In mid-June the government marked its 100th day in office with a major press briefing by both the Taoiseach, Enda Kenny and Tanaiste Eamon Gilmore. In the course of their public statements, on that day, the leaders said that the government was committed to no increase in income tax and no further cuts to social welfare. Both of these commitments are welcome in these most difficult of times. However, in relation to the health service, if we are to examine the first 100 days, of the new government, then we would have to report that very significant, and in fact, growing, problems remain.
From a nursing and midwifery perspective the first annual report of the Croke Park Agreement (covered extensively elsewhere in this journal) confirmed our worst fears with regard to the dramatic reduction in the number of frontline nursing and midwifery posts in the system. The official figures confirm that we have lost 1,012 nursing/midwifery posts which makes up almost 20% of the total reduction in public service posts over the past 12 months. This dramatic reduction, against the reality that nursing/midwifery only makes up 9% of the total public service workforce, is contrary to repeated promises and public statements that frontline health service posts would be protected.
In addition to this we are facing, as and from July 11, a dramatic shortage of NCHD posts that will inevitably lead to a reorganisation of services in an unplanned manner, resulting in the curtailment or complete cessation of activity in hospitals across the country.
We then have the HSE confirming, in its annual report, that demand for health services continues to increase and that it is exceeding its planned level of service activity. The result is that it is significantly overspent and will have to curtail services, for the remainder of the year, in order to live within its original budget.
Somewhat in contrast to these problems, in recent weeks we had the announcement, by the Minister of the establishment of the Special Delivery Unit with the welcome reallocation of funds from the National Treatment Purchase Fund to assist with reducing waiting lists and the number of people on trolleys. This is potentially a very welcome development that will see some reallocation of monies, which would have been spent in the private sector, back into the very much under-funded and overstretched public sector. However, at this time, it is difficult to see exactly how this Unit will work and operate in the context of the manpower and budgetary issues that we face.
Notwithstanding all of these difficulties the health system continues to increase its productivity, month on month, and the most recent figures confirm a 10% increase in day cases and increased attendances at OPD departments and number of home visits. So, even with significantly reduced numbers health service staff continue to perform miracles, every day, in a valiant attempt to maintain services even in the most difficult of clinical environments.
In this context we must continue to push for the types of reform necessary, which will allow us to deal safely with patients presenting for care. This must involve a significant, rapid and comprehensive shift to nurse-led and delivered services, the introduction of protocols providing for the expansion of the nurse’s role and, most fundamentally, an adjustment to the moratorium to safeguard nursing/midwifery posts and thus minimise clinical risk.
In fairness to any Minister, the challenges are great. However this Minister, in his second 100 days must grasp the reality that nursing and midwifery is, as he has said himself, the glue that holds the health service together. He must allow, without further delay, the empowerment and expansion of the nursing and midwifery role so that we meet the needs of patients presenting for care.
The clock is ticking, the honeymoon period is long gone and stark choices have to be made. Minister, if you protect nursing and midwifery from further cuts then nursing and midwifery will protect the patients that present for care. Make that choice.
General Secretary, INMO
|Editorial - Government: 100 days and counting|