1 February 2001 Edition

Resize: A A A Print

Hospital dispute highlights lack of accountability

BY ROISIN DE ROSA

An historic decision was taken at the North Eastern Health Board (NEHB) meeting in Kells, County Meath, last Monday, 29 January. A very large crowd had travelled to Kells, Co Meath, to let board members know that they want the maternity and gynae units in Louth and Monaghan Hospitals retained and extended.

The NEHB decided by 21 votes to 5 not to vote on closure of the units after all, but instead to seek a meeting with the Minister of Health, Mícheál Martin. Sinn Féin TD Caoimhghín Ó Caolain was a member of the delegation that went on Tuesday to meet the minister to present the case for the retention of services. The outcome is awaited before the next NEHB meeting, scheduled for 7 February.

The NEHB, at their annual general meeting the previous week, had discussed a motion seconded by the chair of Louth County Council, Nicholas McCabe, to close the services. Sinn Féin Councillor Arthur Morgan subsequently called on McCabe, as chairperson of Louth County Council, to hold a special meeting to discuss the position Nicholas McCabe had taken on the NEHB in seconding the motion to close the services.

McCabe acceded to Arthur's proposal and called the meeting. Councillors unanimously passed a motion calling on the delegates to the NEHB to oppose the Health Board's motion to downgrade or close the maternity service in Dundalk.

Three councillors abstained, Fiann Fáil councillors Declan Breathnach, Jimmy Mulroy and of course McCabe, the very councillors who represent Louth on the health board.

Morgan's resolution calls on the councillor members of the health board to make themselves accountable to fellow councillors and constituents.

Apartheid health system


``There is no other way to describe our health care system except as apartheid between rich and poor,'' says Arthur Morgan. ``Whether, and when people get the treatment needed depends not upon the urgency of the case, but upon the depth of their pockets.

``There are currently 45,000 people on 26-County hospital waiting lists, awaiting urgent treatment. Everyone knows someone who suffers the apartheid health care system.

``The discrimination between rich and poor in health care, between those on medical cards, and those who are not, is the most glaring and unforgivable example of injustice and inequality, deliberately perpetrated by Dublin governments, through the health boards, in the name of budget restraint, rationalisation and efficiency.''

``This year, the minister built into this health care system a continuing shortage of doctors, by restricting the number of students embarking on the seven-year medical school training.

``The hospitals said they needed 1,800 doctors to meet their needs. The minister, however, thought that 1,300 would be sufficient university places. A compromise was reached of 1,500. So eight years down the road, the minister has already built in a shortfall of doctors.''

``This shortfall takes no account of the thousands of people the Dublin government hopes to attract to work here. It takes no account of the fact that a large proportion of qualified doctors will emigrate upon qualification because working hours and conditions for junior doctors in the medical system are intolerable and unacceptable.

``The situation is the same among nursing staff. In hospitals all over the state, wards are closed and patients lie on trolleys in casualty units because of a shortage of nurses, the direct result of appalling working conditions for nursing staff.

``Take the case of the threatened closure of the maternity unit at Louth General Hospital in Dundalk. The NEHB claims it can't renew its insurance because they need three consultants to be in charge of the service and they don't have them. A local doctor, Mary Grehan, confirms that there are 160 senior registrars qualified to take consultancy jobs, but the minister, supported it seems by some professional interests on the NEHB, refuses to appoint them. That is the issue the closure of the maternity service is about.

``The NEHB threat to close the maternity services pinpoints the lack of accountability of the health boards to the general public. Councillors who are elected to sit on the health boards have, with few exceptions, never made themselves or their decisions accountable to the people they represent. There are no report backs from health board meetings to councillors. Health board decisions are neither transparent nor accountable to the people.

``The notion of equality-proofing health board decisions doesn't hit the agenda at any point. Instead, the health boards operate as quangos to rubber stamp the unacceptable health policies of the government.''

Scandal of overcharging the elderly


Since 1992, the North Eastern Health Board has implemented government policy to free up hospital beds by moving elderly patients to long-stay state respite care. But the health board overcharged them on fees in private nursing homes, public homes and hospitals. It took family income into account when calculating entitlement to support for long-stay care.

The Ombudsman investigated the situation and decided in 1999 that the health board was wrong, that there was no statutory basis for the practice of means testing family incomes. People have a statutory right to long-stay treatment plus £11 weekly pocket money, irrespective of the incomes of their family.

``I find it difficult to contain my anger,'' said Sinn Féin's Maeve Healy, chairperson of the Drogheda Senior Citizens group (DSC). ``Elderly people and their carers were deliberately misled and placed under financial and emotional pressure. People's entitlements were cut or turned down for reasons the state knew were spurious and beyond the law.''

The health board said that they didn't know. They announced in 1999 they had changed their criteria and that they had reimbursed those who had been overcharged. The government allocated £4.5 million to the health board for this purpose.

However, it has now emerged that the NEHB has still not reimbursed those who were penalised. Maeve Healy reports many instances where people have contacted the DSC saying they have received nothing and heard nothing from the health board.

``The state saved millions. Unfortunately, as a result of their `mistake', many people were deprived of care, many have since died, and many carers were reduced to ill-health while caring for their loved ones. How can these people be repaid?

``People were kept in the dark. Nothing was said about their illegal practice of overcharging people. Nothing, it seems, is being done. The health boards need to be made accountable to the people.''

An Phoblacht
44 Parnell Sq.
Dublin 1
Ireland