The crisis in hospital accident and emergency units will continue until GP and other community-based medical services are improved, the new chief executive of the Health Service Executive (HSE), Prof Brendan Drumm, has said, writes Eithne Donnellan, Health Correspondent
His comments, which would indicate he expects no hasty solutions to A&E overcrowding which Minister for Health Mary Harney promised to tackle immediately with a €70 million plan almost a year ago, are contained in his first newsletter to HSE staff yesterday.
Prof Drumm said in the newsletter, which has been seen by The Irish Times, that the public also need to be educated about the high quality of care available at GP level. "We need to steer people away from thinking that if they don't get treated in a hospital they won't get proper care," he said.
"It must be remembered that we could build and fill twice as many A&E units as we have at the moment, but all we would be doing is making it easier for large numbers of patients to access a service ill-equipped to deal with their particular problems.
"A&Es are for accidents and emergencies. They are not a replacement for primary-care services, and they are not equipped to provide this type of service.
"Only when we develop comprehensive primary care and community-based services will we make a real long-term impact on relieving the pressure on A&Es," he said.
The HSE admitted there were 179 patients on trolleys in A&E units yesterday. The Irish Nurses Organisation claimed the figure was as high as 227.
Prof Drumm, who has listed enhancing the role of nurses, controlling expenditure on medication and negotiating a new contract with consultants among his priorities, will today hold his first media briefing to outline his plans for his five-year term as head of the HSE.
The role gives him responsibility for the health service's €11 billion annual budget and its almost 100,000 staff. He told staff his main priority is to simplify the health system so it will be easier for people to access services and easier for staff to deliver them. "Because it is so complex the system can fail and patients can slip between the cracks," he said.
"To simplify access and our ability to deliver care we must introduce team-working right across the organisation."
Prof Drumm expressed the hope he would be able to quickly negotiate a new contract with hospital consultants. Furthermore, he said efficiency rather than inefficiency must be rewarded. Moving to a system of performance-based funding would be critically important to stop staff becoming demoralised and "to justify increased funding for our services . . . "