‘Why does Ireland spend so much on health and have so little to show?’

Vast amounts of health spending are wasted on “committees and talking shops designed to avoid any serious and rational decision-making”, a veteran consultant has claimed.

Decisions on healthcare are made only when it is "seen to be politically expedient", says Dr Donal Murray, a consultant cardiologist in Sligo for the past 30 years.

“As a delaying tactic a new working group is established with a view to kicking that particular can down the road with no consideration of cost or the effects on healthcare.”

Dr Murray says hospital groups were set up with the promise that they would be “masters of their own services, yet their hands are completely tied because they have no access to funding”.

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Last week’s budget saw a €1 billion increase in health spending to €17 billion, the highest on record. This is despite the Health Service Executive overspending its budget by €2 billion in the past four years.

Dr Murray says he is “perplexed” why Ireland as a nation spends so much on healthcare “yet has so little to show for it”. He believes his own experience trying to recruit new staff and to set up specialist cardiac services in Sligo go some way to explaining why.

Recruitment difficulties

His frustrations arise from the difficulties experienced by Sligo University Hospital in recruiting a second consultant to join him in the cardiology unit and in securing action on numerous reports that have recommended the setting-up of a cardiac catheterisation lab in the hospital.

The first time the hospital advertised the post in 2016 there were no applicants. It was readvertised last year and the post was offered to a candidate trained in Ireland and Australia. Last month, however, this person said he would not be taking up the post. With no other candidate deemed qualified at interview, the hospital now faces having to advertise the position for a third time.

“Undoubtedly, the absence of any progression on the provision of a cardiac catheterisation lab [a specialist facility for diagnosing heart problems] was critical to his decision-making,” says Dr Murray. “In the absence of progress on this, the chances of filling the post would appear to be very limited.”

The cath lab sought by Sligo would carry out “bread and butter” cardiac work such as stenting and angiograms rather than dealing with acute heart attack cases, he says.

‘Illogically spent’

At present, most of the work on Sligo patients is done in Dublin or Galway, but travelling to these locations involves long journey times and sometimes, overnight stays for patients in the northwest.

Since 2001, the HSE has spent €10.5 million transferring 550 cardiology patients a year from Sligo to Galway or Dublin, he says. Another €3.6 million has been spent on renting a “temporary” visiting lab in Sligo over that time.

“This is money poorly and illogically spent. If we had gone ahead with a proper cath lab from day one, we would have saved a shed-load of money.”

Asked why the development of a cath lab in Sligo has made so little progress, he says it is due to “our lack of political influence in the world”. The town hasn’t had a heavyweight political figure at Cabinet since Ray MacSharry was minister for finance in the 1980s.