New reality needed on HSE costs - Health can’t fail as water charges did

In some settings, numbers can lose the power to tell the story they are meant to convey. Who can honestly say that they have any practical understanding of how far away from Earth 13,000 light years really is?

That’s the distance to an exoplanet recently identified by Nasa’s Spitzer Space Telescope but would it make any difference, even in this Young Scientist week, to our lives if it was deemed 6,500 or 26,000 light years away? Hardly. In another matrix, how can any dinner-in-the-middle-of-the-day person, any nine-to-five salaryman or woman make any sense of the idea that Everton are expected to make a €22.5m bid for Theo Walcott to run around a field chasing a ball for a few years?

These figures exist outside any normal understanding of rational quantities. Sadly, we are almost at that point of incomprehension, that last-man-standing defeat where we are overwhelmed by the immediate chaos described by waiting lists and ED trolley numbers in the ongoing, never-ending implosion in our health service.

Can anyone really give a decent explanation of the figure given last autumn — almost 680,000 — for people, on this small, rich island, waiting on public hospital waiting lists?

By the end of September, outpatients alone approached half a million. Recent weeks have seen, as the pantomime season trails off, the annual spike in numbers of people waiting in ED for attention that should not involve a wait, at worst, of more than a few hours.

Records have been set and the 700 people on a trolley on any given day milestone is in sight.

Because this is well-harrowed ground a few fundamentals must be acknowledged.

Most counties are struggling to maintain health services they can be proud of. Britain’s Brexit travails have distracted attention from the difficulties undermining the cherished NHS.

In America, Obamacare was the first battle of choice for the Republican administration. We and the HSE are not alone.

Many societies are caught in the very same terrible bind — how to sustain and keep developing a health system facing ever-greater demands without a significant increase in resources.

HSE CEO Tony O’Brien has warned about this repeatedly but this week he was chasteningly clear. The current level of overcrowding will “look like a picnic” compared to what will happen unless capacity is increased, he said.

Even if you accept the OECD assessment that we pay more than most countries for health services but get barely average outcomes it is impossible not to accept Mr O’Brien’s predictions.

The sobering HSE assessment that the 2,500 extra hospital beds envisaged by Government could cost €1m per bed cannot be ignored either. This excludes an estimated €306,000 in annual running costs for each bed.

Water charges were a low point because politicians could not find the courage to tell the truth, to see a good, justifiable idea to fruition.

We cannot afford that kind of evasion on our health services. An honest appraisal of what a fit-for-purpose health system might cost — the tax bill — might lead to the hard-choices mandate, remaking our health service requires.

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