TDs play politics with health services

POLITICAL point scoring by local politicians is putting unrealistic demands on health boards and stopping them from providing a proper service, according to the head of the Southern Health Board.

Sean Hurley also said there was no point in transforming the health service unless management was made accountable for every euro spent.

In a frank review of the state of the health service, Mr Hurley said political competition between areas has resulted in an inflation of demand which is contrary to all medical advice and drives a ‘coach-and-four’ through proper planning.

“Every politician wants every facility at every crossroads in their constituency. That’s not a criticism. That’s what their job requires. But our job requires rationalisation, elimination of duplication and strategic thinking.”

He said what was required now is strong leadership at political and senior management level and a value for money culture embedded in the entire management process.

“As CEO of a health board, I’m a manager of a business. It’s as simple and as complex as that. If health is a business, then value for money is what is going to drive that business from here on.”

The reform now needed has to be radical because the current health system was designed for the population and expectations we had more than 30 years ago, he said.

In his view, reform should go beyond the leaked recommendations of both the Brennan and Prospective reports.

“If reform is to succeed it must address the entire health system and all of its constituent parts and it must start with reform of the legislative and regulatory framework - the Health Act.”

The Health Act, drafted in the late sixties, has been in place since 1971 and when passed the population was 2.9m. Now it’s 3.9 million.

Mr Hurley believes getting the structures right is pivotal to further success and that necessitates radical reductions of the number of organisations in health.

After that the key issue and most immediate priority must be to establish clear accountability for resources used.

“What Ireland requires is an improved culture of accountability within which consultants and other clinicians will have to take far greater interest in the resources that they are using and how they are using them but also moving diagnostic tests from an unquestioned reflex to a justified necessity”

To achieve that level of accountability demands a top to bottom change in the culture within the system and a vastly improved flow of information.