Plenty of acronyms, but very few answers — listening to Health Minister Simon Harris on Morning Ireland yesterday it was difficult to see how any of what he is proposing differs from anything we have heard before.
Once again the National Treatment Purchase Fund (NTPF), invented by Fianna Fáil, is being hailed as the short-term cure to our health-service ills. Subservient for a while to a subsequent Fine Gael creation known as the special delivery unit, the NTPF has been restored to its rightful place as the best method of reducing hospital waiting lists. Or so the story goes.
In reality, the NTPF is a goldmine for those hospital consultants whose contracts allows them to work in both a public and private capacity and who, often through no fault of their own, cannot treat their patients in public hospitals because of rolling theatre closures, staff shortages, and bed closures.
Some consultants, such as eye surgeon Michael O’Keefe, will tell you this is not what they want but that the system is so shambolic it is the only way to get public patients seen in a vaguely timely manner. “Some people will get treatment early, a few doctors will get richer, it will make hospitals more money,” he told RTÉ News At One yesterday.
And so while each administration tries to tell you that its way is the best way and that more and more money is spent tackling overcrowding and waiting lists, the treatment queues continue to soar and successive health ministers leave office without ever getting to the bottom of the acute hospital problem. And those on the frontline, who bear the brunt of that failure, continue to shout from the rooftops for vacant posts to be filled, beds opened, and an end to theatre closures and delayed discharges.
The Irish Nurses and Midwives Organisation is blue in the face from repeating itself but nonetheless did so again yesterday in the face of trolley figures now being “95%” worse than they were in 2006 when Mary Harney declared the situation “a national emergency”.
“The INMO has consistently said emergency department overcrowding and waiting lists difficulties cannot, and will not, be solved without additional nursing staff and an increase in bed capacity,” said general secretary Liam Doran, in what will surely become his epitaph.
Prof O’Keefe despairs that things will never change unless ministers get in on the ground and see exactly where the money is going. “This is all verbiage really, I’ve heard it all before” was his weary assessment of the five-point plan Mr Harris put forward yesterday to tackle waiting lists that have now reached an all-time record high of 530,000.
Mr Harris has come to office with the kind of commitment and vigour previously seen in his predecessor, Leo Varadkar, the man he took a less than subtle swipe at yesterday when promising to “bring a degree of political leadership and oversight to this [acute hospital problem] that has been missing”.
He showed an equal lack of diplomacy when describing the decision by another colleague and previous health minister, James Reilly, to step-down the NTPF in 2011 as a “significant mistake”.
He has also shown a certain degree of foolhardiness by promising to halve, by year end, the number of patients waiting 18 months or longer for treatment.
Where he would do well is to listen to frontline staff such as emergency medicine consultant Fergal Hickey, who yesterday warned of the reputational damage to the health service caused by years of stripping out resources, disincentivising qualified consultants from returning to work here.
Mr Harris would also do well to listen to calls for investment in primary care where we have been told, ad nauseam, that 95% of patients’ ailments can be treated more cheaply.
Yet there is no reference to primary care investment in Mr Harris’ five-point plan. But then trolleys and waiting lists have always been the benchmark against which health ministers’ achievements are measured.
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