ANALYSIS:SUCH IS the level of failure attached to the HSE moniker, people are entitled to be sceptical of any new plans it may have to improve our public health service.
This is the case especially where these plans involve cutting waiting times in hospital emergency departments. Initiatives trumpeted by the Minister for Health, Mary Harney, presumably on the back of past promises made by the HSE hierarchy, have largely failed to ease the length of time many patients spend on trolleys waiting for a hospital bed when acute illness strikes.
However, the latest plan, the Acute Medicine Programme, has redeeming features that should improve its chance of success.
It has its genesis in the clinical trenches of hospital medicine.
It has the backing of doctors, nurses, therapists and patient groups. The clinical supremo at the HSE, Dr Barry White, has worked hard to build the proposal from the ground up.
And it comes at the beginning of the tenure of new chief executive, Cathal Magee, whose specialty is implementing change in public service organisations.
On the negative side, if it needs extra funding, further budget cuts in healthcare could scupper the plan.
It will need the buy-in of hospital consultants, especially some who work in major teaching hospitals who will have to devote more time to looking after recently admitted acutely sick people at the expense of sub-specialty and other interests.
So what difference will it make for patients? Firstly, there should be a standardised quality of care across the hospital system – a patient in west Cork should receive identical treatment to someone with the exact same condition and illness severity living close to St Vincent’s hospital, Dublin.
A big push for care to follow strict protocols is central to the new initiative, as is the creation of a new specialty of acute medicine by the Royal College of Physicians of Ireland. These specialists will focus intensively on people requiring admission through the emergency department and will be key to meeting the plan’s commitment for a senior doctor to assess all patients within an hour of arrival at a hospital.
For patients, this should mean quicker and higher quality decisions than up to now, backed up by same-day scans and other tests.
A welcome move is the development of a national early warning score system, designed to flag patients whose condition is worsening and who may require transfer from a lower-level hospital to a higher-level unit.
With four levels of care provided within each region, it is essential that patients can move quickly between institutions, depending on their condition.
A commitment to “surge capacity” within each region, to be triggered when bed occupancy reaches 85 per cent, should help deal with periods of increased demand.
The development of “Model 2” hospitals may reduce fears of local politicians and action groups that smaller hospitals will be closed.
However, the plan does signal the end of seriously ill people with medical problems being looked after in small, local hospitals.
The system cannot be allowed to carry on its dysfunctional way.
This programme is the brainchild of a wide range of healthcare professionals, who will surely support it.
We can only hope it will offer a better service to patients.