Tuesday 12 November 2019

Reilly can stop inefficiencies -- and save kids' lives -- overnight

Closing beds to stay within HSE budgets is leaving operating theatres empty, writes John Crown

John Crown

I have a certain level of outrage this morning over a report commissioned by the Irish Government, and conducted at great expense by international experts, which found that the same Irish Government was blameless in a major national disaster, one that threatens the health, and indeed the lives, of many of our citizens. I am not referring to the Nyberg Report into our property-bubble driven banking crisis, which after its solemn deliberations were over, and a trifling million euro spent, told us that we had a property-bubble-driven banking crisis.

No, other than the opportunity cost to our health and social services of the million, and the frustration of those who hoped that it would lead to the sight of hooded bankers, developers and Fianna Failers being paraded to the gallows, the Nyberg Report won't actually cause any damage. It's harmless waffle.

The situation may be entirely different with the as yet unpublished but widely leaked Meridian Productivity Report into the Dublin paediatric hospitals, a report which, if misinterpreted, has real potential to harm Irish children. Why?

Readers may remember the controversy about the effects of budgetary cutbacks on Our Lady's Hospital for Sick Children in Crumlin, a fine institution that has achieved an international reputation for excellence in paediatric medicine and surgery despite being quite grotesquely understaffed and chronically underfunded (I refer readers to the articles section of my website www.JohnCrown.ie).

As a result, waiting lists are unconscionable, with corrective surgery for children with crooked spines a particularly egregious example. Tragically, the average Irish patient has worse spinal deformity at the time of surgery than international comparators. Delayed surgery means more expensive surgery, with longer rehabilitation and greater complications. It's not just immoral, it's dumb.

Yet, according to Meridian, operating theatres are working at far less than capacity due to management inefficiencies. The implication that is already being taken is that the hospitals are, in fact, adequately funded by Government (who entirely coincidentally paid for the report), and that treatment delays are due to internal hospital-level inefficiencies.

The reality is somewhat different. The HSE and Department of Health positively demand inefficiency of all of our public hospitals. Operating theatres running at full capacity cost more money than empty operating theatres. How do we keep them empty? Simple. Close the beds which the surgery patients need. This is exactly what has happened in Crumlin. Many beds have been closed down to enable the hospital to live within its HSE-mandated budgetary constraints.

If the bed is closed, the patient who needs the operation can't get in, and the operating theatre is empty.

In fact, Meridian Productivity, who are a British management consultancy who seem to specialise in government-funded work, should compare Crumlin to other institutions, such as Birmingham Children's Hospital, if they want a measure of efficiency. Birmingham has roughly the same number of beds as Crumlin, but three times as many specialists and twice the operating budget.

If the new Minister of Health James Reilly succeeds in implementing the type of reform that his Government espouses, then these problems will cease overnight. Institutions will have the incentive to use every resource efficiently.

However, if we persist in our plan to make an unprecedentedly generous foreign aid donation equivalent to 1,000 times the annual Crumlin budget to the dummkopfs who thought our real estate market was a good investment, then we will see a lot more empty operating theatres and beds.

John Crown is a consultant oncologist, and a candidate for Seanad Eireann the NUI panel. www.johnCrown.ie

Facebook: John Crown for Seanad; Twitter: ProfJohnCrown

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