Irish Hospital Consultants Association say only way to end cynicism on health promises is solutions
“COVID-19 reveals co-dependency that exists between a sustainable economy and properly resourced health system”
IHCA proposes solutions on capacity, local decision-making, and forward planning
“Unenviable choices faced by government will mount-up if we continue to evade obvious remedies to healthcare challenges” – Professor Alan Irvine
The Irish Hospital Consultants Association (IHCA) has said that the unenviable choices facing government due to COVID-19 will mount-up if it continues to evade obvious remedies to the healthcare challenges.
Speaking at the IHCA’s virtual annual conference, the organisation’s President, Professor Alan Irvine proposed solutions to tackle the problem areas of capacity, local decision-making, and forward planning.
Speakers at the virtual conference include the Minister for Health, Stephen Donnelly TD, Chief Executive of the Health Service Executive, Paul Reid and Opposition health spokesperson, David Cullinane TD. Healthcare experts, including Dr Nóirín Russell, Clinical Director of Cervical Check, Brian Fitzgerald, Deputy CEO, Beacon Hospital, Dr Graham Billingham, Chief Medical Officer, MedPro, Berkshire Hathaway, Dr Chei Wei Fan, Consultant Geriatrician, Mater Hospital and St Mary’s Phoenix Park, and Dr Rob Hendry, Medical Director, Medical Protection Society also presented.
Opening the conference, Professor Irvine said that COVID-19 had sharply brought home the co-dependency that exists between a sustainable economy and properly resourced health system, “a co-dependency which perhaps we didn’t truly appreciate up to now” he commented.
He said: “Our leaders in government are making and facing unenviable choices which increasingly involve trade-offs, in particular between living and livelihoods. I am firmly of the view that these choices would never have arisen, at least at such scale, if we had sufficiently invested in our health services over time.
“Time and again, the problems we and others highlighted in our health system were long-fingered. As a result, our health service has been backed into a corner and the consequences are hitting people hard”.
Pointing to the need to take the learnings of the crisis, relent on repeated resistance to obvious remedies, and the need to deliver capacity at speed, Professor Irvine said:
“Report after report has found the key to capacity is people and beds. We are spending more than ever before on a Winter Plan while borrowing €20 billion and counting to meet the cost of the crisis. Yet in budgetary terms, for some 6% of the winter plan budget and 0.15% of current COVID-19 related borrowings we could fix the core problem of vacant permanent consultant posts. The immediate benefits this would have on patient care and waiting lists would also extend to other cost savings.”
Commending elements of the response to the crisis, Professor Irvine said the learnings should be taken and applied to deliver solutions in three areas—capacity, local decision-making, and effective planning and implementation.
He cited transparency in the delivery of acute and ICU hospital beds and an end to consultant pay inequality as the primary mechanisms to address the capacity challenge.
He said: “If we can publish what beds we don’t have, how about publishing what beds we do have and the plans to bridge the shortfall? A systematic approach to regularly publishing success metrics per hospital, starting with a live dashboard on bed numbers delivered and operating, would bring both transparency and greater understanding to this key issue. We recognise delivering bed capacity can be complex. We know it is not a simple case of calling Mattress Mick. But capacity at greater speed has been done before and a solution anchored in transparency would bring a new dynamic to this age-old challenge.”
On devolving decision making to hospitals at local level, Professor Irvine said:
“In the early stages of the pandemic, people noted ruefully about the system’s ability to make decisions quickly. To the great credit of so many, focus and collaboration brought-about improvised solutions at an unprecedented scale at an immensely stressful time. That capacity to flex and local empowerment to plan, recruit, invest, respond, and adapt resulted in better outcomes than had been feared over the past six months. Locally empowered, bottom-up decision making has been proven time and again to work—in healthcare and elsewhere. It is time for the centre to let go.”
On effective planning and implementation, the IHCA’s President said:
“Credit is due to Minister Donnelly, Paul Reid and their colleagues on one notable difference in this year’s winter plan to previous ones—timing. A winter plan published before winter is a rarity. That the system operationally thinks in horizons of seasons rather than years is a sad reflection on the system. In Minister Donnelly, we have someone who, given his professional background, is better placed than any of his predecessors to grasp this fundamental flaw.”