European Health Consumer Index highlights lacking of credibility in HSE waiting list figures

Patient rights need to underpin radical reforms

The quality of healthcare in Ireland has not suddenly fallen off a cliff. It's just that waiting time figures supplied by the Health Service Executive have been rejected as meaningless. Ireland's revised healthcare rating, down from 14th to 22nd place in the European Health Consumer Index, requires urgent attention. But the fall could have happened at any time during the past six years if official figures had been queried. Representations made by patient organisations brought about that change.

Rather than blame the messenger for bringing news of a worse-than-expected health service, the report should be used as a template for action. Complacency is the enemy within any public service. Just as our education system is not a world-beater, neither is healthcare. Both require change.

Our two-tier health system guarantees waiting lists. As a result, those who can afford it buy private insurance to jump the queue. Public patients wait, frequently for months, to be assessed by a consultant. Only then are they placed on an official waiting list for treatment. This system has been rejected as “lacking credibility” by European researchers. They have recommended “radical action” to improve patient rights and waiting lists along with further measures to deal with hospital-acquired infections.

Healthcare in this State evolved to reflect the needs of service providers and patient empowerment is now on the level of Romania. That must change and additional resources will be required. Just as Beaumont hospital needs additional consultants to operate its renal transplant unit and cut long waiting lists, so the Fair Deal nursing home scheme requires extra funding to free up acute hospital beds. These matters involve administrative, as well as funding, considerations. Efforts to stay within budget by limiting recruitment and patient services frequently generate additional, long-term costs.

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On being appointed last year, Minister for Health Leo Varadkar conceded the Government's reform agenda had been too ambition. Promised change had not been delivered. A system of universal health insurance, under which citizens would enjoy equal access to health services, remained a distant prospect. Overcrowding at hospital A&E units reached record levels before additional funding, to facilitate the transfer of recovered patients to nursing home care, was made available. On the positive side, free GP care for children under seven years and for pensioners over 70 would be delivered this year. Planning for the future is as important as fire-fighting in the present. A threatened male obesity epidemic, linked to inadequate exercise and excessive fat and sugars in manufactured foods, could overwhelm the health system. It calls for pre-emptive action.