Madam, - In your Editorial of January 31st, "Harney's medicine for the consultants", you suggest - like so many others including politicians - that a new contract for hospital consultants would resolve the problems of our hospital services. Regrettably, the solution is not that simple.
Urgent elective operations were (again) cancelled at St James's Hospital on Monday due to a lack of intensive care beds. Most outpatient appointments at Letterkenny General Hospital were also cancelled on Monday (not for the first time) because of the overflow of patients from the accident and emergency department into the outpatient clinic areas.
These are but two examples of the daily problems which occur in hospitals and which arise solely from the lack of beds and parallel resources.
On the positive side, St Luke's Hospital, Kilkenny has been highlighted as an example of how emergency departments, combined with acute medical units, can provide a rapid, high-quality service to patients. In this case, extra inpatient beds, intensive care facilities and step-down beds were provided to ensure that the acute medical unit could work properly.
The consultants in Kilkenny, St James's and Letterkenny all have the same contracts. The only difference is that one hospital got the resources while the others have not.
The appointment of extra consultants and the negotiation of greater flexibility for all staff working in hospitals will certainly contribute to an improved service. The IHCA has long supported more flexible work practices and the appointment of extra consultants. However, while we have overcrowded conditions with urgent admissions being cancelled in their thousands, our hospital services will continue to stumble from one crisis to the next. Equity and fairness can only be delivered through capacity.
We have the Minister for Health promising us 3,000 extra beds in our public hospitals. At the same time, we have the chief executive of the HSE telling us that we have enough beds. How can we make progress when there is such a fundamental difference of opinion between the political head and the administrative head of our health services? - Yours, etc,
FINBARR FITZPATRICK, Secretary General, Irish Hospital Consultants' Association, Dublin 14.
Madam, - I was thrilled to hear Dr Liam Twomey, Fine Gael's health spokesman, pledge full backing for Mary Harney's ultimatum to hospital consultants. This could be as significant for the health services as Alan Dukes's "Tallaght strategy" was for our economy 20 years ago.
Of course, like all self-serving vested interest groups trying to protect their own featherbedded position, the consultants will bully and threaten all sorts of disruption. So what? By their restrictive practices, their milking of private patients and their miserly allocation of time and resources to their public patients, the consultants have disrupted our health services for the past 50 years.
All politicians must take this opportunity to break the consultants' stranglehold on our health service - or public patients, in particular, will suffer needlessly for another 50 years. All right-thinking people must now stand four square with Mary Harney to make this happen. - Yours, etc,
DICK KEANE, Silchester Park, Glenageary, Co Dublin.
Madam, - In the week of January 22nd to 29th I worked for 57 hours in Mid-Western Regional Hospital, Limerick and in addition provided emergency radiology cover for the Mid-West region for a further 64 hours. I look forward to Ms Harney's proposed new consultant contract, when I will be working significantly shorter hours for a significantly greater salary. - Yours, etc,
FINTAN WALLIS, Consultant Radiologist, Mid-Western Regional Hospital, Limerick.