A propaganda war is being fought over the nurses' dispute, writes Eithne Donnellan, Health Correspondent
It's often said that truth is the first casualty of war.
And in the current war of words between nursing unions and the Health Service Executive (HSE), the truth also looks like it may be taking a bit of a bashing.
On a daily basis, the HSE, for instance, attributes congestion in a number of hospital accident and emergency departments to the current work-to-rule by some 40,000 nurses who are members of the Irish Nurses Organisation and the Psychiatric Nurses Association. The examples which have been given include the A&E departments of Our Lady of Lourdes Hospital, Drogheda; Cavan General Hospital and Dublin's Mater hospital.
The two nursing unions have hit back, saying delays in these A&E units have been an ongoing problem for years and not something that can now suddenly be laid at the door of nurses on a work-to-rule.
So what is the true position? In reality it's probably halfway between what the HSE and the unions are saying.
After all it's likely there would still be congestion in some A&E units even if the nurses weren't engaged in industrial action. But it's also likely the ban on answering routine telephone calls by nurses involved in the work-to-rule, as well as their refusal to use computers in places like A&E, is slowing down the movement of patients through hospital emergency departments.
Dr Eamonn Brazil, an A&E consultant at the Mater hospital, believes current congestion in the A&E unit of his hospital is partly due to the nurses' dispute but also partly due to ongoing issues which have been highlighted many times. "The difficulty is there is no spare capacity. We are constantly overstretched. So there is no give in the system for something like this," he said.
The HSE has also claimed over the past week that a number of hospitals have had to cancel elective surgery as a result of the dispute.
But again the nursing unions point out that cancelling elective surgery is a regular occurrence in many hospitals. And we know from information released under the Freedom of Information Act that close to 22,000 operations were cancelled by 34 hospitals across the State in 2005.
Some operations probably had to be cancelled as a result of the dispute but whether all cancellations that occurred can be attributed to the nurses' action is difficult to tell.
Fine Gael health spokesman Dr Liam Twomey says he thinks a lot of the problems the HSE are claiming are caused by the work-to-rule, such as the cancellation of surgery, are already endemic in the Irish healthcare system. "In my own area of Wexford the endoscopy list has been cancelled every second week for the last 18 months," he said.
"So to some degree the HSE, I feel, are hyping up the impact of the nurses' action on how the hospitals operate. Having said that, I'm not for a moment downplaying the patient safety concerns I have myself," he added.
Prof John Nolan, a consultant at St James's Hospital, Dublin, said it was ridiculous to say things were any worse in hospitals because of the nurses' action.
"It's a smokescreen. Contrary to what has been suggested by the Minister and others, things hadn't improved in the first place. To improve A&E figures, hospitals have been forced to hide patients in other parts of the hospital like day wards and outpatient clinics, forcing the treatments in those facilities to be cancelled," he said.
However, Louise McMahon, hospital network manager with the HSE, argues that the industrial action is having "quite a detrimental effect" on the flow of patients through A&E.
The HSE had made significant inroads into the A&E problem before the dispute began, she said.
But no matter which side one is on, it is inevitable patients will be distressed and their families inconvenienced by the current dispute. Therefore, the sooner the warring factions are brought together in an attempt to find a peaceful settlement, the better.