Sir, – Recent articles on the funding crisis at Cork University Hospital remind me of the huge amount of energy and time I see wasted by clinicians, managers, politicians and the public fighting over the limited resources in our public health service.
Sláintecare is supposed to be the consensus blueprint for the public health service, but it has never received the required funding or political backing to be fully implemented.
Is there a “perfect” health system in the world? If so, let’s copy it. To my knowledge, all health systems are constrained by their funding and make choices, yet we in Ireland seem to have difficulty accepting this.
Sláintecare is a noble aspiration, but essentially ignores the reality and resources that exist in the private healthcare system in Ireland. Private healthcare in Ireland is not the preserve of the rich; nearly half (46 per cent) of us have private health insurance. Charities also either directly, or through Section 38, play a vital role in the delivery of healthcare in Ireland.
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Many factors, detailed elsewhere, lead to ever increasing healthcare costs.
But it is not just how much, but also how we spend our money that requires discussion. There is a simplistic focus on longevity or quantity rather than looking at the more complex issue of quality of life.
Having an elderly parent has highlighted this to me. My mother and I have found it both challenging yet rewarding talking openly about healthcare issues at the end of life.
There is also the issue of “personal responsibility” for each of us in relation to our health and how we interact with the health services. What is reasonable for individuals to expect from society and what responsibilities should we accept ourselves?
These are difficult questions but avoiding them does not make them go away. Instead, we lurch from one crisis to the next, with the HSE and governments announcing new initiatives, services being reorganised, expectations raised, costs rising and everyone becoming increasingly frustrated.
We will never have a perfect health service, but we could have one whose priorities are understood, whose limitations are honestly acknowledged and whose guiding principles remain consistent beyond the political cycle.
“Hope and expectation of necessity needs conversion to reality”, as an emeritus colleague in rehabilitation medicine recently put to me.
Isn’t it time for all of us to have a mature national conversation on our health service? – Yours, etc,
JOHN MACFARLANE,
Consultant in Rehabilitation Medicine,
Mercy & Cork University Hospitals,
Cork.
