Madam, – In discussing the extent of Ministerial accountability for hospital failures, Stephen Collins (Opinion, March 13th) sees no contradiction in arguing that health professionals should be held to account (ie culpable, as defined in the dictionary) for political failures.
Tallaght hospital is funded by the Health Service Executive to provide a quantum of service to patients in its catchment area. That funding arises on foot of an annual service plan prepared by the HSE and personally approved by the Minister for Health. The hospital’s staffing at consultant level is determined in law and in fact by the HSE. The hospital is prevented from recruiting other staff under the public service recruitment embargo.
Hospital budgets have been put under increasing strain as the nation’s fiscal situation has deteriorated. This difficulty is compounded by the HSE underestimating the demand for patient care in recent years.
There is a fundamental question that society must address. What is to happen if the service which the HSE contracts for in a given year is delivered by a hospital but the demand for that service exceeds its capacity to supply. It is for that reason the Irish Hospital Consultants Association argued that the HSE should not be responsible for any investigation into the Tallaght affair. That call has been echoed by others with an understanding of our health service structure and funding In a year when health budgets, excluding pay, are being cut by €400 million it is likely that other shortcomings will arise in service delivery. There is something inherently unjust in holding the messengers to account for a factor that may well be outside their control. – Yours, etc,