Priscilla Lynch: Is there no end to the bad news about the health service?

While the new year usually brings hope that things will improve in our health services - this year there is a slightly bigger budget and a promising list of 25 health service priorities from the Minister - things just seem to be going from bad to worse.

So far this month we've had record-breaking numbers of people on trolleys (601 at one point), a vote on industrial action by nurses in hospitals beset by persistent overcrowding and yet another maternity services scandal.

The latest bad news is that Ireland's health service has fallen from 14th place to 22nd in a European Health Consumer Index study of 36 countries.

The study found that the official waiting list data in Ireland has lost credibility, that patient empowerment here is on a level with Romania, and healthcare inequality is evident.

So is our health service in its worst ever state? Certainly it's at its lowest ebb since the FG/Labour coalition came to power, with their lofty promises of universal healthcare and an end to long waiting lists and patients on trolleys.

Numerous rounds of budget and staff cuts, coupled with regular scandals showing serious deficits of care, have brought our health service to its knees.

waiting

No one at this stage has any confidence that hospital waiting lists, for inpatient procedures and outpatient or scan appointments will improve.

We've had many promises and excuses from this Government but the sad reality is that patients are simply waiting far too long and their long term health outcomes are being negatively affected.

Behind every number on a trolley or waiting list is a real person.

One of the most worrying health service crises is the difficulty in recruiting and retaining high quality clinical staff.

There are currently over 200 vacant consultant posts in our hospitals, with repeat recruitment campaigns making little impact and worrying gaps in cover and expertise in certain specialties like anaesthesia and transplant surgery.

There are also ongoing problems in recruiting sufficient numbers of junior doctors and specialised nurses, while GPs are also leaving the country in significant numbers and heading abroad for more financially lucrative, secure and family-friendly working arrangements.

Meanwhile, in the private sector, the increasingly exorbitant costs of medical indemnity cover means consultants are shutting up shop, leaving less choice for patients.

The brain drain of our very highly trained medical staff is something to be very worried about. It didn't happen overnight and the HSE and Department of Health have to largely take the blame.

While cutting the level of pay for new consultants and introducing a 'yellow pack' employment programme for new nurses, as well as regularly cutting GP fees, might have been easy and publicly popular, we are now paying a very heavy price.

If this staff exodus is not halted waiting lists will only get longer and we might soon not be able to access GPs as easily as we take for granted.

resolve

Thankfully, consultants and junior doctor members of the Irish Medical Organisation yesterday voted to accept new revised proposals on pay and career structures for hospital consultants. Hopefully that will help stem the current hospital doctor brain drain.

The Minister also needs to keep his commitment to negotiate a long overdue new GP contract and must sit down with nurses to resolve their issues.

His actions on health insurance have had some positive impact, with the VHI cutting and freezing some price plans yesterday - but that is only the tip of the iceberg.

There is much currently wrong with our health service and patients and staff deserve so much better. Over a decade ago our cancer services were a disaster but since then been largely successfully reformed.

That took a major cross-Government effort. A similar approach is now needed to turn our health service around.

Mere fire-fighting is no longer enough.