We are first and foremost responsible for our own health. We are the first line managers of our physical and mental health. We make the first decisions which affect our state of health. We choose how we care for, and how we use or abuse our bodies. We are also sometimes required to make decisions relating to the care of others around us who are unable to make decisions for themselves, children, the infirm, or the elderly. However every citizen of the Nation is also entitled to feel secure in the knowledge that in times of crisis, there is a service designed to care for, heal and restore our body and mind to good health. We must make it possible for all our citizens to secure the best possible health-care at the provider of their choice.
Oversight The Health Service Executive (H.S.E.) should have its mission changed to one of planning, setting standards, and monitoring the performance of medical service providers, The State should ensure quality performance through the establishment of a Medicare review panel, on which a patients council would be represented. In order to ensure the variety and availability of high quality medical services throughout the country,
Primary Health Care:
Community clinics should be the first port of call for any person seeking advice or non-urgent treatment. The availability of 24 hour 7 day clinics in each community could provide access to services, which include blood sampling, x-ray, triage dressings, immunisation and other services, which do not require hospitalisation. relieving some of the burden on our over stretched casualty units. There are at present many such clinics throughout the country providing excellent primary care including home services, and community nursing services. The expansion of these services to include the provision of these services within a local community on a 24 hour 7 days a week basis, should be a priority. To encourage the expansion of these services the state should provide infrastructural finance and free liability insurance to these clinics to encourage General Practice doctors to combine in the provision of these local services.
General Hospital Services :
The second stage in the provision of health care occurs when a person, has become ill and requires hospital treatment either in Hospital or as an out patient. These services must be provided by strategically located general hospitals, or specialist care hospitals. Conditions such as maternity, mental illness, infectious disease, and some specialised areas such as child care and cancer treatment, may be better provided by specialist hospitals, located within easy reach of Major General hospitals. The management and control of those hospitals and medical clinics is best performed within each facility. Each licensed medical centre should be allowed to develop its services in line with best practise, and the needs of the community. Monitoring of these facilities would be done by an independent unit of the Dept. of Health, with strict penalties for failure to meet set standards.
Three areas of Management must be subject to Dept, of Health supervision.
General Business Management.
Clinical Excellence Management.
Customer and Patient Care Management.
Whether these facilities are privately or publicly owned is irrelevant. The standard
of care provided to the patient is the determining factor. The availability of medical
care, free to the consumer, in the facility of choice, must be the overriding factors
in the provision of health care.
Emergency Response Services:
Emergency response units, must be based at strategic facilities across the country,
and attached to general hospitals. These response teams should comprise specially
trained paramedic teams, fully equipped to deal with any emergency, and provided
with the full range of transport options, from motorcycles, 4 wheel drive vehicles,
to helicopter ambulance’s. These teams would be available in cooperation with the
Garda and Fire services.
Respite and After-Care:
When a patient has been treated for an illness or injury, it is often the case that a period of time for recovery, is needed. The best way to deliver this care is at home, with frequent monitoring by the community health care team, in a residential step-down facility. where more intensive after-care is required. These facilities should be subject to the same demanding standards as hospital and clinics, and should be monitored by the Dept, of Health as stated above.
Traditionally people (both in Ireland and throughout the world ) have relied very heavily on the voluntary and religious congregations to provide comfort and support, at the recovery and respite stages of Life. And despite the many campaigns, calling for separation of “Church and State”, people regardless of belief, still rely heavily of these organisations. Until the State provides the resources necessary to fund the respite and after-care services they should refrain from trying to make political capital out of the serious illnesses of those who rely on those services.