Sir, – I read with interest the retrospective of Minister for Health’s Stephen Donnelly’s assessment of the health service in 2023 as “positive but not perfect” (Paul Cullen, “Stephen Donnelly: ‘Things are getting better, but we have a long way to go’”, Interview, News, January 5th).
The Minister alluded to the fact that there were only modest improvements in waiting lists despite the investment of €440 million. What the Minister fails to mention is that this money was spent in private hospitals by the National Treatment Purchase Fund (NTPF). Rather than developing infrastructure in public hospitals which would have been of more long-term benefit in the management of increasing waiting lists, the only beneficiaries were the private health sector. Various governments have spent in the region of €1.5 billion in private hospitals since the establishment of the NTPF, money which would have had far better long-term benefit had it been used to build up infrastructure in public hospitals rather then short-term political mileage.
The Minister is very happy with the new consultant contract and the fact that 1,250 consultants have signed up in the last nine months. This contract is on offer to HSE consultants but is unlikely to be considered in voluntary hospitals which are not under the control of the HSE. Why would a Dublin hospital offer a contract to a consultant that prevents them working in a private sister institution? I would suggest that the majority of people signing the contract are those approaching retirement, to increase their pension, and those who work in specialties such as psychiatry, or in hospitals like Letterkenny, where there is minimal private practice and no access to a private hospital.
The Minister plans to make comparisons between the performance of different hospitals using a health performance visualisation platform (HPVP). Will this be another expensive management tool to tell us what we already know?
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Underfunded hospitals perform poorly due to lack of resources and staff, while better-funded hospitals get increased funding.
This imbalance of funding between the Eastern Region and the rest of the country remains the imbalance is far greater in smaller hospitals. Giving the same percentage increase year on year merely increases the imbalance between smaller and larger hospitals.
Finally, although it should not need to be said again, the single solution to our health service in the short term is extra public beds. There is no crisis in the hospitals’ emergency departments, but there is a crisis of hospital beds, which means patients cannot get out of emergency departments. – Yours, etc,
PETER O’ROURKE, FRCS(Orth),
(Retired consultant orthopaedic surgeon,
Letterkenny University Hospital),
Ramelton,
Co Donegal.