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Less politics, more effort is needed to solve hospital crisis

Posted in Uncategorized by saraburke on January 16, 2015

Analysis from Irish Independent on 16 January 2015.

At yesterday’s health committee, both Health Minister Leo Varadkar and HSE boss Tony O’Brien were very keen to make it quite clear that they were throwing the kitchen sink at solving the over-crowding in our hospitals (Picture: Arthur Carron)
At yesterday’s health committee, both Health Minister Leo Varadkar and HSE boss Tony O’Brien were very keen to make it quite clear that they were throwing the kitchen sink at solving the over-crowding in our hospitals (Picture: Arthur Carron)
At yesterday’s health committee, both Health Minister Leo Varadkar and HSE boss Tony O’Brien were very keen to make it quite clear that they were throwing the kitchen sink at solving the over-crowding in our hospitals.

Varadkar said it was “unacceptable” and “something he was going to continue to take a personal lead on . . . and give it the kind of attention that no other minister has given it in the past.” O’Brien said “nothing would be ruled out” in addressing the crisis.

The day before, during a Fianna Fail private members’ motion on the crisis in emergency departments (ED), Varadkar had a good go at Fianna Fáil leader Micheál Martin’s failure to tackle the issue in the past. And he reiterated the multidimensional approach needed to tackle this now and prevent it from being a persistent problem for patients and health service staff in the future.

Right now, the focus is on freeing up hospital beds for people stuck on trolleys and making supports in the community and nursing home places available for people stuck in hospital.

But there is also recognition that to stop the events of last week happening again and to fix the system, “for once and for all”, they have to work on public health measures to stop people getting sick; better management of chronic diseases; access diagnostics outside of hospital; have more and better use of GPs and community and social care services.

Meanwhile, Martin fiercely rejected Varadkar’s harsh criticism of him. Earlier in the week, Martin said Varadkar must stop being “some sort of detached analyst” and take responsibility for the crises in the health service.

Yesterday, Martin said Varadkar could have averted the crisis if he “applied himself” to the job … and “put half as much effort into actually doing the job as he does to his PR campaign”.

Obviously, the pre-election gloves are off. However, Martin must have been born with a neck made of titanium. He was, after all, the Minister for Health from 2000 to 2004, during one of the previous ED crises, when trolleys in A&Es were one of the biggest areas of concern for citizens in the run-up to the 2002 general election.

Critically, Martin was a member of the Cabinet for 14 years when the health service budget quadrupled from €4bn to €16bn, yet they failed spectacularly to address the crisis, never mind dismantle the two-tier health system or deliver a half-decent health service.

Similarly, Sinn Feín has come out with trite critiques of the ED/hospital crisis, taking a lazy position that the current problems are purely a result of the austerity cuts. It has been well aired by now, but cutbacks have contributed to the crisis, especially the daft budget agreed in October 2013 with the €113m to be found through ‘medical card probity’. The current ED crisis is in part a hangover of those recent budgetary decisions. These, combined with continuous political failure to address the underlying problems, meant the current overcrowding crisis was destined to happen.

And an important component of the solution is that every single Fine Gael and Labour TD must realise that they too are responsible for some of the difficulties facing the health system. They all voted for the three unrealistic budgets that only meant further trouble for an already squeezed-to-the-bone health system.

The first manifestation of their unwise decisions was the medical card debacle and now it’s the final tipping point for hospital overcrowding, trolleys in EDs and unprecedented numbers of delayed discharges and waiting times for a nursing home bed.

These bad political choices directly stemmed from petty party political positions, with Labour (in the guise of Brendan Howlin, Ruairi Quinn and Joan Burton) outmanoeuvring James Reilly, who was then left out to dry by his party colleagues.

Trolley figures have gone down in the last week – they should have, given the attention and efforts tossed at them. The trick now is keeping them down. Can the combined measures have a continued impact?

A major flu epidemic or protracted bad weather resulting in increased pressures on EDs could easily tip the system over the edge again. News that the vaccine given to people at risk of flu and to health professionals is a different strain to the one that could be on its way is not good.

The health system and the minister need a good dose of luck if the short term gains are to be maintained.

But the biggest test of all is whether the HSE and Varadkar use the hospital overcrowding crisis as a reason to “for once and for all” address the fundamental inadequacies in our health system. Here’s hoping they can and they do.

And a little less politics would help.

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