The HSE and ‘special forces’

De Facto

The HSE and ‘special forces’


Liamy Mac Nally

One question remains unanswered by the Government – How much is it willing to pour into Anglo Irish Bank?  The €24billion used to prop up Anglo Irish Bank to date is equivalent to almost one and a half years total budget for the HSE.  Ironically the HSE is imposing cutbacks while the bankers enjoy pay rises!  Government message - greed pays.
Thousands have protested over health cutbacks yet this appears to run off the backs of Government members.  Why is no one in Government expressing concern about supporting bankers at the expense of Irish citizens health?  Where are the Green Party voices?  Is it true that many die-hard Fianna Fáilers feel more betrayed than the rest of us?  Yet, for some inexplicable reason, they will not raise their voices in case they are seen as ‘traitors’ by the party.  What party cannot allow its members a voice, especially those who are critically honest? 
The ongoing disturbing reality is how Minister Mary Harney performs.  Dáil questions to Minister Harney on health are referred to the HSE (the Parliamentary Question Section).  She refuses to deal with them. In her Dáil replies Minister Harney states that the questions will be dealt with by the HSE directly with the TD who raised the question.  In turn the latest lark is for the HSE to hide behind HIQA (Health Information & Quality Authority).  HIQA’s functions: “The Health Information and Quality Authority is responsible for driving quality and safety in Ireland’s health and social care services through: Setting Standards in Health and Social Services; Monitoring Healthcare Quality; Social Services Inspectorate; Health Technology Assessment; Health Information.  Our work spans the entire health and social services system, with the exception of Mental Health Services.”
HIQA is there to check on the HSE.  What appears to be happening, according to some people, is that when the HSE wants to shut a unit like a nursing home or a small hospital it is allowed to be run down.  HIQA is ‘called in’ and the resulting report elicits a response from the HSE that it cannot afford to carry out the required improvements in the recommendations and hey presto, HIQA are the ‘bad boys’ not the HSE!  So we have a Minister who will not reply to health questions and hides behind the HSE, which in turn hides behind HIQA!  In the meantime, the Government continues its rudderless ways while the people of the country pick up the pieces! 
When will the Government allow it to be managed properly?  It must realise that its current configuration is unworkable.  There was some semblance of order to the old health boards, while not without their problems.  There are so many good and committed people within the HSE who are more frustrated than most of us with the way the HSE is being run.  Apart from the fall-out from cutbacks in hospital services in Sligo, Roscommon, Portiuncula, Mayo and Galway there are other services that are also affected like home help, foster care, dental treatment, so-called ‘centres of excellence’ without adequate parking, and the list goes on. 
Dr Muiris Houston, health analyst with the Irish Times, wrote last week about how fortunate we are that HIQA takes its remit as a regulatory body seriously.  He says that if there is a total collapse in the health system then we cannot say we did not see it coming, unlike the banking collapse.
He goes on to cite the culture within the HSE of “carry on regardless” as it withholds information from HIQA and fails to implement its recommendations.  When Susie Long died in 2007 Minister Harney promised that the waiting time for a colonoscopy would be no more than four weeks.  Three years on, the wait is three months and longer for 1,073 people according to the Irish Cancer Society, 25% more than in December 2009.  In 2008, there were 2,216 new cases of bowel cancer in Ireland.  The longer the delay the more dangerous it will be for some people.    
Dr Houston says that there are “enough endoscopists and specialist units throughout the state for a six-week ‘referral to test’ threshold for colonoscopy to be met.”  He cites how the NHS in Britain set up a ‘clinical governance support team’ to deal with problems.  It was like “a 12-member ‘special forces’ team that descended on poorly performing hospitals and dysfunctional health services, taking managers and clinicians firmly by the hand until the problems were sorted out.”  Services improved.
Clergy who failed to speak up when there was a culture of secrecy over child abuse were justly criticised.  The same charge can be made of those who have any power over the health system in this country and remain tight-lipped.  Ongoing support for Anglo Irish means more health cuts for citizens.