Sir, - It is difficult to overstate the crisis in our health services and in this context the report on the health strategy by the National Economic and Social Forum with respect to the Health Strategy is very welcome (The Irish Times, July 8th). In particular, the concerns raised by the NESF regarding waiting periods to see a hospital-based specialist are appropriate and timely.
The current waiting period to attend a consultant neurologist in a public clinic is approximately 18 months. At Beaumont Hospital, which serves as a national centre for neuroscience, the average number of patients seen in each of our three weekly general neurology clinics often exceeds 50, all of whom must be reviewed within a four-hour period. This leads to understandable frustration among both patients and staff - the former because they sometimes experience lengthy waiting times in particularly oversubscribed clinics, and the latter because they cannot provide quality care in such an environment.
Unfortunately, clinic staff are increasingly subjected to appalling verbal abuse by patients waiting for long periods to be seen in particularly busy and overbooked clinics. There is an erroneous perception among the public that our services have enjoyed an unprecedented increase in funding in recent years, and that prolonged waiting times should be a thing of the past. This is manifestly not the case.
Specialist multidisciplinary clinics, many of which have been developed over the past five years with support from industry rather than public funding, are also grossly oversubscribed. The migraine, multiple sclerosis, and epilepsy clinics provide specialist services for up to 50 patients each. The waiting lists for these clinics range from 18 months to two years. The oversubscription, as in the case of general neurology clinics, is partly due to a severe shortage of neurologists. However, clinics are also oversubscribed because timely access to services such as physiotherapy, occupational therapy, speech and language therapy and social services can only be achieved by attending a hospital-based multidisciplinary specialist clinic. These services are not available to many patients otherwise.
As the NESF has identified, it is not acceptable to focus solely on in-patient hospital waiting lists when considering the implementation of the health strategy. Preferential reduction of in-patient waiting lists skews resources in favour of surgical procedures. Large groups of disabled patients who require ongoing medical management have been disenfranchised by the current view of the crisis in our health services.
A substantial and adequately planned expansion is urgently required to deliver quality out-patient and community-based care to patients with conditions that are chronic, disabling and not amenable to a "quick-fix" surgical solution. - Yours, etc.,
Dr ORLA HARDIMAN,
Consultant Neurologist,
Beaumont Hospital,
Dublin 9.