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Writing a new prescription for health

When I became President of the IMO in April 2015, I had hoped that we were moving to an environment where the Department of Health and the HSE had at last recognised the folly of short-term economic policy and were now committed to developing our public health services in a collaborative and realistic manner. And that finally, the Department of Public Expenditure and Reform would see that the provision of healthcare to the citizens of Ireland was an absolute necessary investment in the long-term economic growth of our country, rather than a drain on public finances. Each and every one of us, at some stage in our lives, will rely upon our public health services and they must be protected.

We have had another year of rolling from one crisis to the next. Indeed, I am loathe to even use the word ‘crisis’, as what we see happening in our health services is now the norm, not the exception. The cuts to our health services in the past number of years have left a service that is incapable of meeting the demand. Still, there is no plan — there is plenty of talk about reform but no plan to fix the problems and develop the service. 

We have no plan to deal with:

• A rapidly-increasing elderly population with inevitable additional health needs;

• A massive emigration problem among doctors, coupled with the fact that many of our doctors are due to retire over the coming years. Only 22 per cent of our current trainees are definitely committed to staying in Ireland (Your Training Counts Survey, Medical Council 2015);

• Wholly inadequate capacity in terms of beds in our acute hospitals, rehabilitative settings and nursing homes; and

• A health service that has lost the confidence of the doctors who work in it and the patients who rely upon it.

The root of the problem is funding and there is simply no getting away from that fact. The Government and the HSE consistently spin about comparisons of Ireland’s health spend with other European countries – what they neglect to mention is that they are not comparing like-with-like. Nor is there any reality to the health budget. We are told there is an increase in spend, yet the HSE itself advises the Department that the level of funding allocated is inadequate to meet demand, never mind increase or expand services.  We are already hearing about the HSE deficit — in reality this is not a deficit, it is merely the inevitable outcome of inadequate funding to begin with.

In recent months, politicians have been quick to tell us what they are hearing on the doorsteps, while we as medical professionals witness the decimation of our health services on a daily basis as we attempt to continue to deliver ever-decreasing services to our patients. Yet short of sound bites and more empty promises about health, there is little of substance in terms of a vision for our health services with a commitment to funding that vision. 

In 2015, the IMO committed to a series of campaigns to highlight what we can and should do to protect and enhance this most essential of public services. In April, at our last AGM, we launched 2020 Vision for Health, which set out realistic objectives for a five-year programme for our health services. We have put forward credible and realistic proposals for the ongoing problems in our emergency departments.

Earlier this year in the run-up to the General Election, the IMO launched its own health manifesto Put Health First, which built on the practical solutions outlined in our vision for the health services. Still the HSE and Government appear to be paralysed and incapable of tackling the issues on a system-wide basis and instead focus on short-term measures, which are doomed to failure. Prevarication and holding onto the purse strings are the order of the day.

We had expected that by this year’s AGM, we would have a new Government in place; while there is no sign of that at the time of writing, we are calling on all politicians to agree that it is time for a new ‘prescription for health’.

There must be agreement across the political spectrum that health is a priority — that health needs appropriate and protected funding; that decisions on health should be on the basis of medical evidence, not political whims; that our public health services need to be protected and not taken over by corporate interests; and that we do everything we can to keep our highly-trained doctors working in Ireland.

It is with a sense of pride that I have represented my profession and sought to put our public health services to the top of the agenda and I know that our incoming President, Dr John Duddy, will continue the fight to protect and defend our services and the doctors working in it.

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