Sir, – Dr Ryan of the Irish College of General Practitioners (May 20th) has pointed out that doctors and nurses in practice handle 98 per cent of the Irish population's illnesses. They do so every day without unasked for advice from visiting professors from abroad speaking of leadership development and management practice ("Harvard professor to get €50,000 for six-hour HSE class", Home News, May 3rd).
They just get on with it.
Medical and nursing professionals understand how to work and give service to sick people. HSE and Department of Health managers, however well intentioned, do not.
On the same day an editorial in the Times of London commented on the effect of introducing a private health company, run by clinicians, to reverse the appalling mismanagement by the NHS bureaucracy of the Hinchingbrooke hospital in Cambridgeshire. This was the first time that the independent sector had been brought in to manage an NHS hospital.
Within two years the hospital ranked first out of 46 trusts in the midlands and East Anglia for A&E waiting times and patient care and satisfaction, and is now the top-ranking hospital for patient care in England. The annual deficit of £10 million was reduced to £3.5 million.
This has been done through a shift in managerial responsibility from bureaucrats to clinicians.
Should that be surprising? Nurses and doctors ran our health service, efficiently and cleanly for many years before bureaucrats took over.
Could we just get back to it ? – Yours, etc,
FRANK MULDOWNEY,
Emeritus Professor
of Medicine UCD,
Shrewsbury Road,
Dublin 4.