In health, every cent makes a difference

IT will have been with enormous relief that patients across the country heard last night that the planned three-day strike by the Irish Nurses and Midwives Organisation had been called off.

Already, almost 90,000 people have had appointments cancelled due to the strike, but a three-day walkout brought with it the very real possibility of tragedy.

As it is, the health of many people will have been compromised due to deferred appointments, and the health system itself will be put under enormous strain trying to deal with the backlog.

Details of the agreement still require careful scrutiny; however, the Labour Court does appear to believe that thousands of staff nurses can be moved to higher pay scales without this requiring significant extra money from taxpayers. Reducing agency nursing fees and achieving greater efficiencies should be able to cover the cost. Critically, the Labour Court warns that progress will have to be monitored to ensure that the promised savings are in fact delivered.

This oversight is vital because, as we report on today’s front page, the cost to patients of overspends within the health service is an appalling one. If extra money has to be spent in one part of the health service, it has to be cut from elsewhere. And so the cost overruns at the National Children’s Hospital mean that vital health projects elsewhere in the country will now be delayed.

The HSE will have to put off purchases of new ambulances, CT scanners, X-rays and ultrasound facilities. It may have to postpone new radiation facilities in Galway, a new acute psychiatric unit in Sligo and a new renal unit in Tallaght. Each of these has the potential to place patients’ lives at risk. A broken-down ambulance may not be able to get to a heart attack victim; a worn-out ultrasound device may not pick up a foetal anomaly; a psychiatric patient may take his or her own life because they are not in a safe, purpose-built unit.

And so when the expert groups looking at the hospital overspend are examining why this project has spiralled hundreds of millions of euro over its estimated cost, they must bear in mind the consequences of that overrun.

They must establish why this was allowed to happen, who allowed it to happen, and what exactly we must do to ensure that it is never allowed to happen again. For all our sakes.