Health And Efficiency

The statement to RTE by the Minister for Finance, Mr McCreevy, that no more money would be allocated to health boards this year…

The statement to RTE by the Minister for Finance, Mr McCreevy, that no more money would be allocated to health boards this year fails to take account of the worsening situation in our hospitals and the needs of the most vulnerable of our citizens. In that context, the slogan adopted for Fianna Fail's forthcoming ardfheis, "Partnership with People" rings very hollow indeed. Figures produced to the Dail by the Minister for Health, Mr Cowen, last week, showed just how grave the situation has become. Almost half of the hospitals in this State will be forced to close beds and hospital wards in the period before Christmas. And there is something seriously wrong with either the management of the hospitals, the allocation of resources, or perhaps both. In any event, it is the responsibility of this Government to deal with and resolve the issue as a matter of urgency.

The information about pending bed closures has not come as a thunderbolt from the blue. From midyear it was clear to the Department of Health that every single health board would have to authorise the closure of some beds in order to remain within their allocated budgets. In four out of the eight health board areas, no bed closures will occur before next month. But, at that stage, an estimated 800 beds will be closed in hospitals across the State. The pattern of closures would not suggest an attempt by the health boards to gouge extra resources out of the Department of Health. Only 28 hospitals out of 62 will be affected as their money runs out, which would suggest the level of consumer demand and management factors are the underlying causes.

Earlier this week, officials from the Department of Health spoke of hospitals treating nearly double the number of patients as last year through day and overnight care facilities. That suggests both increased demand and efficiency. But one wonders whether the cost of this higher workload was factored into the health estimates when they were drawn up last year. The Department itself secured an unexpected windfall of £65 million through buoyant health levies and it now appears determined to spend that money on demanded schemes, such as drugs refund programmes. There would appear to be one law for the Department and another for the health boards. Flexibility is allowed in departmental spending; a rigid adherence to estimates is demanded from the health boards.

The need for financial discipline and better quality management within the health boards is recognised, on the basis of their previous poor record. But some review mechanism should exist whereby problems in relation to funding, or management incompetence, could be resolved before bed closures became necessary. Modern, high-tech medicine has a voracious appetite for cash and governments would pander to it at their peril. But adequate hospital care for the poorest sections of society must become a Government priority if its public commitment to social partnership is to mean anything.