Health needs ‘smart team’ of medical experts to protect our patients

WOULD you ask your accountant to service your car? I doubt it very much, unless you weren’t all that pushed about driving safely. So why do we have business managers running our health services and not medical experts?

The current smear test scandal is a medical failure of unprecedented proportion which has happened on the watch of non-medical managers.

The director general of the HSE has a qualification in management. He is not a doctor. The current replacement for Dr Gráinne Flannelly, who stepped aside as clinical director of CervicalCheck, is Damien McCallion, whose qualifications are again in management, not medicine or clinical practice.

Tony Holohan, the chief medical officer of the Department of Health, is a medical doctor by profession, but he hasn’t worked at the coalface of medicine in quite a number of years. No disrespect intended, but it would appear that what is clearly needed to advise the Health Minister in high-risk areas, is a team of highly qualified doctors and clinicians with current, relevant, and on-going experience.

What we have seen demonstrated in the current situation is that when specialists are asked their opinion within the HSE it appears to be purely advisory. There is no layer of expertise which takes responsibility for determining a course.

I am not for one minute suggesting another layer of bureaucracy, but it seems we need to replace some senior civil servants, who are not clinicians, with a specialist team of trusted experts.

Let’s call it ‘a smart team’ of medical experts; people who in their individual field will become guardians of the men and women of this country, ombudsmen if you like, to advocate for and represent the ordinary user of specific disciplines within medical services. They become the go-to person for the definitive determination of best practice.

The remit of the smart team would be to ensure the best possible outcome for every single patient in the country. To name just some sectors where such a system would clearly save lives – oncology, gynaecology and obstetrics, radiology, neurology, psychiatry and so on.

It is my sincere belief, having served for 12 years in the old Health Board regime as chair of the North East Health Board, and in watching the current horror unfold, that it is a good day for many executives in the health service when they get through it without making a single decision. Letters go back and forward, meetings are held, reports are written, but who is ever accountable, and where is the transparency around how conclusions are come to, or service applied?

Failure in the Department of Health is about as serious as it gets, because people die on account of it.

Medical expertise available, and availed of, only in an advisory capacity. There has to be accountability.

The scoping study is a start, as we all scramble around to try to find out how we allowed this to happen. But it needs quality medical expertise and the teeth to get information quickly, before a protracted tribunal roadshow gets under way – more about lengthy reports and large fees than any drive for truth or change.

We have to keep patients at the centre of any public inquiry, and keep laser-sharp focus on outcomes.

We have seriously failed the women of Ireland in this latest medical disaster, as we failed them before with the Anti-D scandal, the symphysiotomy scandal, and the more than 100 women who had their wombs removed unnecessarily. Women in Ireland would be forgiven for thinking we just do not take their health seriously enough. At this juncture, we can put all our energy into searching for scalps – and yes we need accountability – but we have to work at putting processes and people in place who will ensure that this never happens again.

The minister must insist that medically qualified people are put into key roles in the department, and the health agencies of the State, to ensure the women of Ireland, and all patients, are protected at their most vulnerable times in life.