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21 March 2002 Edition

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A&E solution in sight

Last November, amid a lot of hype and hot air, Fianna Fáil launched their new health policy, promising us a world class health service. This week, the reality of what stage that policy is at became clear.

At 4.30am on Wednesday 20 March, a remarkable event happened. A new element in health policy was formulated. The government, through the Health Service Employers Agency (HSEA), was forced to agree important changes in how Accident and Emergency (A&E) services can be run in a better way for patients and workers.

A second precedent was set in that the vested interest of senior doctors and consultants was finally challenged and it seems for now successfully, even though the Irish Hospital Consultants Association (ICHA) believes that the agreement reached might infringe on a doctor's "contractual agreements".

The ICHA is specifically opposed to the proposal that hospitals appoint a bed manager who would play a role in setting the admission and discharge criteria of patients. At present, this decision is completely controlled by doctors and consultants.

Liam Doran, General Secretary of the Irish Nurses' Organisation (INO), believes the agreement reached will "minimise overcrowding and where it is occurring will ensure a consistent, round-the-clock hospital-wide response which will deal with that overcrowding in a manner which is patient-friendly and certainly nurse-friendly".

Doran has portrayed the agreement as being part of a "hospital-wide response" to the A&E crisis. The only questions are why did the nurses have to take this drastic action and be forced into marathon negotiations just to secure a better A&E service? Why was this not part of the Fianna Fáil masterplan last winter? Something is seriously wrong when health policy has to be formulated in the small hours.

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