Hospital consultants must accept their share of the blame for problems in A&E departments rather than constantly calling for more beds, the head of the Health Service Executive (HSE) said today.
Prof Brendan Drumm
The spectacle of hundreds of people sleeping overnight on trolleys in A&E departments has led consultants to call on the Government to meet their pledge of providing 3,000 extra beds by 2011.
But Prof Brendan Drumm said this was a very easy statement to make. "For people to come on radio programmes telling me that all it needs is more capacity, more capacity, more capacity and never mention once that they might have a process issue within the structure when you're dealing with the type of figures I'm talking about seems to me a little unfair to the taxpayer," he said.
At the Joint Oireachtas Committee on Health, Prof Drumm said that in some departments such as radiology, patients were left waiting overnight for ultrasound scans because consultants only worked from 9.30am to 5.30pm.
"The clear resolution to that is to expand our working day, send the patient home, and let the patient (sleeping on a trolley) in from A&E," he said.
The committee heard that the negotiations on a new consultants' contract had been suspended last month, partly due to concerns raised by the consultants' associations about being restricted to work in public hospitals only.
But Labour Party health spokeswoman Liz McManus said she heard Prof Drumm talking about being under pressure from consultants demanding more beds.
"First of all I say 'Get used to the criticism'. I hear that doctors in very important positions are being told to shut up," she said. Ms McManus said the public needed to hear the views of doctors and that any muzzling of them was wrong.
Prof Drumm went on to address the controversy surrounding the HSE's €12 billion 2005 budget - after €56 million of funding for capital investment projects was apparently used for current spending instead. He said he was pleased to say that the HSE had balanced its budget.
He explained the discrepancy by saying that the HSE had two separate accounting systems to reconcile and had been using provisional figures. He said there was now a surplus of €51 million in the capital spending account and a surplus of €39.8 million its income received from the Government.
Prof Drumm said the key problem in the health service was the deficit in primary care, with a lack of alternatives to hospital treatment for people around the country, particularly in Dublin.
"Historically people have looked on their hospital as their health service. But GPs are the most skilled providers of care that are available to us," he said.
The Tánaiste and Minister for Health, Mary Harney
Prof Drumm said an additional €60 million was being spent on primary care services this year, with plans to set up 100 primary care teams around the country.
Tánaiste Mary Harney told the Oireachtas Committee that despite the problems in A&E departments, there had been major successes in improving the health service. She said that 110 consultants and 329 nurse specialists had been hired to improve cancer care and said that death rates from heart problems were down by 50 per cent due to increased interventions.
She said that she agreed with Professor Drum's contention that the problems in the health service would not be solved simply by providing more beds. "There's no question of beds for the sake of them. If we had 5,000 more beds today, we'd probably still have problems," she said.
However, Ms Harney said that 800 of the 3,000 extra hospital beds promised by the Government had been delivered and added that more would come on stream this year.
But Fine Gael Health spokesman Liam Twoomey said cervical screening, radiotherapy and cancer services were still not up to international standards. "There were 200,000 medical cards promised, and that has been watered down to 200,000 doctor-only medical cards," he said.
PA