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Facing the music

The IMO, NAGP and IHCA reacted largely with criticism and disappointment.

Indeed, perhaps the most depressing aspect of the plan was the relatively meagre increase of €30.8 million in funding for primary care, when compared to the €118.4 million increase for acute hospitals.

Overall, the budget for primary care is €808.1 million and the budget for acute hospitals is €4.4 billion.

That being said, the rise in funding for the acute sector was also described as inadequate by medical organisations.

But the relative inertia on primary care is especially concerning in the context of the almost ceaseless political pledges — over many, many years — to make the ‘shift to primary care’, a move that will clearly require a swing in resources from the acute sector. This, of course, may prove politically unpopular in certain localities, despite widespread acknowledgement of the logic involved. 

It was only recently that Minister for Health Simon Harris spoke at the Irish Practice Nurses Association 2016 Annual Conference about how, if we are serious about making the shift to primary care, we have to “put our money where our mouth is” and support primary care-givers.

In the myriad responses to the Service Plan, it was also noted that the document provided no clarity on the funds available for a new GP contact, a matter that Minister Harris previously said was being kept under wraps to enable a negotiation process.

Problems with bed capacity were also highlighted. Indeed, this was the dominant theme of the IMO Doolin Lecture earlier this month, delivered by Consultant in Emergency Medicine Prof Patrick Plunkett. He pointed out that there had been a reduction of 33 per cent in the number of beds in Irish hospitals between 1980 and 2000 (bed numbers reduced from 17,665 to 11,832) and a further 13 per cent reduction in the number of acute hospital beds between 2005 and 2015.

Prof Plunkett warned that there was a further 13 per cent increase in population forecast within the next 15 years and a doubling of the number of people aged over both 85 and 65 years, with a linked rise in demand for hospital admission.

The pressure on our health services will not abate anytime soon and our doctors and nurses are increasingly agitating for better pay and conditions.

Maybe 2017 will be crunch-time.

Happy Christmas and New Year from everyone at the Medical Independent.

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