Despite the claim this week by the Minister for Health that there had been a significant decline in the numbers of people on waiting lists for hospitals, there is reason to believe that this apparent decline was at least as much the result of administrative audit, or "validation", of those lists as the result of extra services being provided. The fact is that, in recent years, the general trend has been for waiting lists to grow in public general hospitals, notwithstanding extra expenditures by health ministers on a series of once-off bases. That can mean only one thing: the overall capacity of the health services to meet the needs of all citizens is insufficient.
This capacity is currently further challenged by a serious shortage of nursing and medical and paramedical professional staff, and by a steadily growing demand from a population that includes a growing number of new immigrants and returned emigrants increasingly attracted here to meet the growing demands of the economy. This is no short-term problem that can be resolved by occasional injections of extra resources in a vain attempt to shorten the waiting lists. It is a long-term and worsening problem that needs the most urgent and (in some areas) radical action if it is to be remedied.
It is now apparent that the depletion and restriction of resources for the health services which occurred in the 1980s still informs the thinking of Government and civil service alike. Recent disputes with both nurses and non-consultant hospital doctors bear testimony to this, as does the exodus of nurses from the hospital services where there are now close on 2,000 vital posts unoccupied. Even if those posts were to be filled, even if the decline of non-consultant hospital doctors from overseas were to be reversed, even if the consultant establishment were to be expanded, there would still not be enough human resources to meet the current and growing needs of patient. On top of that there is the question of physical resources to be met. Then there are reports of an increase in the number of patients seeking treatment for sexually transmitted diseases (STDs), so that STD clinics are becoming over-crowded and there is a four-week waiting list for an appointment to be seen, diagnosed and treated. This affords four weeks for persons, many of whom have by definition been indulging already in high risk behaviours at a time when the potentially deadly HIV infection is still very much about and spreading, to infect others. The most basic tenets of preventive medicine require instant diagnosis and treatment if the increase is not to become an epidemic. There must be a swift and compelling advertising and educational campaign to warn people of the present danger.
But those parsimonious mind-sets in the Government and the public administration have to be altered, and altered quickly, if all the citizens of this Republic are to receive to hospital care they need at the time they need it and at the high standard to which they used to be accustomed. The Government's Budget is a mere three months away. The Minister for Health must insist to his Cabinet colleagues that its figures must reflect the recognition that health care is deteriorating, that the hospital services require expansion, and that waiting lists are unacceptable if patients' health needs are to be as they should be.