Debate is far from over

Remaining issues: So what are we to make of these claims and counterclaims? Firstly, they emphasise the complexity of the issues…

Remaining issues: So what are we to make of these claims and counterclaims? Firstly, they emphasise the complexity of the issues and highlight the practice of using the same evidence to back different conclusions.

However, the detailed analysis and counter-analysis is helpful. It certainly puts pressure on the Taoiseach and the Minister for Health to accurately define what they mean when they say 24-hour medical cover will continue in all acute hospitals.

Do they mean a consultant will be on call from home, as is the case at present? Or are they saying that a consultant-provided health service literally means the presence of consultants in all hospitals 24 hours a day?

The analyses also raise other questions. Have the Hanly reforms been overly driven by surgical considerations - in which there is more evidence that bigger is better - at the expense of common medical illnesses such as pneumonia and heart failure?

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Although the Hanly group was widely representative, some sources have suggested a sub-group of experts had a greater influence. In other words, did those writing the report accurately reflect the input of all those involved in the Task Force?

Finally, should it be acknowledged that the task given to Hanly was too large? Would it have been better if the group had focused more narrowly on the manpower issues considering the short lead-in time to the implementation of the European Working Time Directive (EWTD)?

These, and other questions, are now open for discussion. While the EWTD deadline cannot now be met, let the debate about the future of the Irish health service continue at a deeper level.