The Government's commitment to the Hanly report and the root-and-branch reform of hospital services and medical staffing that it entails is being tested to destruction.
Fierce local opposition to the loss of accident and emergency services in a number of small general hospitals has fed into the politics of the local and European Parliament elections and has caused the Government to modify its position.
The Minister for Health, Mr Martin, visited Nenagh yesterday and told members of the hospital protest group that accident and emergency cover will continue to be provided on a 24 hour basis by medical practitioners, even though the Hanly report recommended that such cover should be withdrawn between 8 p.m. and 8 a.m. Last week, he delivered a similar message to concerned people in the Ennis area.
The concession by the Government followed protest marches involving up to 10,000 people against the withdrawal of services from their local hospitals. Last year, the Minister for Defence, Mr Smith, spoke against the implementation of the Hanly report in Nenagh and was rebuked by the Taoiseach. The position began to change, however, when Mr Ahern advised party candidates at the Fianna Fáil Ardfheis in March that overnight medical cover would continue to be provided in local hospitals. The uncertainty surrounding the nature of that medical cover - whether services will be provided by doctors or consultants on duty, or whether they will be "on call" at their homes - has now been clarified. Doctors will be present in hospitals, but their precise grade has not been specified.
A spokeswoman for the hospital protest groups has dismissed the concession as a sop to local Fianna Fáil councillors facing an angry electorate. She sought the retention of existing consultancy expertise and services on a 24-hour basis in the affected general hospitals.
There is a pronounced sense of drift in the Government's approach to reform of the health services. The long working hours of "junior doctors" will be in breach of EU law by next August. Negotiations on a "common contract" with consultants are dragging on. Overcrowding at our major hospitals has been described by the Irish Nurses' Organisation as a "national emergency". Administrative reform is lagging. And the Royal College of Surgeons yesterday called on the Government to fulfil its pledge to open 3,000 extra hospital beds. The Government's 10-year reform plan for health services and administration, of which Hanly is only a part, has become bogged down.