Hospitals won’t cope, warns HSE chief

With emergency admissions increasing every year, hospitals will be unable to deal with planned surgery in the future unless something changes, HSE chief Tony O’Brien has warned.

“In fact, if these trends continue, all work will be emergency work, and we will be unable to accommodate elective work,” said Mr O’Brien.

The country’s health service had to change because of the country’s ageing population.

“Unless we plan for the changes now we are going to run into significant difficulties in 10 years’ time,” Mr O’Brien told the Oireachtas committee on the future of healthcare.

The HSE was already facing those challenges — there was a 5%-6% increase in presentations to emergency departments year on year, and this was affecting the number of beds available to do elective work.

Mr O’Brien also told the committee he was “greatly concerned” that there was not enough money provided to replace ageing ambulances, X-ray machines, MRIs and other equipment.

Money that would be available over the next five years — €2.25bn — did not meet the €3.64bn needed to deal with the long list of priority replacements to maintain safety and quality in the healthcare system.

He pointed out that a lot of equipment was replaced at the height of Ireland’s economic boom and most of it was ageing very rapidly.

“Looking at the next 10 years, we need to be spending in the order of €9bn in health capital in order to address issues of infection control and ageing equipment.”

Mr O’Brien said the HSE was created with a “big bang”, essentially to centralise operations, but it was not well thought through.

“Overall, we have learned that you simply cannot manage 105,000 staff from one central location.”

Following a government decision in 2011, they were now at a stage of “advanced progress” in slowly unwinding much of the health authority’s central structure.

Seven hospital groups, nine community healthcare organisations and a national ambulance service had been established.

Mr O’Brien said the new bodies should be given at least five to seven years to properly bed down before evaluating them and considering any further changes.

There was also a need to build a general public consensus about the maximum, appropriate and feasible investment in health and social care over the next 10 to 15 years.

“In other words, how much is the taxpayer willing to hand over for the health service it wants,” he said.

Chair of the committee, Róisín Shortall, said a recent OECD report showed Ireland was “close to the top” regarding health spending.

“Are you saying that we have to spend even more than any other OECD country, or isn’t there an issue about getting much better value for money in terms of the existing spend?” she asked.

Mr O’Brien said a “very substantial” amount of money was spent on health and the realignment of services allowed an opportunity to make “better’ use of it.


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