IT HAS been another eventful year in healthcare. The most prominent “scandal” of 2010 was that involving unread X-rays and unopened referral letters at Tallaght hospital. An investigation by Dr Maurice Hayes concluded a shortage of consultant radiologists combined with management weaknesses at the hospital were among the main factors why some 58,000 X-rays were left unreported between 2006 and 2009.
His analysis of the inadequate processing of letters from GPs referring patients to Tallaght introduced a new term to Irish healthcare. “Queuing to queue” describes what happens when electronic outpatient booking systems are unable to plan beyond a 12-month appointment window. We are told the system is being revamped but a wider problem persists: because of a continuing failure to record waiting times from the time a patient is referred by their GP until they are seen by a consultant, a true measure of public hospital waiting times still eludes us.
Following budget cuts of €724 million, the health system faces even greater challenges in the year ahead. Both capital and day-to-day spending have been severely pruned and may have to be cut further following the low final uptake for the Health Service Executive (HSE) redundancy scheme. The HSE national service plan for 2011 states it will maintain the level of service provided in 2010 despite the significant cut in funding. However from the perspective of individual patients and front- line staff, such ambition is unlikely to be fulfilled. Previous funding cuts have brought service reductions; those away from the front line may not make headline news but nonetheless erode the system’s capacity to look after people in their own homes and communities.
On a positive note, the Minister for Health has directed the HSE to implement minimal funding cuts in the areas of mental health and disabilities. Priority will be given to respite services which provide an essential safety valve for the thousands of unpaid carers who look after vulnerable people in their own homes.
Acute hospital services face considerable challenges in 2011. A national shortage of non-consultant hospital doctors will worsen and may force the curtailment of 24 -hour-service in some specialities in certain hospitals. This has the potential to seriously threaten patient safety and must be proactively managed by the HSE if tragedy is to be avoided. Patients needing emergency department care will likely experience longer queues and prolonged waiting on hospital trolleys.
Of major interest for 2011 will be the effect of the HSE’s national clinical programmes. The brainchild of clinical care director Dr Barry White, they will focus on standardising care so that the person in west Cork with a stroke receives the same level of care as a patient with the same condition attending a Dublin teaching hospital. While it may take some time for the full benefits to be realised, the initiative promises to deliver a system-wide standard of care for the first time.
The health system cannot be exempt from today’s economic challenges but must strive at all times to protect the most vulnerable.