Now, the extent of the mess Simon Harris is inheriting is much worse than was feared. The biggest problem is that everything that needs to be fixed in the sector is so urgent, but scarce financial resources preclude that from happening as quickly as it needs to, so expectations will have to be tempered by the cold, hard realities.
Where to even start is the biggest question, as there are no obvious quick fixes, and the new Minister is starting from an even lower base than he could have anticipated as the HSE tries to head off an anticipated €500m overrun in its current budget with a suspension of the recruitment of doctors, nurses and midwives in hospitals, which – bizarrely – seems to be more for its own administrative purposes and must be quickly reversed to avoid further compromising patient care and safety.
The elderly will also suffer as the HSE wants to cut back on home help and homecare packages to save money at a time when an extra 20,000 people are and will be joining the ranks of old age pensioners every year for the foreseeable future. Another vulnerable sector that has become the poor relation of the sector in recent years is mental health services and this needs the investment it has lost out on to be restored urgently and increased to meet growing demands.
The perennial big problems of the public health sector, such as overcrowding at Emergency Departments and long waiting lists for outpatient clinics and treatment continue to grow, with the latter now having passed the half-million mark, which is totally unacceptable. As always, vulnerable sick people suffer the most and one has to wonder how many lives these delays are costing while we wait for those in charge to come up with a sustainable plan to tackle them.
Universal health care has been shot down as unaffordable and Fianna Fáil says it won’t back Fine Gael’s plan to abolish the HSE and set up hospital groups and community health organisations as trusts, as this would make matters even more bureaucracy-heavy and complicated. Provision of primary care in the community needs to be stepped up urgently while the Minister works with all parties on an acceptable masterplan.