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Powder keg over healthcare has simmered away for two decades

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Robbie Dwyer protests against the closure of Roscommon A&E

Robbie Dwyer protests against the closure of Roscommon A&E

Robbie Dwyer protests against the closure of Roscommon A&E

WHAT an hysterical week it has been. The people of Roscommon need to take a very deep breath. As a county they are in danger of collective hyperventilation.

It appears as if rational thought has been abandoned with talk of people getting bullets in the head, texts being sent calling people murderers, and threats of road blockades being bandied about. There was far less brouhaha when the IMF came to the town. Speaking of which, it is extraordinary that in all the talk we've heard on rationalisation of health services the fact we don't have the money for duplication of services -- particularly those that are unsafe -- seems hardly to have been mentioned.

The powder keg that was detonated in Roscommon this week has been building over 20 years, and is a microcosm of all that is wrong in politics and the medical system in this country. You have to wonder what the extent of this week's protest means for the wider economic sphere and the Government's endurance in the longer term.

There are a number of players in Roscommon. We have a Minister for Health who indulged not just in naive but in bad politics, giving unnecessary commitments relating to Roscommon Hospital prior to the general election. He was aided and abetted by two local TDs. Another player is an exceptionally bright, articulate and incendiary independent TD. Luke Ming Flanagan is in some danger of choking on his own hyperbole. The opposition parties are doing what they do best when it comes to health policy, opposing for the purposes of naked political gain rather than any great concern for the local population.

Thrown into the mix are medical and other staff, some of whom have a vested interest in ensuring that the status quo is maintained, who are expert at preserving their own territories. Those who are familiar with both will know that national politics is really rather benign when compared to the bear pit that is medical politics.

Above them is the HSE, which is such a beaten docket in terms of credibility that senior managers could sign pledges in their own blood in relation to Roscommon Hospital and still not be believed.

In the middle of it all are the people of Roscommon who are now in such a state of frenzy and fear that there is little place for logic or common sense. The pre-election promises made to them were most unfair and their bitterness, in that context, is entirely understandable.

Added to the political bumbling and untruths has been the approach of the HSE. People in any part of the country, not just Roscommon, who are asked to accept a change in their hospital services, can quite rightfully point to the experiences of other communities around the country where the process of changing how their health services are delivered has been quite a mess. As far as people are concerned they are being asked to give up what they know and trust, but with really no idea what they are giving it up for.

But the fact remains that patients have been put at risk in a number of smaller hospitals across the country.

The machinations are too detailed to get into here but suffice to say we know the HSE identified a total of 10 smaller hospitals over which it had concerns. There are four remaining hospitals where risks are still being addressed.

The controversial Roscommon hospital emergency department sees only 13,000 patients each year, significantly fewer than other A&E units around the country.

It is usually staffed by junior doctors and has no full-time emergency consultant. You don't need a medical qualification to realise that is not a safe way for a hospital to be treating patients.

The alternative offered, which is the opening of an urgent care centre and more serious emergency cases being transferred to a bigger hospital, makes perfect sense. This is provided, of course, if the new system in Roscommon is properly organised and funded; that there are sufficient ambulances, located in the right places; and enough resources are allocated to the hospitals to which people will be transferred in the future.

There is no denying that given the current state of our health system these are very big ifs. But it is not all bad news. Dr Reilly may have made a hames of Roscommon but hopefully has learnt from it. The signs so far are that he is a resolute presence in the Department of Health.

A friend is recovering this week from surgery after breast cancer.

She is receiving her treatment in St Vincent's Hospital in Dublin and couldn't speak more highly of the experience. She feels comfortable in the knowledge she is attending a centre of excellence, and getting the best treatment available.

SHE thinks it's a pity that women are fearful when things have improved so much. It is not that long ago that we were despairing of the cancer services in Ireland, particularly breast cancer. But this is an example of how things can be turned around. (I appreciate that people in Sligo may disagree.)

That change involved a senior person -- Professor Tom Keane -- being brought in from the outside.

He took responsibility and was seen to be doing so, and took breast cancer as his starting point.

Crucially, he appeared to have access at all levels of the system including political. He had hurdles to jump but the result was the successful setting up of a network of eight specialist cancer centres throughout the state.

We still have catching up to do in cancer treatment, and it will be a number of years before we can properly measure the success of these changes. But there is no doubting the improvement.

Irish Independent