Heart Beat:Events in our health service sometimes occur in ways that beggar belief. Just such was the PPARS debacle, indeed scandal, writes Maurice Neligan
Psychiatric services in our country could, without stretching the imagination, be described as the orphan abandoned by a harried and destitute medical system. In the face of glaring inadequacies in just about every aspect of healthcare, it is easy to ignore the plight of arguably our most vulnerable people.
Once more as in my response to PPARS, I seek assurances that the following story is not true. It would be depressing beyond endurance that we could have sunk so low. What am I on about now? Well I'll tell you. If you're an ordinary caring sort of person I suggest you read this sitting down and digest it slowly. Then see how it fits with your moral compass.
A Vision for Change (2006), produced by an expert group, purports to outline the development of mental health services here over the coming years. The implementation of this report has been criticised in two recent publications by two independent bodies. One is called The Emperor's New Clothes and is from the Irish Mental Health Coalition. It alleges that much of the budget allotted to the HSE to implement vision has been redirected to other areas of need within the health service.
We are told that 57 per cent of the €25 million allotted for Vision in 2006 was not spent and that only 40 per cent of the same sum in 2007. Now wait for this piece of typical HSE obfuscation; "the balance of the funding from 2006, 2007 was time delayed to address core deficits in existing mental health services". The Department of Health said that before additional funding was provided, the HSE had to demonstrate that the money allotted was efficiently used in promoting the changes postulated in Vision.
Dr Jimmy Devins, Minister with responsibility for Mental Health, is quoted as saying: "It is appropriate in 2008 to pause and review the situation to ensure the consolidation of the investment to date."
Don't give up on me just yet. What this means is that you formulate a policy, allot funds and then not having delivered the funds, pause to see how everyone is getting on. Well, to the ordinary person, they couldn't be getting on without the necessary investment.
These people, however, live in a parallel universe, where maybe this makes sense to them. It is palpable nonsense. The money that should have gone to mental health was diverted to other stressed areas in the service.
The second document pointing out the shortcomings in the delivery of the programme is called Lie of the Land and it was produced by the Irish Psychiatric Association.
It claims, among other things, that lands associated with psychiatric facilities have been disposed of for significantly less than true value and the opportunity to invest such monies in the service has gone a-begging.
Now for the bit that I hope is not true. Plans for the development of a 60-bed acute psychiatric unit at Beaumont have been shelved to allow enough space for the development of a co-located hospital there. I ask again, can this be true? A facility designed to alleviate the dreadful problems of the acute psychiatric service and to take pressure off the conditions in St Ita's Portrane is to be set aside so that somebody can make money from a private hospital located on public land.
Let there be no mistake here. Co-located hospitals are first and foremost about making money for somebody. Otherwise nobody would build them.
"But hey; €350 million for the Mater Private, let's all get a share of that. We'll get loads of tax breaks, like all the hotels and various housing white elephants. So long as the State provides a rotten service and the daft Hospital Treatment Fund fills our beds, it's bonanza time.
"We won't even have to train staff, we'll just poach them from the run-down demoralised public hospitals, and there'll be no nonsense in this world of customers and clients, of taking long stay or difficult problems. Boston here we come, to hell with Berlin.
"Yes, of course private health insurance premiums will have to rise to make sure we all make a profit, but it's very cheap here any way. The average American family with comparable insurance pays four times more per annum than we do. That's the future brother."
To those who think this geographical direction is desirable I suggest that they look at Michael Moore's recent film Sicko about the American healthcare system. It deals with the problems engendered in a society where 16 per cent of the population have no health insurance.
Cases have been recently documented of patients who cannot pay, or cannot continue paying, being forcibly abandoned in city "skid rows". American medicine is among the finest in the world for those who can get it. If we're all happy with that, onwards to Boston.
I don't think that's what ordinary Irish people want. I think we want a system that serves us all fairly and always puts the patient first.
That's not the way we're heading. Avarice and its exponents have re-categorised the sick and stricken in our society as customers and clients and greed takes precedence over the needs of our most vulnerable brothers and sisters.
"Every man for himself and let the devil take the hindmost." Is this the motto for a caring society?
Maurice Neligan is a cardiac surgeon