Government under siege as Hanly row flares up

A FURIOUS row has broken out between the Government and critics of its plans to centralise acute hospital care with both sides accusing the other of lying.

Last night, Health Minister Micheál Martin said he was "baffled" by the arguments put forward by a new national health lobby opposed to the implementation of the Hanly Report, the Government's blueprint for health reform.

"I believe they are deliberately misrepresenting the truth to secure political advantage. Their criticism is fundamentally wrong," the minister said.

The lobby group, which lists a number of politicians among its members, yesterday launched a damning analysis of the Hanly Report, rubbishing its recommendation that centralising acute services in bigger hospitals would result in better patient outcome.

The report by health economist Catherine McNamara claimed a strong body of research examining the relationship between hospital size and patient outcome only found reasons to centralise services for five procedures, including paediatric, cardiac surgery and surgery for pancreatic cancer. Hanly recommended centres of excellence to treat the majority of illnesses.

Ms McNamara's report also claimed Hanly ignored international evidence, which showed hospitals with more than 500 beds were high-cost and inefficient. It further ridiculed Hanly's claim that many life-saving emergency measures were not affected by proximity to a hospital, the argument used to justify the downgrading of local A&E units to nurse-led minor injury units.

"There is good evidence that A&E treatment within an hour of an accident or heart attack can save many lives," said Ms McNamara.

Ms McNamara and lobby group members Senator Kathleen O'Meara and consultant physician Dr John Barton accused the Government of selective use of British reports on health reform to boost their case for Hanly.

Mr Martin and the Taoiseach Bertie Ahern accused the health lobby of "scaremongering". However, in what will be seen as an attempt to limit the negative backlash against Hanly in the upcoming local elections, the two men have given a commitment to retain 24-hour medical cover at local hospitals. However, they both failed to specify the nature of that cover. Hanly had recommended nurse-led minor injury units, open 12-hours a day, to replace A&E cover at local hospitals.

The Government also came in for criticism at the weekend from David Hanly, the author of the controversial report. Speaking at a meeting of clinicians in Dublin, Mr Hanly said he was disappointed at the lack of progress made in implementing the report, which is predicated on the provision of 3,000 extra hospital beds and a highly trained ambulance service. Just 568 beds have come on stream since the National Health Strategy launch in 2001.

As regards the ambulance service, Emergency Medical Technicians are unable to carry out advanced life-support procedures five years after a government strategy urged legislation to allow them do so.

Mr Hanly also said there was little chance of the Government being able to meet the requirements of the European Working Time Directive (EWTD) by its August 1 deadline, which reduces junior doctors' hours to 58 a week. Hanly's specific remit was to see how the EWTD could be implemented.

Yesterday the Taoiseach admitted they could not meet the deadline. He also admitted on The Week in Politics on RTÉ last night that hospital waiting lists would not be eliminated by May 2004, a promise made by the Government before the 2002 general election.

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