An Unhealthy State

Sir, - Maev-Ann Wren has highlighted what she feels are the causes of our healthcare system's inadequacies

Sir, - Maev-Ann Wren has highlighted what she feels are the causes of our healthcare system's inadequacies. According to her, the Church and hospital consultants are the culprits. She has intimated that hospital consultants are lining their pockets by creating waiting-lists. This is an outrageous accusation based on little or no knowledge of what happens at the coal-face of the healthcare system in Ireland.

Speaking from experience - as one of these pocket-lining, lazy, greedy consultants who, like all of my colleagues, plough our way through crowded public clinics without adequate medical staff and in appalling conditions - I take great exception to her comments. I can confidently state that my role and the role of most other consultants that I know around me will stand up to any scrutiny.

As a working doctor, as distinct from a talking doctor, my colleagues and I have a far better knowledge of the ills and the problems that we meet every day in the coal-face of the public healthcare system, which we highlight regularly to hospital managements.

Perhaps I could suggest a few areas: The problems of Accident and Emergency have been with us for years. There has been no serious attempt to solve them and this results in the loss of elective beds in all our hospitals, leading to cancellation of elective surgery and medical admissions. In casualty departments themselves, patients wait for hours and even days for treatment. Surely after all this time a solution to this problem could be found if there was a will to do so?

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Day care has been well established and yet in many of our hospitals it functions at about 3540 per cent of its capacity, when it should be about 75 per cent. Imagine what this would do to reducing the waiting time for public patients for surgery and other procedures.

We have had a great fanfare about waiting-lists initiatives. This is at a time when elective operating lists are functioning at perhaps a third or a half of their capacity every day of every week in most specialties. At the same time as we have to cancel these elective patients, we then have waiting-list initiatives going on in the same specialties on the same day of the same week. Surely this money that is now being wasted on waiting-list initiatives for political gain could be put into the present system so that elective lists could go ahead in the hospitals, and doctors could work at their full capacities.

We continue to appoint doctors when there are no facilities for them in hospitals because of the lack of infrastructure. There are no wards, no beds, no office and no staff and they cannot function. The whole argument of increased manpower that Ms Wren has been so eager to highlight and blame on consultants is irrelevant with the present inadequate infrastructure.

Perhaps if Ms Wren were to sit in on some overcrowded, understaffed clinics and observe at first hand the job lot and the enormous responsibility undertaken by the overworked hospital consultants, she might have a more balanced view, and then be able to give a reliable and responsible account. - Yours, etc.,

Michael O'Keeffe, FRCS, Consultant Ophthalmic Surgeon, Mater Hospital, Dublin 7.