Sir, - Your Editorial of September 5th highlighted some of the deficiencies in our hospital services. The many shortcomings experienced by nursing and medical staff result from underfunding - and in particular a lack of planning.
You referred to the inexplicable delay in publishing the report of the Medical Manpower Forum. The IHCA confidently expected this report to be published last December. It was assumed that negotiations on revisions to consultants' contracts would follow immediately and would have been completed within six months. In reality, the report has yet to be published and we have yet to receive a date for the final meeting of the committee charged with the responsibility of signing off this report.
A review of the bed stock in hospitals and other institutions has finally got under way. It would seem that this review will centre on the needs of the population until the year 2010. In our opinion, any review of hospital bed requirements should be for a minimum of 25 years. Despite an increasing and ageing population, hospitals are working with the same number of beds since 1989.
Every shortage in our hospital services, whether it be of nurses, junior doctors, consultants or beds, has been well flagged for years. Yet successive governments seem to lack the vision to anticipate demand and plan accordingly. Health policy is decided in reaction to crisis, rather than as a means of avoiding such crisis.
For many years the number of attendances at our accident and emergency units has stood at about 1.25 million. The Department's reaction has been to increase the number of A & E consultants from 12 to 16. If A & E units are to be kept open 24 hours a day, 365 days of the year in 40 acute hospitals, it is obvious that 16 A & E consultants cannot provide the service that patients expect. This problem has existed for years, yet the obvious solution has not been implemented.
Increased funding, which is undoubtedly needed, should follow comprehensive, long-term planning. Over 70 per cent of hospital admissions are emergencies. This same sense of emergency should be reflected in the Department's capacity to plan and fund our health services. - Yours, etc.,
Finbarr Fitzpatrick, Secretary General, Irish Hospital Consultants' Association, Dundrum, Dublin 14.