The stress imposed on both staff and patients in our hospitals, even in the best of circumstances, is considerable. In recent years, it has reached an unacceptable level because of the failure of successive governments to provide the most basic resources so that patients can be diagnosed and treated quickly and effectively.
The stress is amplified when patients are placed on waiting lists and then discover that their caring staff are unable to find the time to listen and talk to them about what is happening. In the case of the staff, the unacceptable level of stress is manifest in their individual withdrawals from the public hospital service because of their inability to fulfil their vocational commitments.
It is a vicious circle which has, in recent decades, caused a decline in the quality of care in Irish hospitals from a level which was among the best in the world. The absolutely unacceptable two-tier system evidently drives more and more people into paying for health insurance in the hope that they will be able to by-pass the increasing queues for hospital care. And, apart from that vicious circle, there is a very long-standing need to ensure that all patients attending a hospital can have medical care provided by fully qualified consultants rather than by qualified non-consultant doctors who still need the additional training of supervised experience to hone their expertise.
There is every reason, then, to welcome the report in Thursday's editions of this newspaper that the longawaited publication of the First Report of the Forum on Medical Manpower is now imminent. This report deals with many of the issues which have created the problem of decline in the quality of Irish hospital services even if it was not mandated to address the damage to hospital services which resulted from the cut-backs of the 80s. This widely-representative forum has assented to very significant increases in the numbers of consultants in Irish hospitals, has acknowledged the pressing need for career structures and formal training programmes for non-consultant doctors and the need to integrate proposed changes in medical staffing with relevant changes in nursing structures recommended by the independent Commission on Nursing a couple of years ago.
The full implementation of the Forum's proposals will take time and will be costly. (An estimated £800,000, for instance, will be required annually to provide the support services that an average consultant will need, and it will need the addition of more than 600 extra consultants to bring Irish hospital services up to the level that exists in Scotland.) There is also a clear requirement to increase the number of hospital beds to provide for the needs of the growing and increasingly elderly population that now needs hospital care.
This State's record in the implementation of reports on our health services is not good. But regardless of the costs in this case, and acknowledging that there is still much work to do on the detail of the report's substance, urgent implementation is essential to ensure that our hospital services can be rescued from the crippling despond into which they have spiralled in recent times. It will be costly, but it is necessary.