Health reform crisis - Time for a resolution is running out

A day after Finance Minister Brian Cowen announced €11 billion in funding for health - its highest ever - more doubt was cast upon the quality of the service that will come into operation next January.

Yesterday, the Government published legislation for the implementation of the new Health Service Executive (HSE), on the day it descended into yet more turmoil.

IMPACT trade union members in the health sector voted overwhelmingly to withhold co-operation with its implementation, just days after the chief executive officer designate, Professor Aidan Halligan, changed his mind about accepting the post.

When originally launched last year, the most extensive reform programme of the health system in 30 years was billed as a radical reform programme to provide better patient care, better value for money and better management.

At this juncture, our nascent health system appears to be more fragile than the current model it is due to replace, being without a chief executive to manage it, or employees prepared to run it.

The 15,000 trade union members, who are the managers and administrators of the service, decided by a massive seven-to-one ballot to endorse industrial action which, if carried out, would have a calamitous effect on the transformation of the health service.

Because they are worried about job security, conditions and work locations, IMPACT members are prepared to block the introduction of the new health reforms, leaving the service in an extremely serious vacuum.

When the HSE assumes responsibility on January 1, health boards will have been abolished, but at this stage it appears that there might not be a properly functioning executive, which is to be responsible for the day-to-day running of the service.

It is utterly unacceptable that the country’s health service should be subjected to such an appalling prospect and with time running out both sides have to devote whatever time and effort it takes to resolve this impasse.

The chairman of the interim health service executive, Kevin Kelly, said yesterday that he had on several occasions given the union assurances on the issues they had raised and the current situation arose from misunderstandings that could be resolved.

In the same breath he said they were moving towards an orderly transition from the old to the new system.

It is clear that the union considers that something more serious than misunderstandings are involved. It is also patently obvious that if they are allowed to fester, and not addressed with the utmost urgency, it is the health service and those who need it who will suffer.

It has been alleged that the union may be engaging in a tactic to ensure that members will be assured certain positions in the new structure when the transformation of the service takes place.

It would be unfair to give such a charge any currency and while they are entitled to be concerned about job security and conditions, it has to be assumed that the union members’ approach to the health service mirrors the concern it warrants.

The timing of the Government in publishing the Health Bill just ahead of the Dáil’s Christmas recess has also to be questioned. The bill should have been published long before to allow a proper and full debate take place on such a radical reform of the health system.