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Public and private sectors must fight austerity

• For the first quarter of 2013 retail sales came in much lower than expected. The reason for this is ongoing reduced consumer confidence, as one authoritative economic commentator noted: "As things stand, all consumers are seeing is more austerity, more taxes and less disposable income."


The Coalition's response to the rejection of Croke Park II also prompts concern. If no agreement is reached, public servants will face potential pay cuts, a permanent freeze in increments and loss of protection from compulsory redundancy.

The US Economic Policy Institute has said that public-sector job cuts also cause job losses in the private sector. First, public-sector workers need to use inputs into their work that are sourced by the private sector. Second, the economic 'multiplier' of state and local spending is sizeable.

For every dollar cut in salary and supplies of public-sector workers, another 24 cents is lost in purchasing power across the economy.

Clearly there needs to be some reduced public spending on the pay side, especially for higher-paid public servants. Fairness and equality, however, decree that there also needs to be reduced pay for high earners in the private sector, especially those on exorbitant incomes.

Austerity fatigue is growing. Last Saturday in Iceland the Independence and Progressive parties were returned to power after years of biting austerity measures. Significantly perhaps, from the Fine Gael/Labour Coalition's perspective, the Icelandic electorate returned a centre-right government that had ruled over their country's financial collapse just five years previously.

On the same day, a Red C opinion Poll showed that most voters, including those in the private sector, have more sympathy for the public service unions than perhaps might have been expected.

Fundamentally, there is increasing awareness that the well-being and prosperity of us all, in the private and public sector, is inextricably linked.

The continued pursuit of austerity, however, erodes social and economic solidarity and thus national recovery.

Perhaps, despite the inherent challenges, it is time now for the Coalition to catch up?

Dr Margaret O'Keeffe

Mayfield, Cork

Lessons of Savita case

• The recent inquest into the death of Savita Halappanavar has raised important issues about hospital infection in obstetrics. Much of the public attention appears to have been directed at the expert opinion of Dr Peter Boylan who suggested that Irish law prevented necessary treatment to save Ms Halappanavar's life. We would suggest that this is as much a personal view as an expert one.

Furthermore, it is impossible for Dr Boylan, or for any doctor, to predict with certainty the clinical course and outcome in the case of Savita Halappanavar where sepsis arose from the virulent and multi drug-resistant organism, E.coli ESBL.

What we can say with certainty is that where ruptured membranes are accompanied by any clinical or bio-chemical marker of infection, Irish obstetricians understand that they can intervene with early delivery of the baby if necessary. Unfortunately, the inquest shows that in Galway University Hospital the diagnosis of chorioamnionitis was delayed and relevant information was not noted and acted upon.

The facts as produced at the inquest show this tragic case to be primarily about the management of sepsis, and Dr Boylan's opinion on the effect of Irish law did not appear to be shared by the coroner, or the jury, of the inquest.

Obstetric sepsis is unfortunately on the increase and is now the leading cause of maternal death reported in the UK Confidential Enquiry into Maternal Deaths. Additionally there are many well-documented fatalities from sepsis in women following termination of pregnancy. To concentrate on the legal position regarding abortion in the light of such a case as that in Galway does not assist our services to pregnant women.

It is clear that maternal mortality in developed countries is rising, in the USA, Canada, Britain, Denmark, Netherlands and other European countries. The last Confidential Enquiry in Britain (which now includes Ireland) recommended a "return to basics" and stated that many maternal deaths are related to failure to observe simple clinical signs such as fever, headache and changes in pulse rate and blood pressure. Many of the failings highlighted in Galway have been described before in these and other reports.

The additional problem of multi-resistant organisms causing infection, largely as a result of antibiotic use and abuse, is a serious cause of concern and may lead to higher death rates in all areas of medicine.

Ireland's maternal health record is one of the best in the world in terms of our low rate of maternal death (including Galway hospital). The case in Galway was one of the worst cases of sepsis ever experienced in that hospital, and the diagnosis of ESBL septicaemia was almost unprecedented amongst Irish maternity units.

It is important that all obstetrical units in Ireland reflect on the findings of the events in Galway and learn how to improve care for pregnant women. To reduce it to a polemical argument about abortion may lead to more – not fewer – deaths in the future.

Yours sincerely,

Dr John Monaghan, Portiuncula, Galway

Dr Cyril Thornton, Cork Clinic, Cork

Dr Eamon McGuinness, Mt Carmel, Dublin

Dr Trevor Hayes, St Luke's, Kilkenny

Dr Chris King, Letterkenny General Hospital

Dr Eileen Reilly, Galway Clinic, Galway

Prof John Bonnar, Trinity College Dublin

Prof Eamon O'Dwyer, NUI Galway

Prof Stephen Cusack, CUH

Dr Rory Page, Cavan General Hospital

Dr James Clair, Mercy Hospital, Cork

Stop oppressing women

• You can nearly write the script when it comes to the unbelievable cowardice that has been consistently demonstrated by our politicians. Despite two referendums, pro-life groups supported by the disgraced Catholic Church want a third referendum and to place another article in our Constitution.

You can almost smell the fudge, the suggested six consultants' approval in the case of suicide, politicians voting against their party whips in an attempt to save their seats in their constituencies.

It's not so long ago that women were being arrested in Connolly Station after importing condoms on a train from Belfast.

The time has come for legislators to wake up and legislate.

As a country we need to recognise the rights of women and stop oppressing Irish women because it's the easier political option.

David Moore

Donabate, Co Dublin

Paid like a banker

• Regarding the news item: Gardai want to "be treated like judges" in pay talks – I wish (like a thousand others) that I could be "treated like senior bankers" in our pay talks!

Catherine Ryan

Newbridge, Co Kildare

Road to nowhere

• The roads around the M1 motorway, at Dublin Airport, have recently been changed. To get to Malahide and the north side of Dublin, motorists are being directed on to a slip road which used to lead to the N32 but now it takes them to the R139.

However, there is no R139 road. It seems to have been stolen. The old N32 is still there, taking traffic down to the Malahide Road as efficiently as ever. So where is the R139? If anybody finds it could they please give it back to Fingal County Council. They don't seem to be too worried about it, so perhaps they don't realise it has gone missing.

John O'Connor

Raheny, Dublin 5

Irish Independent