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Editorial - Care of patients must come first

As you know only too well the past 12-18 months for those working in the frontline of the Irish public health service have possibly been the most difficult, most demoralising and most frustrating period in your working life.

Through a mixture of policy initiatives, handed down by government, and as a result of centralised dictatorship, championed by the corporate management of HSE, patients, clients and those in the frontline providing care have seen services curtailed or closed and standards of care diminished. This deterioration has come about as a direct result of the recruitment embargo and the decision making process which removes, from all frontline professionals, control of the working environment and authority to ensure care is at a safe and adequate level.

This headlong rush to slash and burn, is explained away by those who do not know or understand the requirements for safe patient care as being absolutely necessary in the face of the difficult economic and budgetary situation facing the country. Furthermore, as we have sought to explain when recommending rejection of the “Croke Park” proposals, the government, rather than seeing the error of its ways, persists in this flawed approach. They do so by insisting on a further 6,000 job cuts in the health service over the next three to four years as an absolute requirement within the proposed agreement.

When challenged about this nonsensical policy, which would see 6,000 job cuts in a totally haphazard and unplanned manner, both the Minister and the HSE suggest “redeployment” can address all problems arising from staff shortages. This only confirms their lack of understanding about what is needed when working at the patient’s side to ensure their needs are fully met.

In commenting upon this whole issue it is also worth contrasting the approach of the Department of Health and the HSE with regard to frontline staff and the approach of the Department of Education towards the filling of teaching posts. It is quite clear that a political choice has been made, which correctly ensures frontline teaching posts are filled but the same government, or at least fellow cabinet members, do not seem to afford the same importance to protecting frontline health services. Can it be that the existence of a two-tiered health system that ensures those who can pay will access care is clouding the judgement of the government on ensuring the same level of protection for essential healthcare as it appears to be giving to the social good of education for all?

It is against this stark background that the INMO, at our recent ADC, brought forward our alternative vision for the future of our health service which is entitled “Promoting a Better Health Service”. The framework for this vision can be accessed on our website (www.inmo.ie).

It will be clearly seen that the core principles are placing the patient at the centre of the service and giving to frontline professionals devolved power over budgets and the standards of care available to that patient. The INMO recently met with the Minister for Health and we have challenged her to examine our alternative vision, lift the staffing embargo on nurses and midwives and adopt the other measures that we propose so that we can protect care while living within the overall budget framework.

The INMO will continue to challenge the Minister and the HSE to accept our alternative way of protecting the health service because of our fundamental belief that the current approach will damage our health service for decades to come. Notwithstanding our difficult economic situation political choices can be made and the INMO, in its role as advocates for its members and our patients, has put forward an alternative vision.

The government, Department and HSE must now demonstrate, in the interests of patients and staff, a greater willingness to listen than to dictate and direct.

Patient care must come first.

Liam Doran
General Secretary, INMO

Editorial - Care of patients must come first
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Irish Nurses & Midwives Organisation (Cumann Altrai agus Ban Cabhrach na hEireann). The Whitworth Building, North Brunswick Street, Dublin 7. T:0016640600 E:inmo@inmo.ie