PSYCHIATRIC SERVICES are reverting back to "the asylum system" as a result of staffing shortages caused by Government funding cutbacks, the Irish Hospital Consultants Association (IHCA) was told.
In her address to the conference, IHCA president Dr Margo Wrigley, a psychiatrist, said community psychiatric teams were at the point of falling apart as nurses were being brought back to hospitals to cover in-patient rosters.
She said that, as a result of the Government's moratorium on recruitment and new strict policies aimed at restricting staffing levels, nurses who retired or left were not being replaced.
Dr Wrigley said the new ceiling on staffing levels took no account of patient needs. She said that in one of the areas where she worked, staff numbers will have to drop by 49 before any frontline healthcare workers can be employed.
The Department of Health should end the moratorium on the recruitment of nurses and put in place a system of targeted redundancies, she added.
Dr Wrigley said she would welcome a policy of replacing services in hospital with those in the community, if this was competently put in place. "In reality, this policy just means a cut in hospital services without any possibility of staff moving to the community. We should be helping people in their own homes. Instead we are going back to the asylum system."
The IHCA president said the Health Service Executive (HSE) was dysfunctional and disconnected from those involved in delivering patient care. She maintained the centralised system for managing the health service operated by the HSE was cumbersome and not fit for purpose.
The HSE's hierarchical system had put extraordinary limits on what could be decided by local services and hospital managers, she said. "To get any decision, layers of bureaucracy have to be traversed, by which time the request has become diluted, deprioritised and lost in the morass."
Dr Wrigley said many managers and administrators were also demoralised. There was a "pervasive fear amongst managers of being seen to step out of line, then losing favour and being moved to the side".
Now, unlike during the cutbacks in the 1980s, there was not even a pretence that frontline services were unaffected, she added.
"Today, the State and its agencies are not just cutting the cost of providing care - they are crudely cutting the amount of care itself."
Dr Wrigley strongly criticised the impact of the Government's moratorium on recruitment and the imposition of a staff ceiling in each hospital and service around the country. By not replacing nurses who left or retired, those remaining in place were put under increasing pressure, she noted.
She warned: "As their numbers drop and the number of patients rise, this pressure increases, making their lives increasingly difficult. So more retire early if they can. The pressure on the remainder increases.
"Agency nurses are brought in, each of whom costs 40 per cent more than directly employed staff, so the budget shoots up, adding to the crisis."
