Sir, – Fintan O'Toole writes that 46 per cent of the population pays for an inpatient health insurance plan and that this allows faster access to healthcare than the other 54 per cent gets ("Skipping the vaccine queue isn't a breach of the health system, it's the system", Opinion & Analysis, March 30th). He acknowledges that he is one of the 46 per cent (as am I) and that he pays up (as do I) because he is afraid he won't get necessary medical carer when he needs it.
Why is it that a public health system which we fund to the order of about €20 billion each year cannot provide an acceptable level of care to that half of our population which is forced to rely on it?
Survey after survey shows that our system is one of the best-funded in the developed world but also one with outcomes which are mediocre at best. We know we have a problem. What is the solution?
The HSE’s Health Service Employment Report (HSER) shows the growth in HSE and section 38 employment numbers over the period between October 2013 and January 2021. The overall growth was about 26 per cent from 100,000 to 127,000.
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The increase for medical and dental specialists was 41 per cent, for nurses and midwives 18 per cent, and for health and social care professionals 36 per cent.
The headcount in management and administrative roles increased by 32 per cent – not startlingly ahead of the overall increase of 26 per cent. But here’s the startling bit. Within that cohort the increase in the most senior “executive management” roles was from 172 to 364, an increase of 112 per cent.The corresponding increases were 82 per cent in senior management, 62 per cent in middle management and 17 per cent in clerical. An interesting benchmark is that the headcount in home help decreased by 2 per cent over the same period.
In short, whoever was pulling the strings on the resourcing of our health service over the past seven years decided that the solution to our well-flagged problems was a more than doubling of executive management, increases of 82 per cent and 62 per cent , respectively, in senior and middle management, 40 per cent more doctors and dentists and 18 per cent more nurses.
The pen is clearly mightier than the stethoscope. – Yours, etc,
PAT O’BRIEN,
Crossmolina,
Co Mayo.