President warns of ‘economic view’ of health system

President Michael D Higgins has warned against the dangers of examining healthcare in excessively economic terms.

Care of the ill was not an item that belonged to the private sphere, to be purchased on the market, the President told a conference of community nurses in Dublin today.

Practical ethical issues in terms of the creation of a “fully human landscape” arose where the rights of patients were made secondary to any economic view or the pressure for efficiency, he warned.

Speaking about the profession of community nursing, the President said interdisciplinary teams should involve “a sharing of concern rather than a sharing of status”.

A lot of work needed to be done across the professions to improve this, he said. Sometimes, hostility to change got in the way of personal judgment and discretion, which were both critically important qualities.

Frequently, the word “professional” held connotations of coldness, distance and “doing it by the book”. “The word professional shouldn’t ever exclude empathy in the areas of health and care and the relationships between human beings.”

“It is better to sink with an imperfection that is human than to know nothing and achieve some kind of false perfection,” he said to applause from delegates at the conference of the Institute of Community Health Nursing.

President Higgins said society needed to move on beyond the phrase “disability” and talking about getting through the barriers to full participation in society through the lifecycle.

He said community nurses were dealing with the problems caused by changes in the structure of society. Many grandparents are now looking after their children while their parents are spending a lot of time in traffic because they are a long distance from work.

The policy of closing down institutions and moving people back into the community for their care posed a challenge for society in terms of its receptivity, resources and the skills of the people providing the services.

“This has to be thought through with care, it can’t be done on paper, and it can’t be done evenly in all circumstances.”

Delegates at the conference were highly critical of plans by the HSE to employ newly qualified nurses in the community as part of its latest cost-cutting plans.

Siobhan O’Brien from Cork said the proposal showed a total lack of understanding of the realities of a service that was already stretched.

John Hennessy, the HSE's national director of primary care, said graduate nurses would not be required to work "single-handedly" in the community but they would be deployed where larger teams of community nurses were in place.