PUBLIC SATISFACTION in the Health Service Executive (HSE) is much greater than the perception given in the media, it has been claimed.
Prof Anthony Staines, professor of public health at Dublin City University (DCU), said a report he and a colleague conducted last year found that the public had a positive perception of the health service, but it was ignored by the media because it "conflicts with their master narrative".
"That's a common finding throughout Europe. Most people are happy with their own health service. There is another story about the HSE but it is not being told," Prof Staines said at the inaugural lecture on Information Systems in Health Planning at DCU last night.
Prof Staines said the HSE was far from perfect, but was suffering from the way it was set up in haste in 2005 by the Minister for Health and Children, Mary Harney.
He said proposals to abolish it must be "stoutly resisted" as the experience in the UK with the National Health Service (NHS) found that such structural changes can often be counter-productive and paralyse staff for several years while the changes take place.
"If you abolish the HSE, you will end up making the same mistakes and they will take another two years and we will be where we are now except that the management will be more confused than what they are at present," he said.
Instead, he believes the HSE should be given time to implement its transformation programme which is trying to focus on building up community primary care systems to take pressure off hospitals.
"The HSE is not perfect, but it is the only show in town," Prof Staines said. "People knock its transformation programme, but there is a lot of sense in it in trying to change the focus on the delivery of services.
"It is important that we support the HSE," he said. "It is said that the HSE doesn't exist yet. It is still trying to be delivered. There is an element of truth in that."
He explained that the HSE has been hamstrung in that regard by having a poorly funded GP system unlike in the UK where teams of GPs working with community nurses and consultants provide an alternative to the hospital system.
He said there was a case for funding GP services through the HSE and also a case for making GP services free to the public regardless of means.
A recent report by the Adelaide Hospital Society found that providing universal free GP services would cost €700 million a year.
The society has also calculated that the health services could be transformed at a cost of €2.1 billion a year, which would give not only free GP services, but also free prescriptions and would be financed by a social health insurance to which everybody would contribute. It would still mean that per capita spending on health in Ireland would be less than the OECD average.
Prof Staines said: "If you look at the money it would cost to do GP services as part of the national framework, it is buttons. It is less than the increase in funding between this year and last year in the HSE," he explained.
"We could go from the mess we are in at the moment to a really more effective service for very little money."
Prof Staines identified major problems with the health service.
He described the co-location plans as a "screw-up of monumental proportions" and he also criticised the consultants' contract negotiations which he said would eventually end up quadrupling the costs of consultant services in our hospitals.
