The hospital system in the Republic is insensitive to vulnerable groups in society such as older people and those with disabilities, a medical conference has been told.
Dr Cillian Twomey, chairman of Comhairle na nOspidéal and consultant geriatrician at Cork University Hospital, told a symposium on contemporary issues in hospital practice that "as the bed situation tightens vulnerable groups fall out of the system".
He told doctors attending the conference at the Mater Hospital in Dublin yesterday that if you come from a lower socio-economic group or have a disability you do not easily fit into a niche within the system as at present structured.
Dr Twomey said in restructuring the health service we must be driven by what patients wanted. He referred to a British patients' survey which found people wanted to see a minimum standard of care in hospitals. They wished to be treated by highly trained staff and have direct access to a consultant. Patients wanted to be involved in decision-making and would welcome a greater level of health promotion.
Referring to the health system in Finland, which aspires to provide care under a " rule of 3s " - which states that you can see a GP within three days, see a specialist in three weeks and receive hospital admission and treatment within three months - he said although the Finns did not always achieve this goal, the system was better for having clearly outlined the standard it wished to achieve.
In a reference to the current crisis affecting acute hospital beds Dr Twomey said one of the principal reasons for this was that, "We have gone from having five hospital beds per 1,000 of the population in 1981 to three per 1,000 in the year 2000". He added that although the health strategy "Quality and Fairness; a health system for you" is an excellent document "relatively little has happened in terms of implementation and the strategy needs to progress in a practical way".
Prof M.X. Fitzgerald, dean of the faculty of medicine at University College Dublin, told the conference we had a "highly dysfunctional" health service which needs to be depoliticised. "We need to reconfigure the system, which with eight hospitals with fewer than 90 beds in each, must be regarded as not sufficiently safe".
He added that by maintaining the current system the State is actually preventing the regional development of the health service. It encourages a steady outflow of patients, who require specialist care, to Dublin, Cork and Galway, he said. On the issue of competition in the health service Prof Fitzgerald said the National Treatment Purchase Fund represented "sham competition". He advocated an approach similar to the culture shift which took place in the university sector when research funding became competitive under the Programme for Research at Third Level.