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    From the latest issue
  • 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.

  • From previous issues
  • 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.

  • Editorial

    Making training count

    Catherine Reilly | 23 Aug 2018

    Interns being asked to perform duties above their grade.

  • Editorial

    Time for a new vision

    Paul Mulholland | 09 Aug 2018

    At the turn of the millennium, it was recognised that Ireland’s mental health service needed an overhaul. The process of admitting patients into psychiatric institutions was strongly criticised for not only lacking in transparency, but also for contravening human rights. The Mental Health Act 2001 was introduced to rectify this. At the time of its introduction, the Act was acknowledged as a significant legislative step in advancing human rights protections for these patients. The Act was enacted five years before the publication of A Vision for Change, which also aimed to bring Ireland’s mental health services into the modern world. The mental health strategy sought to transform the existing institutional model of care into one based in the community, and recommended an integrated multidisciplinary approach to addressing the different factors that contribute to mental health problems.

  • Editorial

    The demand for equal pay

    Paul Mulholland | 19 Jul 2018

    When, after years of negotiation, a new consultant contract was finalised in 2008, it was meant to usher in a new era for the health service. The new contract promised consultants pay increases, in return for agreeing to reduce private practice, and working time flexibility. Under the terms of the deal, it was hoped the number of consultants would almost double to about 4,000 over the coming years, thereby creating for the first time in Ireland a truly ‘consultant-led’ health service.

  • Editorial

    Capacity for change?

    Paul Mulholland | 05 Jul 2018

    What do we mean when we say ‘capacity’ in the healthcare system? The obvious aspect that comes to mind is built infrastructure, that is to say, hospitals and beds. But this is only part of the answer. Hospitals without people to work in them would not be hospitals. Though such a statement may seem facetious, it is at the heart of the problem that the group charged with advising on capacity in the Irish healthcare system had with their terms of reference.

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