Doctors speak out : Public Health Service Must be Supported

We write as doctors with extensive experience working  in the public sector. We write out of frustration and anguish on behalf of patients and of our health service. We believe that the sustained attack on the public health system, both by constant criticism, and the withholding of essential funds for infrastructural development, is damaging to our entire society. 

While it is clear that aspects of the current health system are fragmented and inefficient, there are also many aspects that work well. This must be acknowledged.  The vast majority of patients who attend their general practitioner, or who are admitted to a public hospital receive high quality evidence-based treatment.

It is time to change the poor public perception of health care in public hospitals, and to recognize that clinical care within the public sector is of the highest standard. Our public hospitals provide world-class care, but in primitive surroundings.  Accessing that care is the problem.

The fundamental problem within the public health system is that the front line is inadequately resourced.  Also key pathways that allow  general practitioners and hospitals to communicate effectively and work together  have been systematically ignored. This has come about partly because frontline health staff, doctors and other key healthcare professionals, are often excluded from the design and planning of services.

Blaming those working in the front line for infrastructural flaws only serves to exacerbate the problems and demoralises those striving to provide a high quality service. Current systems that penalise hospitals for overcrowding in A&E, without providing resources to resolve the factors that lead to overcrowding, are misguided and deeply unfair to both patients and front line health workers.

We live in a civilised society. Health is not a commodity to be bought or sold. Our health system must strive to provide access to treatment and clinical care that is independent of means. All patients must be treated according to clinical priority, whether emergency, elective, acute or chronic, and healthcare must be  integrated across primary, secondary and tertiary services.

In order to achieve this, it is essential that those of us working on the front line, doctors and other health care specialists, are involved in the design, planning and    implementation of services. We recognize what the problems are. We are in a position to help  configure and integrate services. We are accountable both to our patients, and to the state at large.

Further investment in clinical services within the public system is urgently required to improve the access to care. This will need to include substantial capital investment in primary care and  hospitals, and investment in interface services linking GPs with hospital-based services.

A systematic failure to address the long-standing infrastructural problems within the  public system has led to our current difficulties.  But in the resolution of these problems, we must remember that one of the essential obligations of a civilised society is to provide equitable access based on need, and regardless of the ability to pay. This is what the public sector does best.

We would like to get on with the job.

Roisin Costello             General Practitioner
Robert Daly                  Consultant Psychiatrist
Norman Delanty           Consultant Neurologist
Colin Doherty               Consultant Neurologist
John Doherty                Consultant in Geriatric Medicine
Ciaran Donnegan          Consultant in Geriatric Medicine
Michael Farrell             Consultant Neuropathologist
Hugh Flood                  Consultant Urologist
Kate Ganter                 Consultant Psychiatrist
Paula Gilvarry               Public Health Doctor
Orla Hardiman              Consultant Neurologist
Joe Harbison                Consultant in Geriatric Medicine
David Hickey               Consultant Renal and Transplant Surgery
RoseAnne Kenny         Consultant in Geriatric Medicine
Chris Luke                   Consultant in Emergency Medicine
Tim Lynch                    Consultant Neurologist
Fiona Molloy                Consultant Neurophysiologist
Joan Moroney              Consultant Neurologist
Risteard Mulcahy          Consultant Cardiologist
Kieran Murphy             General Practitioner
John Nolan                   Consultant Endocrinologist
Ray O'Connor             General Practitioner
Brenda O'Halloran       General Practitioner
Christine O'Malley         Consultant in Geriatric Medicine
Eamonn Shanahan        General Practitioner