Madam, - The news that "Harney may appoint hundreds of consultants" (The Irish Times, January 26th) will be welcomed by Irish hospital consultants overseas who are available to return to serve Irish patients. There is no doubt that the Irish health service needs reform, redesign and modernisation, as your readers, as well as Government Ministers, know ever so well.
Patient safety, clinical productivity and engagement with HSE management need to be at the heart of such service reform. This requires systematic embedding, which must include the consultant workforce.
Consultants are the natural leaders in the hospital service. Consultant expansion is long overdue. However the culture and practices of some "sitting" hospital consultants perhaps stifles reform. New consultants should be appointed to oversee and implement reform, without the pressures and distractions of private practice.
Ultimately, improved quality of care, value for money and avoidance of waste are the prizes for the public and the profession. I hope Minister gets on with it. - Yours, etc,
SIMON P. KELLY, Consultant Ophthalmic Surgeon, Bolton Hospitals NHS Trust, Bolton, England.
Madam, - The Dublin coal suppliers did not like the ban on smokeless coal but we like the fresh air. The taxi-drivers did not like deregulation but we can now get a taxi. The solicitors did not like the Personal Injuries Assessment Board but we can now get reasonably priced insurance cover. You can be sure these groups suffered a loss of income with the changes forced on them and, as a solicitor, I can say I have.
All the evidence points to the consultants' common contract being the root cause of the health service problem. The consultants are the gatekeepers of who comes and goes into hospital. It is not unreasonable to ask them to work 40 hours a week so that the well-resourced infrastructure can be used to the maximum. If they want to do private work, let them do it outside the hours we taxpayers are paying for.
The taxi-drivers, solicitors and coal-suppliers had to accept government policy. So should the hospital consultants. Unlike the others, they are in guaranteed State jobs and are assured of a continuing income no matter what happens.
We elected a Government to do a job. Let them get on with it. - Yours, etc,
RODERICK TYRRELL, Haddington Road, Dublin 4.
Madam, - The Government should impose price controls on hospital consultants in their private practice. If prices were capped at €45 per consultation, this would greatly increase the attractiveness of public sector contracts compared with private practice. At the stroke of her pen Mary Harney could improve the affordability of healthcare, reduce our inflation rate and bring the IMO to heel. - Yours, etc,
VICTOR SHEAHAN, Tralee, Co Kerry.
Madam, - Allow me to support Minister for Health Mary Harney in her efforts to break the private sector cartel operated by the highly paid professional sub-contractors to the public health service, commonly known as hospital consultants.
Her battle is one recently won by President Hugo Chavez in Venezuela by the construction of a parallel health service staffed by 30,000 Cuban medics. He broke the private medical cartel and the ordinary people of Venezuela now have equal access to good quality medical care, many for the first time in their lives.
She may have fewer options than he, but her battle is equally necessary.
Let's see an end to the State-facilitated practice of wealthy, educated doctors profiting from the misery of poor, sick Irish people. In any civilised society, healthcare is a right, not a privilege. - Yours, etc,
SIMON McGUINNESS, St Joseph's Cottages, Ashtown, Dublin 7.