Madam, – I am a consultant neurologist who is proud to be associated with the AMNCH (Tallaght hospital), despite all its failings. However, I am fed up with the Department of Health and the HSE wringing their hands in public every time there is a perceived “systemic failure” in the system, as if it had nothing at all to do with them. They then feed selected health statistics to journalists who willingly write their diatribe and become judge, jury and hangman all in one.
Let us look at some alternative health statistics that have not been circulated in the past couple of weeks by the Department of Health and the HSE, which might show the AMNCH in a somewhat better light:
Out-patient attendances:
AMNCH: 209,304. St Vincent’s University Hospital: 137,307. St James’s Hospital: 166,751.
Emergency attendances:
AMNCH: 78,271. St Vincent’s University Hospital: 40,869. St James’s Hospital: 47,062.
In-patient discharges:
AMNCH: 22,265. St Vincent’s University Hospital: 15,971. St James’s Hospital: 22,006.
These figures are from the HSE Service Plan 2009 (Appdx pges 78-81). I presume the HSE and the Minister of Health were aware of these statistics. If so, how can they justify the numbers of radiologists for instance in St Vincent’s University Hospital compared to the number in AMNCH, when on every parameter noted above AMNCH has more patients in out-patient clinics, in-patients and in the A & E department?
Which hospital has the lowest number of whole-time equivalents of radiologists? What have the department, the Minister or the HSE done to correct this deficit? Why are they so reactive to a problem rather than proactive in preventing a problem? Maybe journalists should look at some of these issues.
When Prof O’Dowd sees the figures above maybe he will show a little more understanding as to why the problems have arisen; despite these deficiencies we still manage to see more patients than the other nearby institutions which he obviously thinks perform much better than we do.
Turning to my own department – neurology. Until 2006, I was essentially single-handed. Since the early 1990s, several reports on the neurology services in Ireland have been produced and identified the deficit – the latest “Neurology Needs Document” still remains unpublished.
Although to be fair, the Department of Health and the HSE have steadily increased the number of neurologists in the country, we still have the worst ratio of consultants to population in the developed world, comparable to those in many undeveloped countries.
Thus, with the best will in the world, it is impossible to satisfy all the needs of the patients or the GPs in the locality for neurological services. My clinics are fully booked up for over one year ahead and that is despite seeing more patients than would be judged safe to see in any objective assessment and certainly way above the Association of British Neurologists’ recommended figures.
My department is not alone; many of the departments in the hospital struggle without the appropriate space or staff to provide a full service of the type that we would all like.
If the money followed the patient, then AMNCH would have a much higher income to give the level of service that we would all love to provide.
None of this is to deny many of the problems that have been identified in the past few weeks, but I refute the idea that it is AMNCH’s fault alone. The Department of Health, the Minister and the HSE all regularly produce their own statistics, some of which I have identified above and thus they must have been aware of the relative deficit in the radiology department – why did they not take action before now? – Yours, etc,