The on-going economic success of this State has done little to improve the quality of our health service. If anything, the service has worsened - that much was made clear by speakers at the Irish Medical Organisation's annual conference in Killarney. General practitioners pointed out that more patients could get medical cards ten years ago than today. They talked of parents on low pay taking chances with their own health and the health of their children because they are not entitled to a free GP service or free medicine. An income which leaves them in poverty is too high to entitle them to a medical card.
The organisation's president, Dr Mick Molloy, spoke of patients sitting on chairs in hospital emergency departments waiting for a trolley on which they will, in turn, wait for a bed. Ten years ago the practice of patients lying on trolleys was seen as an indictment of the hospital service. Today the patient on a trolley is privileged compared to other sick people. Moving older patients out to nursing homes is seen by health planners as one way around the current shortage of beds.
In the light of all this, the lukewarm reception which the Cabinet recently gave to the report of the Medical Manpower Forum came as a disappointment. The report, if implemented, would improve the public patient's chances of being treated by a consultant. Consultant numbers would almost double - a move which, apart from any other consideration, is needed to provide a career path for hospital doctors. Otherwise these doctors, condemned to years and years as trainees and "junior" doctors regardless of how much expertise they have accumulated, will be lured away by an expanding National Health Service in Britain.
The Cabinet seemed to make its approval for this plan conditional on the costs which have still to be negotiated with health service unions. It hardly represents a full-blooded endorsement of the need to improve the quality of our health services. Nobody doubts the commitment of the Minister in this regard but there are growing suspicions that he has a fight on his hands in Cabinet when it comes to getting the money to do the job that needs to be done.
That job is enormous and it is vital that the Cabinet commits itself to seeing it through. We need, at the very least, a huge extension of the number of people who can qualify for free GP treatment and medicines for themselves and their families. We need thousands more acute and rehabilitation beds in hospitals and we need the people to staff those beds.