We really can’t have it both ways - Waiting times in health service

BY any criteria, by any standard of decency, today’s report that more than 20,000 children are waiting for a hospital appointment, that some children have to wait more than two years for an MRI scan and that 250 children have waited up to two years for life-recovering orthopaedic surgery is another terrible, shaming indictment of this society.

It also shows our chest-out harrumphing about “treating all of the children of the Nation equally” for the dishonest, offensive lip-service it really is. That those children made to wait so very long for basic health services are condemned do so only because they do not enjoy the comfort blanket provided by private health insurance deepens the injustice. It once again underlines the sense of failure and chaos that have dogged our health services for far, far, too long.

This sense of slapdash, on-the-hoof policy making is underlined in another area of children’s health provision. Before the last election Taoiseach Enda Kenny gave a commitment to open the by-now mythical National Children’s Hospital in the lifetime of the outgoing Government. That, of course, did not happen but the pldege is inevitably recycled in the current manifesto — on page 65, it’s covered in a short sentence and unencumbered by a commitment to an opening date though a “revised” date of 2020 has been mentioned elsewhere. Don’t count your hospital beds before the ward is opened though, just last week a decision on the current proposed site, beside Dublin city centre’s St James’s Hospital, was deferred until May because of planning “complexities”.

Efforts to cut hospital waiting lists seem doomed even if they are well resourced. Last autumn waiting lists rose despite tens of millions of euro being pumped into the system. The number of people waiting more than 18 months for inpatient or daycare treatment exploded by 11,710% since a low recorded by the HSE in late June last year. The number of patients waiting for a “long” time was up 563%. More than 13,000 patients had been waiting over 18 months for an outpatient appointment, and more than 2,200 were waiting that long for inpatient or daycare treatment. Though health minister after health minister, each as determined as the other, has tried to confront the failings in our health service, none would claim to have been successful. The HSE and all its works seems caught in the deadhand grip of an unshakeable culture ringfenced by an utter absence of accountability.

Over the weekend, an unusually open politician suggested he could fix the health service if he did not wish to be re-elected. That is an indictment of us all not the HSE or the politicians who try to reform it. We complain about the failure but have we got the stomach for the kind of game-changing initiatives needed to bring the service up to scratch? Would we tolerate the closure of underutilised local services? Would we tolerate a focussed, selective redundancy programme to cut bureaucracy? This principle applies right across public life and as polling day approaches politicians are more than happy to exploit this weakness, a weakness that means we must accept perpetual failure in of public services, or re-elect those with the courage to upset cosy cabals.