IMO submission urges 'crisis plan' to address health service problems

The Irish Medical Organisation has called for an immediate "crisis plan" for the health service in addition to the Government's forthcoming health strategy. The doctors' trade union has also called for the development of a network of primary care centres using private funding which it maintains will alleviate pressure on accident and emergency units and hospital outpatient departments.

At a presentation of the IMO's pre-Budget and health strategy submissions yesterday, the organisation's chief executive, Mr George McNeice, said: "The purpose of a strategy is to project, plan and budget for long-term objectives. What is needed is a crisis plan to deal with the fundamental issues that would have an immediate impact on the health service for patients and healthcare workers."

According to the IMO, the key elements of a crisis plan should include an immediate increase in the number of consultants in specialities where there are the highest waiting-list figures as well as the approval of locum appointments by hospitals so that elective surgery admissions can be continued during leave periods.

Other issues which need to be addressed and funded separately from the health strategy included the upgrading of 70 community hospitals across the State to step-down facility standard for people discharged from acute hospitals. By allowing patients who no longer require acute medical care to transfer to these hospitals, waiting lists would be reduced and rehabilitation services enhanced at community level.

The organisation suggests an initial investment of an average £150,000 for each of the 70 institutions would make a crucial contribution to addressing the waiting list problem.

The IMO's main primary care proposal is that private finance, through the availability of capital allowances, be used to fund a network of primary healthcare centres. In its submission, it proposes specific amendments to the 1997 Taxes Consolidation Act to give effect to it.

The new centres would perform an effective "gatekeeper role" for hospitals. It would allow hospitals to function more effectively. Services provided would include GP services; community health promotion; women's health; training facilities for primary healthcare professionals; outcome, audit and research and drug budget management.

Dr James Reilly, chairman of the IMO GP committee, told The Irish Times a recent study had shown that a typical urban general practice of 1,500 GMS patients with a full range of ancillary staff loses money.

"I am aware of approximately 3,000 GMS patients in the west Dublin area who are having difficulty accessing primary care because of resignations by GPs from the medical card scheme."

Asked about a statement by Ms Maura Mallon, research and policy officer with the IMO that the selective preferment of a particular age group within the GMS "would aggravate existing injustices and inequity", Dr Reilly defended GPs' decision to vote for the over-70s deal earlier this year. "While it would have been preferable to see 150,000 lower income individuals benefit, the enhanced payment levels agreed to by doctors highlights the gross inadequacies in GMS fees at present."

The structure, level and method of utilisation of resources in accident and emergency units also need to be reviewed, according to the IMO's submission. It proposes that all hospitals have fully staffed emergency theatres working 24 hours a day as well as ensuring all accident and emergency departments have an adequate number of 24-hour observation beds.