This newspaper’s series “ a sick system: the ailing health service” highlighted three major causes for our dysfunctional health system: broken political and administrative promises, an abrupt cut in funding and a significant exodus of expensively-trained health care professionals who prefer to work abroad. Just one in four of the Government’s promises in health have been fully implemented since 2011. Half have not been implemented at all and the remaining 22 per cent have been partially implemented. The most revolutionary commitment – the introduction of a Dutch-style system of universal health insurance (UHI) – has been all but abandoned. And we are no closer to the introduction of a single-tier health service to replace the current public/private mix.
The finger of blame points to a sclerotic and chronically dysfunctional bureacracy. Well past its sell-by date, the HSE was, according to the programme for government, supposed to be consigned to the dustbin of history by now. However, even after the unacceptable failures of senior managers at Portlaoise hospital, political inaction since these shocking revelations confirms the sinecure that is an administrative post in the HSE.
Swingeing salary cuts, a jobs freeze and a perceived drop in training standards, mean young health professionals now see emigration as their default option. Many speak of “rediscovering the joy” of professional practice abroad, a sentiment in marked contrast to the chaos and uncertainty surrounding the health service here.
It seems the taxpayer, having contributed substantially to their education, may not see the benefits of this training. Already posing a risk to patient safety, a system that relies heavily on locum doctors and agency nurses on short term contracts is one without a stable foundation.
Temporary workers cannot be expected to provide leadership, let alone make independent decisions about patient care. As the series illustrated, the Republic’s health service may be just one bad winter away from breakdown. In the words of one patient advocate: “It’s sad that nothing gets done, still, unless there is a huge patient outcry”.