Tuesday 25 June 2019

Health Minister's job now seems to be telling us all what he can't deliver

Minister for Health Leo Varadkar with Tánaiste Joan Burton. Photo: PA
Minister for Health Leo Varadkar with Tánaiste Joan Burton. Photo: PA
Colette Browne

Colette Browne

Good news everyone. Patients languishing on trolleys are not a sign of a broken health service - they're actually an ingenious ploy to boost staff productivity.

That's according to the Minister for Distancing Himself from Health, Leo Varadkar, who claimed that providing hospitals with extra beds and resources would not solve overcrowding problems.

"When a hospital is very crowded, there will be a real push to make sure people get their X-rays, get their tests and, you know, 'let's get them out in four days'.

"When a hospital isn't under as much pressure, you start to see things slowing down and it might take five, six, seven days to get the person discharged and that's [the] length of stay, so all these different factors come into play all the time," he said.

Evidently, Mr Varadkar favours a no-frills, Ryanair-style approach to the health service, where as many people as possible are packed into an uncomfortable, confined space to be attended to by a minimum of staff before being unceremoniously ejected in as short a time as feasible.

Defending his comments on 'Morning Ireland' yesterday, Mr Varadkar was adamant his remarks did not amount to a suggestion that hospital staff were lazy slackers.

"I didn't refer to staff at all actually … I've never in 18 months as health minister sought to blame the problems in the health service on individual staff," he sniffed.

But, unless there is a secret army of androids performing patients' X-rays and tests in hospitals, it's hard to understand how his comments could be anything other than a dig at frontline workers.

Mr Varadkar's comments were not just an affront to reason, they were also at odds with his own party's commitment to hire thousands of new healthcare workers and open hundreds of acute beds if returned to office - announced with great fanfare yesterday.

In fact, speaking in the Dáil earlier this month, the minister lambasted Fianna Fáil-led governments for closing 1,845 acute beds between 2005 and 2011 and trumpeted the fact that 202 extra beds had recently been made available.

This belated decision to reopen beds makes sense when one considers that Ireland has one of the lowest numbers of acute hospital beds in the OECD, while one consultant, Dr Fergal Hickey, has estimated that A&E overcrowding causes between 300 and 350 unnecessary deaths every year.

Mr Varadkar's disastrous handling of a perfectly predictable question about hospital overcrowding is the latest in a series of gaffes from senior Fine Gael ministers. The party's shambolic start to this election is hard to fathom, given Enda Kenny was the only one in the country who definitively knew the date and time the Dáil would be dissolved. Despite this forewarning, they still managed to make a mess of it.

Mr Varadkar, whose job as minister seems to be to occasionally announce the various things he cannot deliver in the health service, informed us last week that free GP care for all was no longer achievable in the lifetime of the next government.

Unfortunately, Mr Kenny didn't get the memo and when unambiguously asked, "when will there be free GP care for all?", on 'Morning Ireland' on Friday, responded that the party "hopes to deliver it in the lifetime of the next government".

It was left to Mr Varadkar to explain yesterday that the Taoiseach didn't mean what he said, he actually meant something entirely different - that free GP care for under 18s would be delivered in the next five years.

The jettisoning of a core policy proposal makes more sense when one considers the government has failed to add a single GP training place in the entire five years it has been in office. In its programme for government in 2011, the Coalition promised to increase the numbers of GP training places so that free GP care for all could be delivered by 2016.

However, the numbers have remained static since then - 157 training places on a four-year programme, which just about covers the number of GPs that retire every year.

In its latest manifesto, Fine Gael has again promised to increase the numbers of GPs who train every year. Even if they do manage to fulfil their promise this time, those additional GPs, assuming they start training immediately, won't be qualified until at least 2020.

This lack of basic planning and foresight, when it comes to the delivery of such a central policy plank, is nothing new. Having assured everyone that universal health insurance was the panacea that would solve the iniquitous two-tier health system for years, Fine Gael also abruptly dumped that policy late last year, saying it would be far too costly.

To add to the Government's woes, latterly it was revealed that waiting times for emergency treatment are the worst in Europe, cancer survival rates are among the lowest in Europe, while long delays for outpatient appointments jumped 40pc last month alone - with 13,763 people now waiting more than 15 months for an appointment.

There may be worse to come. When the HSE's 2016 budget was being finalised late last year, HSE director general Tony O'Brien, in correspondence with the Department of Health, warned "2016 [would be] the most difficult year the health service has faced over the last 10 years".

In response, the secretary general of the department, James Breslin, questioned the "realism" of this assessment and suggested phrases like "residual funding deficit" and "significant operating shortfall" be dropped from the plan.

Instead of engaging with Mr O'Brien's concerns, the department seemed more interested in pretending they simply didn't exist - determined to present an optimistic appraisal to the public and hope for the best.

While politicians will make all sorts of outlandish promises about the kind of gold-plated health service they will deliver if elected, it's worth remembering that if we even managed to get the basics right - like treating people with dignity and in a timely fashion in A&E - it would be a huge improvement.

Irish Independent

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