In a week when the Government has decided to expand its ministerial transport fleet and has apparently rejected a public/private approach to a new national stadium, the bad news concerning our public health finances has been brought into sharp focus.
The leaked memo from management at Dublin's Beaumont Hospital, indicating a potential €21 million shortfall by the end of the year, is stark. A reference to the possible closure of the hospital's night-time dialysis shift - a suggestion that directly threatens the lives of up to 70 people - marks a new low for our ailing public health system. And while such a move is unlikely to be made in practice, it speaks volumes for the pressure felt by our acute hospitals as their financial positions deteriorate. It was both correct and timely that the chairman of the hospital's medical board moved to reassure patients while indicating that a chronically difficult situation at Beaumont was about to become unsustainable.
The failure to provide adequate funding for our health system in last December's Budget estimates is at the root of the current wave of service cutbacks across the State. In response to a deterioration in our public finances, the Minister for Finance elected to abruptly apply a brake to spending. His move was always likely to produce a situation akin to switching off the engine of an aircraft in mid-flight. The health service had enjoyed three years of relative but vital growth until last December. Rather than introducing a measured slowdown in additional funding, Mr McCreevy decided to pursue a more painful route.
Healthcare outcomes can never be measured in annual results. The minimum time-frame for both growth and assessment must be five years. A system of multi-annual funding, whereby hospitals and health boards can introduce measured growth, would have helped to avoid the alarm and disquiet we have witnessed this week. And, while there must be better accountability and value for money within the public health service, it is unreasonable to expect improved outcomes until the necessary structural changes have been implemented.
Serious questions must now be asked about the validity of continuing with the treatment purchase fund in the present climate. Transferring funds to the private sector and to hospitals abroad while public facilities here are closed because of financial cuts is unacceptable. There is still time to avert a repeat of the severe cutbacks sustained by the health sector in the late 1980s, for which we continue to pay a heavy price.