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Editorial - Turning point for health service

It is my belief that January 17, 2012 marked a major turning point for the existence of a public health service, fit for purpose, in this country.

On that day, both the Minister for Health and the HSE openly acknowledged – when presenting the health service plan for 2012 – that there would be significant cutbacks in services and that the system would be unable to meet expected demand.

Past health ministers, supported by the HSE, argued that reductions in health expenditure could be realised while maintaining ‘existing levels of service’. Indeed they were proved partially correct because activity figures show that the health service, despite declining resources, increased its activity levels every year for the past five years. It also exceeded most of its treatment targets thanks to frontline staff.

However, every INMO member realises that this was achieved in the context of a significant drop in the quality of care available to patients, caused by staff shortages and the loss of patient dignity and privacy, due to ED overcrowding.

This year it has been openly acknowledged that the level of funding allocated will not allow previous levels of service to continue; and there will be contractions, cutbacks and a complete curtailment of services in all areas, without exception.

One direct manifestation of this is the statement that the public service will lose 555 long-term nursing home beds in 2012. A deeper analysis of the service plan also confirms year-long closures of acute hospital beds in most acute hospitals across the country. There will also be a decrease in in-patient treatments and in day-patient activity.

All of these tangible cuts in healthcare services will be further exacerbated by the unmanaged and uncontrolled loss of more than 3,300 staff, who have indicated their intention to leave on or before February 29, 2012. This includes over 1,640 nursing and midwifery staff, who intend to avail of their right to retire in the next four weeks. Even at this late stage, the HSE is unable to confirm how many of these posts (the majority of which are frontline) will be replaced, or how it will ensure that all patients receive safe care through the safe practice of nurses, midwives and other health professionals.

It is necessary for every citizen to think about the repercussions of dismantling our public health service. Political choices are being made: it is apparent that all recent governments formed the view that the health service is not an essential social good, but something that can be curtailed and contracted without consequence.

Perhaps this is simply a side-effect of our two-tiered health system in which over 50% of the population hold private health insurance and believe that they will be minimally affected by contraction of the public health service. Maybe it is because the remaining 50% are arguably less able to engage with the political system, and therefore unable to urge it to protect the essence of a civil society.

Our society must unite and force the entire political system to safeguard our public health service. Regardless of the political party in power in the UK, the National Health Service (NHS) has always been a prized possession, protected by the UK government. It is time that we treated our own public health service with the same sense of urgency, importance and pride – our health is our wealth.

We must not allow our public health service to contract so much that the citizens of Ireland are unable to be cared for – in a proper and quality-assured way – when they need it most.

Liam Doran
General Secretary, INMO

Editorial - Turning point for health service
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