It is ironic that the Government is allowing private hospitals to develop across the State in an unplanned way when it fails to accept there is a need for more hospital beds, the final day of the Irish Medical's Organisation annual conference heard on Saturday.
Dr Seán Tierney, a consultant at Tallaght hospital, said that despite the fact that the Government did not accept there was a need for more beds, it was through tax breaks, almost €11 billion in private hospital projects, either planned, already under way, or completed and in operation in recent years.
He called for the expansion of private hospital capacity to be regulated "to avoid the bungalow-blitz phenomenon of the '70s being replaced by the hospital blitz phenomenon" of this decade.
Furthermore, he proposed the State should ensure it was given a shareholding in new private hospital developments in return for the tax relief it provided.
"It is irresponsible of the State to invest taxpayers' money so heavily in the private sector while at the same time denying the need for additional capacity, without obtaining an equity stake in the form of a shareholding in return for this investment of public funds," he said.
Dr Declan Bedford, a public health specialist in the northeast, criticised the plans of Health Minister Mary Harney to develop private hospitals on the sites of public ones. He said these should not be developed on the basis of a political ideology.
He could not see why the sites of public hospitals could not be used instead to develop other services badly needed for public patients.
Dr Hugh Bredin, a consultant in Galway, said that with the crisis in the health service, he would not be opposed to the use of public hospital sites for the development of private hospital sites so more facilities could be provided for patients. A&E overcrowding was also debated and the IMO urged the Department of Health and the HSE to ensure no patient had to wait on a trolley in A&E once a doctor decided the patient should be admitted. They also deplored the fact that ambulances had to drive around hospital car parks waiting for trolleys to become available for their patients.
Dr Tierney said more beds, both acute hospital beds and long-stay beds, were required to solve the A&E problem. An independent review in 2001 identified the need for 3,000 extra beds but fewer than a third of them had been provided. He also appealed to the HSE to stop arguing about how many patients were on trolleys every day. "Rather than engage in debates on how many angels can dance on the head of a pin, we should have a firm commitment to patients on when this situation will cease."
Separately, the conference voted to oppose "the autonomous practice of medicine" by advanced nurse practitioners. Dr Tony Healy said these nurses, of which there are about 21 and there are plans to increase them, tried to act autonomously, which they had no right to do. However, if something went wrong, it was consultants who would be sued.
The IMO was given a mandate by the conference to look at the feasibility of introducing "a career grade" of doctor in public hospitals, a special grade for hospital doctors who had finished their training but did not get consultant posts.
Some delegates expressed concern about such a grade of doctor, saying it would result in the new grade of doctor doing the work of a consultant for half the pay or would lead the Minister to use it as a way of getting rid of "those troublesome consultants". The issue is to be examined further.