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    From the latest issue
  • Editorial

    Financial pressure in uncertain times

    Paul Mulholland | 10 Jan 2019

    As usual, the HSE published its service plan just when most people were turning their attention away from the news towards the reprieve of the Christmas period. Although the completion of the plan has to abide by certain timelines, it is almost as if the Executive doesn’t want a detailed and forensic examination of its annual mission statement.

  • From previous issues
  • Editorial

    A turning point for society?

    Paul Mulholland | 20 Dec 2018

    In a year dominated by women’s health issues, it is fitting that this last Medical Independent of 2018 contains an interview with the first female Chair of the Institute of Obstetricians and Gynaecologists. Dr Cliona Murphy speaks about the central role doctors played in the referendum campaign to repeal the Eighth Amendment and her own decision to advocate for a ‘yes’ vote. She said many medical professionals felt it was their duty to give a voice to “those women who would not be strong enough to stand up and give their personal stories”.

  • Editorial

    The subjective nature of experience

    Paul Mulholland | 06 Dec 2018

    HIQA recently published the results of the second National Patient Experience Survey, the largest survey of its kind in Ireland. According to the survey, the majority of patients (84 per cent) said they had a ‘good’ or a ‘very good’ overall experience in hospital in May 2018. Although there were negative findings — for instance, 40 per cent of respondents said they did not have enough time to discuss their care and treatment with a doctor, while 34 per cent said that they were not adequately informed about ‘danger signals’ to watch out for when they went home — the survey results, in general, paint a more positive picture of the health service than is usually portrayed in the media.

  • Editorial

    The ‘bloodless realm’ of official speech

    Paul Mulholland | 26 Nov 2018

    The recent revelations of structural problems in school buildings bring to mind one of the best Irish novels of modern times, Mike McCormack’s Solar Bones. Near the end of the novel, the lead character, Marcus Conway, a civil engineer with the local council, refuses to sign-off on the construction of a new school due to concerns about the foundations. This brings Marcus into conflict with a local councillor and the building contractor, who end up circumventing him and building the school anyway. The parallel between the real-world developments and the story is a testament to McCormack’s insight, almost literally, into the building blocks of Irish society.

  • Editorial

    No happy New Year wishes from Taoiseach

    Paul Mulholland | 15 Nov 2018

    Remember January 2015? That month, the annual emergency department (ED) crisis hit hospitals harder than usual. The number of patients on trolleys in hospitals across Ireland reached a record number of 601 on 6 January (an unwanted record that has since been broken). Patients and healthcare staff looked to the HSE and the Minister for Health for a solution to the crisis. But the Minister at the time, Leo Varadkar, was nowhere to be found. Mr Varadkar had escaped the harshness of the Irish winter and was on a sun holiday in Miami.

  • Editorial

    Values cannot be viewed in isolation

    Paul Mulholland | 05 Nov 2018

    During the opening ceremony of the London Olympics in 2012, an entire segment was devoted to the NHS. The decision was taken by the ceremony’s director to protest the cuts being made to the health service by the Tory-led government. The decision to showcase the NHS in such a high profile event was also indicative of the special place it holds within British society.

  • Editorial

    Getting clinical audit right requires time

    Paul Mulholland | 25 Oct 2018

    The benefits of clinical audit have been much discussed in recent months in reference to CervicalCheck. Throughout the controversy, medical professionals stressed repeatedly the necessity of audit to benchmark quality and help service improvement. While regret has been expressed about how the audit results were communicated to the women, the importance of doing audits was highlighted again and again.

  • Editorial

    A health policy collision course?

    Paul Mulholland | 15 Oct 2018

    On Drivetime recently, there was a discussion about how the Government’s commitments on climate change were at odds with their plans for agriculture. According to the argument, the EU target to reduce national greenhouse gas emissions by 20 per cent by 2020 compared to 2005 levels, which Ireland has signed up to, is in direct contradiction with the plans for agricultural expansion contained in the Government’s Harvest 2020 strategy. Such policy clashes are not unusual, as different branches of Government have their own agendas. But there can also be different policy agendas within the same sector, which are ideologically and practically irreconcilable.

  • Editorial

    Reduction in sepsis-related deaths is to be welcomed

    Paul Mulholland | 04 Oct 2018

    Good news stories are a rare thing in Irish healthcare, at least from a media perspective. It is in the nature of news outlets (present company included) to focus on problems. Also, chronic emergency department overcrowding and large waiting lists, which have not been helped by a prolonged recruitment crisis, mean the positives are difficult to see.

  • Editorial

    Transparency — what’s sauce for the goose...

    Paul Mulholland | 24 Sep 2018

    Following the publication of the Scally report, there has been renewed focus on the issue of open disclosure in the health service. Given the unacceptable comments many of the women at the heart of the inquiry received from medical professionals about their audit results, a push for greater transparency is not only understandable, but necessary.

  • Editorial

    Questions remain following pay review

    Paul Mulholland | 13 Sep 2018

    How much are pay issues contributing to recruitment difficulties within the health service? If you ask the IHCA and the IMO, they say salary cuts are the main reason why there are so many consultant vacancies. In particular, the medical representative bodies have pointed to the new-entrant salary cut imposed in 2012 as the main current recruitment obstacle. Yet, according to the Pay Commission, established to examine recruitment and retention issues in the healthcare sector, current pay arrangements are not “a significant impediment to recruitment” in themselves. For example, for NCHDs, the report states that implementation of recommendations from the Seventh Assessment of NCHD Posts on issues such as protected training time and transfer of tasks will have a positive impact on recruitment.

  • Editorial

    Responding to CPE

    Paul Mulholland | 03 Sep 2018

    HIQA announced last week that recent inspections have found some hospitals are not compliant with HSE screening guidelines for carbapenemase-producing Enterobacteriaceae (CPE) superbugs. The continued lack of compliance is particularly concerning given CPE was declared a national emergency in 2017.

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