MERRIMAN SUMMER SCHOOL: The Hanly report has been vilified, subverted and ridiculed in certain parts of the country because its proponents have failed to counteract the deeply-held views expressed by opponents of the reforms, according to UCD Professor of Medicine, Prof Muiris Fitzgerald.
Prof Fitzgerald told the 37th Merriman Summer School in Ennistymon, Co Clare last night that the concept of a seven-day acute medicine, seven-day acute surgery and 24-hour fully staffed A&E service demanded by opponents of the Hanly report was past its sell-by date.
Speaking in Co Clare, where opposition to the Hanly report has been strongest, Prof Fitzgerald claimed the debate in opposing Hanly had become aggressive - "where Hanly will mean 'people will die' and worst-case scenarios are ingeniously constructed usually involving life-threatening incidents occurring in geographically remote areas".
He said: "This kind of 'competitive shroud waving' where deaths from heart-attacks vie with demises from car accidents has been brought to a fine art in Ireland. These are powerful images which Hanly proponents have not matched."
Prof Fitzgerald warned the advocates of reform that "unless concrete stories and images of life saved are emphasised, the compelling arguments for reform can be drowned out by graphic sloganeering of those resolutely opposed to any change".
He added: "Proponents of the Hanly message must counter with powerful images of lives saved, limbs salvaged and reconstructed, cancer and heart disease survivors living better and longer lives, and safer and more successful surgery."
Prof Fitzgerald said the Hanly report had generated huge controversy, bringing spectacular public marches in a small number of provincial towns, and provoking shrill congestion of the local, regional and national airwaves, pickets on the Dáil and multiple sieges and protests at councillors' houses, TDs' clinics and Dáil chambers.
He added: "All of this despite the unstoppable logic and rightness of the Hanly prescription for better hospital services in every region of the country. Its implementation would, in my opinion, transform the efficiency, effectiveness, safety and equity of Irish healthcare.
"It provides a model that ensures that the major additional resources that are required to be put into a reformed hospital system will reliably deliver ambitious health targets, reduce waiting lists, and attract and retain the best and the brightest of doctors to its training programmes.
"Most of all, the Hanly formula will redress geographical and regional imbalance and make each region of the country highly self-sufficient with a large expanded array of new effective services delivered by multi-disciplinary teams - thus preventing the current haemorrhage of referrals out of the regions towards Dublin, Cork and Galway."
On the bid to implement the Hanly reforms, Prof Fitzgerald said ultimately it might not be "subtlety of discourse or the negation of powerful images by even more powerful counter-images", but that it might get down to the notion of trust and a commitment to dialogue and then to put services in place conjointly, with consultation, in a highly visible way in the pilot sites.
He said a key initial principle should be that no service was withdrawn until its clearly superior replacement service was introduced.
"Another crucial principle is that every new service in a region must bring a dividend both for the new regional centre and the network of smaller hospitals."
Prof Fitzgerald said the pilot sites should see "concrete evidence" of improvements.
"But two things are certain - no party or interest group can veto, on the one hand, or on the other hand, steam-roller through the reform package. It cannot be introduced by stealth - neither can it be blocked or shouted down by the enemies of progress.
"These programmes have so much to offer the regions now and in the future, that no responsible group can turn them down."
He said a "fantastic opportunity" had been provided to the regions to create "superb community-responsive services" that would be a model for the rest of the country and "bury forever the dependence on Dublin".
