Healthcare - Financial and hygiene concerns

The fear that up to 100,000 people could lose medical cards due to the Government’s plan to cut €660m from funding for the Department of Health is leading to a considerable degree of anxiety among older vulnerable people. This seems to be a perennial problem for successive governments.

Health Minister James Reilly has been faced with the largest cuts from his department, but part of the problem is that the department has failed to achieve the savings projected for the earlier cuts announced.

Before the end of each year the HSE has required extra funding to help it cover the final months. Over the past five years the need for such extra funding has ranged from €148m to €595m. Dr Reilly has suggested the overrun needed this year will range between €150m and €200m, but others have suggested it will be even higher. The current health problems are considered so difficult that henceforth both Taoiseach Enda Kenny and the Public Expenditure Minister Brendan Howlin have been given oversight responsibilities for the health department’s budget.

Health has long been a burial ground for political reputations. Many prominent politicians suffered dreadful political damage. When Fianna Fáil returned to power in 1997 the future taoiseach Brian Cowen was appointed minister for health and children. He was faced with so many administrative land mines that he famously described the health portfolio as “Angola”. Problems within the HSE have seemed insoluble even at the best of times.

The difficulties are not confined to finances. The Health Information and Quality Authority (Hiqa) published further hygiene reports yesterday warning of risks to patients at the Mater, St Vincent’s and Tallaght hospitals in Dublin, and Nenagh General Hospital following unannounced inspections. The report was particularly critical of conditions at Nenagh, where inspectors complained that dirty sinks, soiled toilets, and unclean floors posed a risk to patients.

The best performing hospital was Ennis General, which the inspectors found to be very clean, though they did note that some hand hygiene opportunities were missed there, too.

MRSA, the hospital superbug, poses a deadly health risk to all hospital patients. There have been many critical reports highlighting dangerous or irresponsible practices at other hospitals, so it is alarming to learn that proper hand hygiene is still a fundamental problem among healthcare officials.