Madam, - The Irish Association of Internal Medicine (IAIM), comprising consultant physicians in general medicine nationally, discussed the Hanly report at its meeting in Wexford last weekend. The association expressed disappointment and concern at not been directly consulted and involved in formulating such an important report which affects patients' access to care.
The association has grave reservations that the report is not patient-centred and raises serious problems for patient access to hospital care. The recommendation to move patients directly from primary care to tertiary care facilities is neither evidence-based, necessary nor affordable. Tertiary care is significantly and more expensive than secondary care.
With adequate resource funding of primary and secondary care facilities, more than 95 per cent of patients can receive quality care locally.
Regional and tertiary hospitals are already overstretched with patients waiting days on trolleys for admission to acute hospital beds. This interferes with the ability of these hospitals to deliver their regional or national specialty responsibilities. Therefore it does not make sense to further load these centres with extra patients who can be treated locally.
The association advises exploration of all alternative solutions to the European Working Time Directive which will not adversely affect patient care. - Yours, etc.,
JAMES A. O'HARE, MD, FRCP, FRCPI, Consultant Physician, President, IAIM, Mid-Western Regional Hospital, Dooradoyle, Limerick.