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Editorial - Government must show leadership

In recent weeks the public health service has again been in the news for all of the wrong reasons, beginning with the confirmation that the health service is overspent (I would never accept it had a sufficient budget to begin with).

The reason given for this was because it treated more sick people than was provided for in the ‘service plan’. Then, we had the departure of the CEO of the HSE, Cathal Magee, in what was a very unsatisfactory environment with overt conflict between the HSE and the Department of Health.

After this, an editorial in a national newspaper called for the resignation of the Health Minister due to the fact that he was not in charge of his brief and was uncertain about delivering real reform.

On top of all of this, the Troika (it could be argued the ‘real government’ in the form of the IMF/ECB/EU) told our government that it must further contain health expenditure. Throughout these developments one was left with the distinct impression that our leadership, at political/ policy/operational level, has lost all sight of the true purpose for the existence of a public health service.

It beggars belief that the public health service has been criticised nationally and externally for its behaviour. This is despite the fact that it has improved efficiency, effectiveness and performance in terms of treating more patients, reducing length of hospital stay, decreasing waiting lists, decreasing waiting times for treatment, and delivering more home care visits.

Over the past eight months the public health service – despite huge challenges, unmanaged reductions in staffing levels and ever increasing demand – has demonstrated its ability to respond to the needs of the community. However, instead of being praised, the political and management tiers have criticised its performance, demanded further cost reductions, and stated that the health service cannot continue at its current level of activity and expenditure. This demand that finances must come before patient care is intolerable, unacceptable and inexcusable.

The government must accept that we are at a crossroads with regard to the size, shape, competence and nature of the public health service. It is unacceptable that a government, which knows the health service has performed miracles in the past four years, does not realise that the health service has suffered enough and must be allowed to treat sick people who present for care.

In criticising the political and management system, I am not suggesting that we must not continue to ensure effective and efficient controls over health service finances and the elimination of waste and duplication where it exists. But equally, you cannot continue to cut, both in financial and human resource terms, a health service year on year and still suggest, while you sit in an ivory tower, that same public health service can meet the needs of sick people who have nowhere else to go.

I believe our public health service has never faced a starker challenge. It is imperative that, in tandem with the Herculean efforts of staff, our government defends our service, telling the Troika and others, that further cuts cannot take place without serious societal consequences.

This is about maintaining a health service that will do no harm and will turn no one away. Government, the ball is in your court and we do not expect you to drop it or sell the citizens of Ireland short.

Liam Doran
General Secretary, INMO

PS. The INMO extends a special warm welcome to our new undergraduate degree students, in colleges across the country. This journal is specially tailored for them and we hope that this is the first step in a long, happy and successful career in nursing and midwifery.

Editorial - Government must show leadership
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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