More to latest health crisis than the flu

Sir, – As the latest health crisis continues to unfold, I read that Minister for Health Simon Harris has order that a “bed capacity review” be undertaken as a matter of urgency.

With such reviews now being the order of the day, might I recommend that he also urgently commission a comprehensive “GP capacity review”?

I am perhaps somewhat biased but do believe that the rapidly unfolding crisis in general practice is going to be the final straw in what is becoming an existential crisis for our health service and country as a whole.

As a practical example, in four weeks, the appointment capacity of my practice is going to reduce by 16 per cent when my colleague goes on maternity leave. It has simply not been possible to secure a qualified locum to replace her.

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Furthermore, over the next two years, our appointment capacity is certainly going to reduce by a minimum 25 per cent due to demographic change and retirement.

Let me spell it out for people: very few doctors currently want to work in Irish general practice.

Those that want to work outside of the main urban areas are as rare as hen’s teeth.

It appears that few of the in excess of 1,000 senior HSE managers want to even acknowledge let alone begin to address this issue.

Communities around the country have long benefited from an excellent GP service while often being failed by an inefficient two-tier hospital system. I fear greatly for the health and wellbeing of the Irish population as this crisis worsens. It can only worsen the huge health inequalities that already exist.

History will not be kind to a management system that ignored clear warning signs for at least a decade that the service was both underfunded and unviable in many cases.

It will be even less kind to politicians who saw general practice during this time as a mere conduit to vote buying with nonsensical policies such as introducing “free” care for population cohorts into an already overburdened service.

The Minister for Health should make no mistake – the flu is far from the cause or source of all our problems in health. – Yours, etc,

Dr SHANE CORR,

Carrickmacross,

Co Monaghan.

Sir, – Living abroad, I have had the opportunity to share stories about Ireland to people from all across Europe and further afield. As emigrants, we are provided with the opportunity to compare and contrast livelihoods with those who have come from different countries throughout the world. As part of my collection of Irish stories, I sometimes recount the time I spent four days in one of Dublin’s A&E departments back in 2011.

As part of the discussion, I usually ask those around me how long they think I stayed on a trolley before being moved into a ward.

To date, the responses have included the following: “Four hours?”; “I am going to say something extreme like six hours?”; “You couldn’t have been on one for more than eight hours. Otherwise it would have been in the newspapers.”

If only those individuals could see the stories appearing in Irish newspapers these days. – Yours etc,

MICHAEL BRUTON,

Brussels.

Sir, – The never-ending demand “more beds, more beds” by the various “experts” as the solution to the current A&E trolley situation calls to mind the great satirist HL Mencken when he wrote “for every complex problem there is an answer that is clear, simple, and wrong”. – Yours, etc,

CATHAL O’SULLIVAN,

Rathmines,

Dublin 6.

Sir, – In the light of the current correspondence on the performance of the Irish healthcare system, readers might be interested to know how Irish expenditure on healthcare compares to some other countries. The OECD collects and publishes such data on a regular basis. The following are the figures for Ireland and a small number of other countries (total expenditure in 2015 per head of population in US dollars): Ireland $5,131; the US $9,451; the UK $4,000; France $4,407; Finland $3,984; OECD average $3,814

Apart from the US and Ireland, these countries provide universal free healthcare coverage. The US is an outlier, with expenditures more than twice that of other countries while leaving a significant proportion of the population without health cover.

It is not difficult to work out who benefits from this. Ireland is also out of line with the norm in developed countries. We should look more to Berlin than Boston for the right approach. – Yours, etc,

MICHAEL FITZGIBBON,

Dublin 4.

Sir, – The “trolley count” compiled by a vested-interest union now appears to be the litmus test as to how our health Service is performing. Politicians from all parties queue up to add their soundbite as to how we have arrived at this near-crisis situation. These same politicians are fully aware that we spend a higher share of national income on health services than any other developed country, other than the US, but with far poorer outcomes.

When will our politicians accept the fact that our health service is broken. It needs fixing, not more money. It is controlled by vested interests, both unionised and non-unionised. It is weighed down by inefficiencies and restrictive practices, with expensive imaging equipment and operating theatres lying idle over weekends and most of the night.

Politicians need to take on the vested interests and introduce meaningful reform, and hopefully we will have a health service that delivers outcomes proportionate to our spend.

Politicians, heal thyself! – Yours, etc,

DONAL O SULLIVAN,

Blackrock,

Co Dublin.