the public waits to have 20 per cent of its beds handed back, is intolerable and inappropriate.
Prof Redmond concludes: "It is time to see what the independent sector can deliver". That experiment should no longer be inflicted on an uninformed public, for the benefit of an unaccountable private industry. - Yours, etc,
Prof GERARD BURY, School of Medicine, UCD, Coombe Healthcare Centre, Dublin 8.