AFTER A year which saw the spread of the first global influenza pandemic in over four decades, there is a need for continued vigilance in 2010. So far the Republic’s health service has responded sensibly; the death rate from the disease has been less than it might have been, although the severe viral infection has hit those with pre-existing medical conditions hard. But the national swine flu immunisation programme must continue, with a particular need to maintain high vaccination rates among younger children. The virus may be on the wane at present but the nature of pandemics is one of cyclical waves of infection, with the ever-present danger of a mutation of the influenza bug leading to more severe illness.
The coming year will see also the departure of Prof Tom Keane, the State’s first cancer control director. He will return to British Columbia, having significantly revamped our cancer services. A quietly competent individual, he circumnavigated the sometimes incestuous waters of Irish healthcare with great skill. It is widely accepted that he has permanently improved cancer care here, an achievement for which he deserves gratitude.
Probably the greatest challenge facing the public health system in 2010 is the significant cut in its budget. Both capital and day-to-day spending have been severely pruned. With about €1 billion gone from the 2010 health budget, there will be an impact on patient services. Already there is evidence of a shortage of essential items like wheelchairs and other aids and appliances for people with chronic neurological conditions. Refurbishment grants to enable people with disabilities remain in their own homes have been severely curtailed.
Unfortunately, cuts like these, well away from the front line of acute medical care, will erode the system’s capacity to look after people in their own homes and communities. Not alone does this conflict with the main plank of public health policy – that of developing our primary care services – but cutting services for the chronically ill directly impacts on waiting times in hospital emergency departments. These patients become acutely unwell following the withdrawal of home supports and so place additional pressure on hospital services.
It must be acknowledged, however, that after years of increased funding, there is fat to be cut from the national health budget. Failed talks between public service unions and the Government in the run-up to the Budget had a silver lining in the form of proposals to save money by transforming work practices in the health service. The unions must not turn against their own proposals, including an offer to extend the hours that constitute the normal working day. This step alone would bring significant savings and improved efficiencies across the health service. Although understandably bruised by the outcome of the talks, health service unions must act in the national interest by further exploring opportunities for change with Government.
It will not be easy to maintain services this year. But from adversity comes opportunity, which must be grasped in the interests of patients and their families.