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The healthcare budget of the public system has been mauled over the last four years. This is set to continue into 2014. There are two consequences.
The first is that service provision has been cut to pieces. The second is that medical risk has increased, so that lives are at risk. Notwithstanding new institutional structures, the dysfunctionality and the contradictions in policy are evident.
The cuts and the ‘savings’ have depopulated the public system of medical and nursing staff.
We know, from the international data, that cuts of this nature, and on this scale, will cost far more to correct than the putative ‘savings’ to meet short-term budgetary ‘ targets’. The Departmental allocation to health, and the allocation to the HSE, are wholly inadequate.
Government policy is disingenuous. A fictional ‘overspend’ has been injected into the policy narrative, when the reality is that funding of the public system falls far short of what is required.
The Government is in denial of the facts, and the truth with which senior clinicians and management are having to contend; and it’s not for lack of being told.
The ‘spin’ is unworthy of the kind of dialogue to which patients and the public are entitled.
In terms of budgeting, and maintaining services, public hospitals are in an impossible position.
There is little recognition of what hospitals like the St Vincent’s Group have achieved in these circumstances. Nor is there recognition of the quality of leadership that has built world-class university teaching hospitals, based on public private partnership.
The Government — and there is collective responsibility here — is deconstructing the public healthcare system. Hospital management, and medical and nursing staff, are being hung out to dry.
It’s worse than that: the denial and the ‘spin’ are working.
But in their criticisms of the ‘mote’ in the eye of those who are struggling to manage the public system, it would be prudent of the Government to deal with the ‘beam’ in the eye of public policy.
Professor Ray Kinsella
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