Sylvia Thompson finds out some New Year aspirations.
Brian Howard, Chief executive, Mental Health Ireland:
My biggest wish for 2005 is that the Government and service providers will move much more quickly from policy proposals to urgent action. Too often, policy proposals for mental health services have been of limited value because the necessary action was absent.
Our sector slipped through the net again in the recent National Disability Strategy, which seeks to underpin participation by people with disabilities in society, including those with a mental illness. The narrow definition of disability and the length of time between assessment and provision of services must also be corrected.
Much has been achieved in community-based mental health services since Mental Health Ireland was founded in 1966 - including an 80 per cent decrease in the numbers resident in mental hospitals.
I hope that 2005 will see further recognition and support for the unique contribution made by the more than 1,700 volunteers in our 95 local Mental Health Associations who do such splendid work in their communities - representing the interests of those with a mental illness who otherwise would be without a voice; complementing the statutory services in providing housing and support for former residents of mental hospitals and educating young people about the importance of maintaining good mental health.
Finally, I think it is well past time to reverse the year-on-year decline in the proportion of funds for mental health which has been occurring for many years in the Health Budget and I would hope that this will happen in 2005.
Paul Williams, journalist and author
Just over two years ago, I attacked Bertie Ahern in my column in the Sunday World about the state of the Irish health services. The previous year, I had watched my father dying in a Dublin hospital. I had witnessed at first hand the underfunded and understaffed health service as it struggled but failed to keep up with demand.
Later that year, our Taoiseach, Bertie Ahern told me personally how he was going to revolutionise the health service. In that election, he convinced us to trust in him and Fianna Fáil. Now, two years later, further cutbacks have been made. Waiting lists are still mounting up.
Cancer patients are travelling hundreds of miles to get treatment. People who pay €2,500 in health insurance are lying on trolleys in what's often more like a battle zone. I would be terrified to get sick in this state.
I think Mary Harney is brave to take on the job of Minister for Health and she obviously feels she can make a change. But, the number of horror stories we are still hearing from the A&E departments shows the problem is a chronic one. And any solution to the problem will have to focus on A&E departments.
Emily Logan, Ombudsman for Children
Ireland has the youngest population in Europe. It also has an extremely high rate of child poverty. This means that many under 18s suffer from health inequalities. One way to redress the balance would be to examine the extension of medical cards to all children, so that no child is excluded from access to medical services. It is a sad fact that in modern Ireland some parents are forced to choose between a visit to a GP or feeding their family.
My Office often hears about the difference between rural and urban provision of health services for young people. If services were extended beyond the Capital everybody could have equal access to these services.
Primary care for children and young people needs to be developed. Sick children and young people want to be near their family and friends. Services for them should be developed to facilitate this.
Ireland doesn't yet have a national picture of child health. It is really important that that statistical information is coordinated so proper planning provisions can be put in place.
Finally, Article 12 of the UN Convention on the rights of the Child states young people and children have the right to have a say in things that affect them. This includes healthcare. My Office has heard and witnessed some really good models of active participation by young people in children's hospitals and in the North East and the North West regions which could be replicated elsewhere.
Aidan Gleeson, consultant in emergency medicine, Beaumont Hospital, Dublin
Mary Harney's 10-point plan is a step in the right direction. Unfortunately, she left out a few key elements. Even if you give 1,000 extra beds to the Irish system, you'll still have a problem with patients on trolleys because of the competition between elective and emergency patients. I would like to see a target time announced for patients attending A&E departments.
Britain had the same problem as we have with patients on trolleys and the problem was virtually eliminated there within two years with the introduction of a four hour target time for patients to be dealt with.
Introducing such a target time in Irish hospitals would help us work out where the problems really are. The greatest problem for us is that people can be on trolleys for days with no pressure on the rest of the system to alleviate our difficulties.
Seventy per cent of beds are occupied via the Emergency Department in this hospital. If we send patients on trolleys to the wards, patients would be shifted through the beds in the wards more quickly. This may require additional beds and services and the availability of cardiography; MRI scans, more ward rounds, step-down facilities for some patients etc but if we had a target time in the A&E department, we could then see what other problems needed to be addressed. The chief executive for each hospital should be responsible for this target time - otherwise it will have minimal impact.
Dr Jane Wilde, director of the Institute of Public Health
It is a good time to be living in Ireland. We can reasonably expect that fewer than one child in a hundred will die in the first year of life, life expectancy is growing, and health and quality of life has improved remarkably over the last 50 years. But it is better for some than others - amazingly so.
Our chances of getting ill and our length of life are closely related to our income. Inequality plays out in all the major threats to our health and those who are poorest suffer most. Gross inequality harms individuals and society and we need to tackle it.
We take understandable pride in the health of our economy. But there is more to development than the economy. And we can take little pride that so many are left out in the cold unable to enjoy the benefits of prosperous Ireland.
Tough times too for those who are trying to provide care. Those working in health and social care do their best in a service facing unprecedented demand. The health service reforms are creating mammoth change with many people unclear about what this means for them. People desperately need encouragement and sustained political and management support for a culture which values their technical and caring skill.
New Year is a time of hope. Ireland is now a rich country. Have we the collective will to ensure good health for all our citizens by promoting a more equitable society and a health service which offers equitable access for all? My hope is that we do.