The effect of health issues on the recent elections was hugely significant. Asked in an RTÉ exit poll how various factors influenced how they voted, a majority – 57 per cent – said they were motivated by the removal of discretionary medical cards. Many stories of handicapped children with lifelong genetic disorders losing their GMS entitlement, coupled with reports of adults with advanced cancer denied discretionary medical cards, struck a chord with weary voters. Monday’s latest performance assurance report from the Health Service Executive confirms their concerns.
The pace at which medical cards are disappearing is accelerating, with a drop of over 50,000 in numbers covered over the first three months of this year. Even before this year’s reviews it appears that some 1,000 a month were losing discretionary medical cards in 2013. The performance report also reveals a significant increase in hospital waiting lists, with the numbers waiting more than eight months for inpatient or daycare treatment rising from four to over 4,000. Some good news – a 3 per cent fall in patients waiting on trolleys in emergency departments – is tempered by a failure to reach a targeted drop of 10 per cent.
Meanwhile, comments about the health service from the recently departed chief executive of the Health Information and Quality Authority (Hiqa), Dr Tracey Cooper, are hardly reassuring, to put it at its mildest. She told this newspaper the health service lacks accountability and fails to learn from its mistakes. Alarmingly, Dr Cooper noted the health system “does not know how many patients it is killing and harming”. Nor is she optimistic that patient safety issues are being adequately addressed, noting the Republic has “quite a long way to go” to reach safety levels of the best health systems internationally.
After some eight years spearheading a number of major inquiries into health service failures, including instances of substandard breast cancer care and lapses in maternity standards, Dr Cooper’s reflections are a source of profound concern. In particular, her assertion that there are no consequences for lapses in patient care, even when they recur on a repeated basis, demands action.
While there is some improvement in regulation of the health professions, there is no forum to which health managers are answerable. This must change so that safety recommendations from investigations are either acted on promptly or executives responsible for continued inaction are sanctioned. Whether Minister for Health Dr James Reilly is the person to spearhead urgently required remedial action is open to question. His considerable medical expertise aside, he has had three years to put his stamp on the health service. Many would argue with justification such blatant failings should not feature in a modern health service.