Madam, - The current commentary on Irish hospitals seems to avoid saying the harsh words that there is a crisis in the Irish health system.
On the one hand, the State cannot invest in the hospital infrastructure owing to the enormous amount it spends annually on the running costs (and other budgetary constraints), and on the other hand, there seems to be inadequate control on that annual spending.
Are there any simple solutions? Unlikely, and I don't purport to have the answers, but it does seem logical that building the infrastructure by tax-driven incentives should achieve the first objective facing the State.
It would contain the costs of building new hospitals and would deliver them in a faster timeframe. Of course, the State would be obliged to lease the buildings from the owners but that is all it would have to do.
And the rental values are likely to be less than would otherwise be the case, owing to the tax incentives which would reduce the costs of development. So really all that matters in this scenario is that the State protects itself by negotiating a keen buy-back clause.
The hospital building would be managed and run by the State (however it should decide to do this, whether by direct employment or engaging specialists in hospital management) thereby providing hospital services to all patients. The notion of "private" hospitals was driven out of frustration with the existing infrastructure and the existing management inadequacies.
Any reservations which one might have regarding the morality of tax incentives as a means of building the infrastructure should be tempered in the knowledge that the end product would represent good value and deliver quickly.
Regarding the controls on annual spending, one can only infer that the State is happy with the status quo of being one of the higher-cost health systems in the EU, otherwise it would be implementing the procedures and practices which would eradicate wastage, over-payment for poor services, and gross mismanagement.
It might resolve some issues by engaging independent hospital managers to implement these practices and procedures, and we might expect some of the vested interests to accept changes in the interests of our patients.
The HSE has to be allowed some time to hone its knife, sedate the patient and commence operations, but it has also to be cognoscent of the fact that the patient has arrived at the accident and emergency department oozing blood and gasping for oxygen. - Yours, etc,
TOM WALSH Johnstown, Navan, Co Meath.