Madam, - Maurice Neligan makes a simple yet compelling point: that those in front-line caring roles in the health service are never consulted (Health Supplement, January 27th).
Their views seem not to count for much, yet without their expertise, experience and commitment the level of service provided today, given the inadequate resources getting through to the front line, would not be possible.
Unless that reservoir of practical knowledge is brought to bear, will we get the health service we deserve? Today the system is driven from a bureaucratic perspective without any apparent grasp of what is happening on the ground.
This is not to suggest that those in senior management positions are not motivated by a genuine commitment to help people. But they are out of touch with day-to-day realities and their lack of knowledge can cause real and unnecessary suffering for those whom the services are meant to serve.
If we are serious about reforming the health services and maximising the return on the considerable resources we expend, we must first ensure that the managers in overall charge know what is going on.
Therefore, should we make it mandatory that all senior managers spend, say, at least one or two days a month working in a front-line caring area to ensure that the policies they are seeking to develop address real human needs? - Yours, etc.,
ALICE LEAHY, Director, TRUST, Bride Road, Dubin 8.