Wednesday 13 November 2019

Primary health care delusion

HSE spokespeople seem to equate low hospital admission rates with "quality effective service". This is delusional.

Fewer people, an estimated 53,000, will receive care they need if admissions to acute public hospitals are cut as planned. Better co-ordination will not solve problems of scarcity.

It is absurd to talk of "timely access" to "clinical decision-makers" when doctors are in such short supply.

Ireland's per-head ratio of hospital specialists is extremely low, as is the country's complement of family doctors. Primary care is a mirage. Of the planned 200 primary care centres, only 50 will be operational by 2011. Of the 530 primary 'teams' promised, only 110 were in place by May 2009.

These were denounced by leading GPs as "virtual".

Even if these cyberspace teams had an earthly existence, "moving" care from hospital to the community is a vast and untried experiment. Central to this is the culling of 2,000 acute public beds -- in a country with one of the lowest bed-to-head ratios in the developed world.

Although there is little evidence they work, US models of chronic disease management are now being implemented in Ireland under HSE's so-called "transformation programme".

A new internal market is being created under the banner of "integrated" care. Public hospitals may lose significant funding unless they can "compete".

Chronic diseases, such as cancer and diabetes, are being brought to market -- patients will effectively be sold in batches to the lowest bidder. The new disease contracts will "integrate" primary, hospital and continuing care, while destabilising and disintegrating public hospitals. Private hospitals in receipt of public monies hitherto reserved for public institutions will be the only winners.

The HSE's spin on privatisation, aka 'modernisation', badly needs exposing; when will the media begin to question it?

MARIE O'CONNOR
Dublin 7
(Author: 'EMERGENCY: Irish hospitals in chaos')

Irish Independent

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