Madam, - As doctors with extensive experience working in the public sector, we write to you out of frustration and anguish on behalf of patients and of our health service.
We believe that the sustained attack on the public health system, both by constant criticism, and by the withholding of essential funds for infrastructural development, is damaging our entire society.
While it is clear that aspects of the current health system are fragmented and inefficient, there are also many aspects that work well. This must be acknowledged. The vast majority of patients who attend their general practitioner or who are admitted to a public hospital receive high-quality evidence-based treatment.
It is time to change the poor public perception of healthcare in public hospitals and to recognize that clinical care within the public sector is of the highest standard. Our public hospitals provide world-class care, but in primitive surroundings. Accessing that care is the problem.
The fundamental problem in the public health system is that the front line is inadequately resourced. In addition, key pathways that allow general practitioners and hospitals to communicate effectively and work together have been systematically ignored. This has come about partly because front-line health staff, doctors and other key healthcare professionals are often excluded from the design and planning of services.
Blaming those working in the front line for infrastructural flaws only serves to exacerbate the problems and demoralises those striving to provide a high-quality service. Current systems that penalise hospitals for overcrowding in A&E, without providing resources to resolve the factors that lead to overcrowding, are misguided and deeply unfair to both patients and front-line health workers.
We live in a civilised society. Health is not a commodity to be bought or sold. Our health system must strive to provide access to treatment and clinical care that is independent of means. All patients must be treated according to clinical priority, whether emergency, elective, acute or chronic, and healthcare must be integrated across primary, secondary and tertiary services.
To achieve this, it is essential that those of us working on the front line - doctors and other healthcare specialists - are involved in the design, planning and implementation of services.
We recognise what the problems are. We are in a position to help configure and integrate services. We are accountable both to our patients and to the State at large.
Further investment in clinical services within the public system is urgently required to improve the access to care. This will need to include substantial capital investment in primary care and hospitals, and investment in interface services linking GPs with hospital-based services.
A systematic failure to address the long-standing infrastructural problems in the public system has led to our current difficulties. But in the resolution of these problems, we must remember that one of the essential obligations of a civilised society is to provide equitable access based on need, and regardless of the ability to pay. This is what the public sector does best.
We would like to get on with the job. - Yours, etc,
ROISIN COSTELLO,
KIERAN MURPHY,
RAY O'CONNOR,
BRENDA O'HALLORAN,
EAMONN SHANAHAN,
General Practitioners;
ROBERT DALY,
KATE GANTER,
Consultant Psychiatrists;
NORMAN DELANTY,
COLIN DOHERTY,
ORLA HARDIMAN,
TIM LYNCH,
JOAN MORONEY,
Consultant Neurologists;
JOHN DOHERTY,
CIARAN DONNEGAN,
JOE HARBISON,
ROSE ANNE KENNY,
CHRISTINE O'MALLEY,
Consultants in
Geriatric Medicine;
MICHAEL FARRELL,
Consultant Neuropathologist;
HUGH FLOOD,
Consultant Urologist;
DAVID HICKEY,
Consultant in Renal
and Transplant Surgery;
CHRIS LUKE,
Consultant in Emergency
Medicine;
FIONA MOLLOY,
Consultant Neurophysiologist;
RISTEARD MULCAHY,
Consultant Cardiologist;
JOHN NOLAN,
Consultant Endocrinologist;
c/o Beaumont Hospital,
Dubin 9.