Consultants and health reform

Madam, - Contrary to the assertion in your Editorial of December 8th, medical consultants are not "resisting change" and reform…

Madam, - Contrary to the assertion in your Editorial of December 8th, medical consultants are not "resisting change" and reform of the health services. On the contrary, consultants drive the vast majority of changes in health service provision.

Developments in surgery, such as day case keyhole surgery, open heart surgery and lung transplantation, and in medicine, such as the introduction of new regimens in cancer care, show this to be case.

You are right to say that negotiations on a revision of the present consultants' contract are "at a standstill". The Minister for Health and Children invited us to enter talks without preconditions on either side. The board of the HSE subsequently imposed a precondition which also broke the provisions of the national agreement, "Sustaining Progress".

It has become clear that, despite the best efforts of the independent chairman, the HSE has no intention of undoing the damage it has caused by its precipitous and ill-judged decision of last January. We, however, remain available and anxious to enter meaningful discussion and debate, but it should be on the terms as laid out by the Minister. The ball is in the HSE's court.

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The second point requiring clarification relates to the provision of hospital beds. The commitment was for 3,000 additional public hospital beds and not 2,000 as stated in your Editorial.

The Acute Hospital Bed Capacity Report, published in January 2002, which forms the basis of the Government's commitment, advised us that there was then a complement of 11,832 public in-patient beds. The report recommended that an additional 2,840 in-patient beds and 190 day-case beds be provided.

The Minister told the Dáil, in answer to a parliamentary question on November 1st, that there are 13,349 in-patient and day beds available. From the information provided, it can be deduced that there are currently 12,079 in-patient beds and 1,251 day-case beds. That means that a net additional 235 in-patient beds have been provided in five years.

Incidentally, in answer to a separate question on the same date, the Minister said there were 13,255 in-patient and day beds available. - Yours, etc,

DONAL DUFFY,

Assistant Secretary General,

Irish Hospital Consultants Association,

Dundrum,

Dublin 14.