HEART BEAT:The health service is being strangled by the lack of beds
IT WASN’T just the bankers, it wasn’t just the developers. It couldn’t have happened without the tax breaks given freely and often for very dubious schemes. These tax breaks are still extant for building private hospitals. This at a time when the numbers carrying private insurance are dropping, the VHI is losing money and has regulatory issues, and the current private hospitals are facing financial difficulties. Some are dependent on the divisive and dubious concept of the National Treatment Purchase Fund, an institution that itself has a very uncertain future.
It’s analogous to the hotel situation, where the established and competent institutions were swamped by tax break-driven constructions, for which there was no public demand. Nor will there be such demand in the foreseeable future. I suppose it is just part of the drive to privatise the health service. This Government and this minister have no legitimate mandate to impose this inequitable course upon the rest of us.
Now we’re to have a bank inquiry of sorts. It won’t be transparent and public, and it will drag on until everyone is sick of it. The investigation mustn’t suggest that Government policies or personalities are in any way to blame. If it comes to the worst, a few lower-tier developers and bankers can be tossed to the wolves and we can all move forward. That’s all for another day.
Meanwhile, let’s have a look at perceptions and realities within the health service. Tony Benn once said “we should put the spin doctors in spin clinics where they can meet other spin patients and be treated by spin consultants”.
Having been poisoned for years by toxic doses of spin, it’s about time we developed systemic immunity. Spin pervades every part of the health service at all levels. Those who know the truth, the harsh realities of a failed system and who speak out are demonised; they are cranks or vested interests. The real truth is known to but a few enlightened ones who will press on with their agenda, regardless of the damage done and the suffering caused. We will have the best health service in the world. Really, I ask myself, do they believe it?
Let’s throw the cold water of reality on this escapist fantasy. Let’s kick a few sacred cows. Let’s point out the myths and inconsistencies we receive, instead of a decent health service.
The OECD report, Health at a Glance 2009, has just been published. It is available from the OECD bookshop and may be ordered online. As well as providing raw statistics, it provides comparisons of all facets and outcomes across the 31 countries of the organisation. There are problems with the statistics. One is that countries differ from one another in the categorisation of posts and services, for instance, public versus private. More importantly, a lot of the data is submitted by central governments which tend to put the best foot forward. That being said, these data, covering 2002-2007, are essential reading for those involved or interested in healthcare delivery.
Keep the above dates in mind. The figures show that Ireland has 2.7 acute hospital beds per 1,000 of population. The OECD average is 3.8 per 1,000. Since compilation of the data, there has been or is immediately due, a further subtraction of circa 2,000 more beds from the acute hospital system. We are at the bottom of the ladder in numbers. Prof Drumm repeatedly tells us that we have too many beds in our acute hospital system. It is a wearying and false mantra.
The lack of beds is strangling our hospitals. It means elective patients cannot be admitted as they are caught in a vice between emergency cases and those presenting from AE on the one hand, and those patients who cannot be discharged, owing to lack of long- term care beds. We are told the HSE envisages a further reduction of 40,000-50,000 inpatient treatments during this year. This is one way of solving the problem. Don’t treat the sick. It is similar to moving patients waiting in AE to extra beds in the wards. Shifting the problem somewhere else and spinning an improvement in AE figures, is merely rearranging the deckchairs and ignoring the real problems.
On Wednesday, the 20th of January, there were 500 patients on trolleys in our hospitals. This is a new and shameful record.
mneligan@irishtimes.com