Better sharing required in health services, conference hears

More hospital groups and load-sharing could help reduce waiting lists within the health service, a Dublin medical conference has heard.

Dr Alan Smith told an audience at the Royal College of Surgeons in Ireland there is no short-term fix to the lasting problem of under capacity, waiting lists, appointment cancellations and backlogs. However he added: "The first move is sharing it around," and he suggested that better communication and teamwork could place patients waiting for treatment with providers who had the capacity to help them.

Dr Smith, the HSE’s Special Delivery Unit Director of Performance Improvement, warned the conference that effecting change within health services the world over was particularly difficult.

“Often various interests clash over reform,” he said. “And it isn’t pretty when they do.”

Addressing the conference Maximising Day Surgery in Ireland, Dr Smith said: "Everyone knows health sector reform is difficult and it often takes a shock – budgetary or political, or a scandal to drive change. There is inherent resistance and that makes it really difficult."

Health practitioners and managers were often prompted to fight change out of a fear of getting it wrong, but he suggest that everyone should take note of James Joyce’s maxim: “Mistakes are the portals of discovery.”

He also cited what he called the universal laws of health care which state that when faced with reform people will complain, they will state there are never enough resources and assert that “the last reform failed”.

Modern medicine had become the art of managing extreme complexity, Dr Smith added. He warned: “You can’t keep it all in your head,” and he pointed to the existence of some 13,000 illnesses and syndromes and 6,000 drugs designed to manage them.

The conference was urged to practise “teamwork – really” and “communication – really”. Pressing the need for reform, Dr Smith said 40 years of hospital management had to change to meet the demands of more complex health care and of an ageing population.

The answer lay with people within the health service and not processes, he argued. “Information Technology is only an enabler,” he said, “If you can’t write a sticky note…. then you don’t need an IT system.”