THE IRISH health system has too many hospital beds and, even allowing for our changing demographic, a proportion of hospital beds could be closed, according to the chief medical officer (CMO) of the Department of Health.
In his first media interview since taking up his appointment in December, Dr Tony Holohan told The Irish Timesthat "some of our models of care that exist are no longer appropriate in a high-cost environment".
He said there were entire specialities where the care of patients could largely take place on an outpatient basis.
Rheumatology, neurology, ear, nose and throat, endocrinology and eye problems were areas where bed numbers could be cut and patient care moved to an outpatient or a community setting, he said.
The new CMO, whose office has for the first time been given an executive role within the Department of Health, is now responsible for patient safety and quality in the health service.
He rejected the proposition that extra money was required for the system to improve patient safety and said he sees the economic downturn as an opportunity to prove that greater efficiency and improved patient safety “are one and the same”.
Dr Holohan said he hoped to be more proactive in communicating health promotion initiatives and “more visible” around medical leadership issues.
Asked how he saw the role of the Department of Health since the Health Service Executive (HSE) took over the day-to-day running of the health service, he said the department was responsible for policy setting and oversight.
But he acknowledged that “collectively”, the department could do a better job of explaining its role to the public.
Commenting on the growing feminisation of medicine and its effect on manpower, he said, “In my view it is a reality and is neither a problem nor an advantage”, adding that it was up to the health system to plan for the reality.
But he is a supporter of postgraduate entry to medicine, such as that offered by the University of Limerick and the Royal College of Surgeons in Ireland: “I hear fantastic things about the [postgraduate] students and in particular their enthusiasm,” he said.
The new CMO, who as deputy was responsible for the primary care strategy, believes primary care could take over from hospitals to the extent that Prof Brendan Drumm, chief executive of the HSE, says it can. And he feels that having general practitioners as gatekeepers to the health system is important.
“The health system can be difficult to understand and it probably works better if patients can be guided through secondary care by their family doctor,” he said.