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Stark insight into hospital failures

The continuing need for openness and accountability could not be more starkly illustrated than in the report on the Tallaght Hospital A&E department from the Health Information and Quality Authority.

The main reason for welcoming it is that we can learn a lot from it. In particular, given the times we live in, it shows that lack of money was not the only cause of the failures in Tallaght, and perhaps not even the main one.

There is good reason to think that this is the case in much of the health service, although one must hope situations such as that outlined in the report are rare.

But Tallaght may have differed more in the scale of its failings rather than their nature.

The sorry state of affairs, reported by the authority, led to appalling conditions for patients in the emergency department.

But there may be wider problems in what the report calls a "cultural belief" that the routine practice of accommodating patients on trolleys in corridors is acceptable.

The inescapable fact is that the ¿14bn health budget will continue to fall for some years yet, and will see no significant real increase for the foreseeable future. It will need first-class management, sensible structures and determined removal of anyone who is not up to the task, to maintain, still less improve, services.

The report shows just how far we have to go.