Sir, - The Health Service needs a complete root-and-branch overhaul. Were any commercial organisation to operate with the same degree of inefficiency, duplication, and disorganisation, it would become insolvent very quickly.
There are committed and diligent individuals working in the hospital system but their endeavour is eventually drained by a feudal system of fiefdoms that reward equally the effective and the inefficient. Archaic systems and practices, duplicated unquestioned for over half a century, frustrate even the most diligent. Authority is usually focused upwards and responsibility downwards - a combination which paralyses any system. There is little evidence of any proper service audit, and budgetcapping as opposed to real cost effectiveness is the rough tool universally applied.
The cultural cohesion which typifies a successful modern business organisation is absent and aspirations towards a seamless service are realistically laughable. When lap-tops, the latest mobiles and other gadgets have become more necessary than patient beds, the outcome is obvious.
Some years ago, the BBC's Yes Minister series did a feature on an NHS hospital that had no patients, but all departments of administration were busy all day! We may not be far from that model as the number of beds are reduced and administration gadgetry is increased. Who at the end of the day makes these preferential decisions? I have no doubt but that the current nurses' strike is fuelled in part by the resources that nurses see wasted on peripherals, duplication, etc.
Perhaps when the Public Account Committee is finished with DIRT and shirts it could take a look at our health service, including the workings of the Department of Health. We may be far more shocked than we have been to date, if that is possible. - Yours, etc.,
Dr Padhraic O'Conghaire, Churchfields Clinic and Medical Centre, Lower Salthill, Galway.