Madam, - In the space of less than a week your newspaper has highlighted the tragic death in childbirth of Tania McCabe, the deaths of 15 people in Ennis General Hospital - at least in part attributed to C-difficile infection - and the deaths of between 350 and 500 people every year from the effects of stroke. All of these people might still be alive if it wasn't for staff shortages, overcrowding, lack of resources and bad organisation in the health service.
Yet, unbelievably, in the very same week you report proposals to reduce staff, close beds, curtail A&E services and abandon planned developments so that the HSE can live within its budget. A patient-focused health service has been abandoned for panic-stricken book-keeping to control the budget without any reform of how it is spent.
This must make truly terrifying reading to sick people and their families.
It is time to shout "Stop". It is time to stop throwing good money after bad and to draw up an immediate plan to put the focus back where it should be - on the patient.
This, of course, should have been done more than three years ago when the HSE was being set up. Instead, it was just a cobbling together of old structures with a brand-new layer on top that cannot be expected to deliver results despite the best efforts of Prof Brendan Drumm, whose commitment I do not doubt. In the rush to establish the HSE by the politically-driven date of January 1st, 2005, the shape of the organisation became a hybrid rather than a planned, viable model. Layers of administration should have been taken out and decision-making, with responsibility for budgets, clearly assigned at the appropriate level.
The centralised system is a disaster. It has taken all the power of decision away from those who are closest to the people the system is there to serve.
Minister Harney talks a lot about reform. But there has been no actual reform in the way the service is run and financed. It should be fundamentally restructured so that money and resources are directly related to the care needed and given, in a hospital or in the community. This is generally described as "the money following the patient". The reform so urgently needed will require more money in the short term but will save money through efficiency in the long-term. More importantly, it will put patients at the centre.
Someone needs to stop panicking and take charge. Otherwise, things will only get worse. Already vitally needed new services are being put on ice just to keep the system going.
The Labour Party has long argued for reform that would lead to Universal Health Insurance, which has proved its worth in many countries. The Adelaide Hospital Society has just published its proposals for a somewhat similar model. We must have an engaged public dialogue on what kind of health system we want in Ireland. However, the changes I am suggesting above cannot wait for that.
The stark truth is that, if the HSE's proposed cuts go ahead, services to patients will be further reduced and people will die. - Yours, etc,
JAN O'SULLIVAN TD, Labour Party Spokesperson on Health, Leinster House,Dublin 2.