Madam, - Peter Boylan (February 22nd) echoes the feelings of many people including myself who have worked in the health service and must deal with that Department regularly. However, while focusing on "systemic maladministration" is important, the root cause of the problem is an insensitive management philosophy driven by an emphasis on the wrong kind of performance indicators, benchmarks and other business tools.
Health professionals who take time to care properly for their patients are made to feel they are "wasting time with people". Pouring more resources into the system without reforming management thinking will not succeed. Only a philosophy of caring is appropriate and that means fundamentally that both patients and front-line health care professionals are treated as people and that time is allowed for better care in a holistic framework.
A 50-year-old man who has been homeless for several years provided me with very practical evidence of this recently when he described what happened when he went in search of treatment. "They don't see you now, they examine you on the computer and give you a piece of paper, then you leave."
If people suffer from deep psychological problems and have difficulty coping, processing them like an inanimate object will ensure only that they drift from one service to another, never getting the help they need and costing the State even more money. An even greater irony is that the current management philosophy, which is supposed to help expose inefficiency, has served to help senior mangers cover up the failings in the system. Far from making life better for those in need, it has actually created outsiders, as those who have sought to speak out have been made to feel excluded.
This tendency is not exclusive to the health service, but is apparent across all of the social and homeless services. The current management philosophy must be replaced by a people-centred philosophy of care or the current push for reform will not succeed. - Yours, etc.,
ALICE LEAHY, Director and Co-Founder, TRUST, Bride Road, Dublin 8.