NO. HIQA, is a body set up by Mary Harney to oversee standards in the health service. However, they come to that task with a certain background (like all of us) and having looked at the CVs of the main people involved I can see that small hospitals are not their cup of tea. In a letter to the Irish Times last week, a very prominent surgeon pointed out that large hospitals are no safer than the smaller ones. Mary Harney, in all the reports she commissions, gets the result she wants us to hear.

Yes, but this situation has been engineered by the HSE and former Health Boards by lack of resourcing and neglect and lack of proper managment systems, which all points to an agenda to create an excuse to close them by shattering the public confidence in them. But due to the problems that have surfaced in the large hospitals I would be just as concerned about safety in those too.

If the report in The Village magazine is true then we have more to worry us all about what is happening in our health services.

It is all about the "terms of reference" set down by the Minister. The HSE have a fantastic ability to state only those parts of a report that assist them in what cutbacks they believe are necessary. All other parts don`t get a mention. The goal seems to be to close ALL small hospitals and then replace them with Private Health Centres with 24 doctors, pharmacy, dentists etc. under one PRIVATE TAX DRIVEN roof !!!

I am concerned about the safety of patients in hospitals, not just the small ones.

However,when one looks at the reasons for safety concerns, the all seem to come back to the same route cause and origins; namely: HSE Policy.

In some cases, funding is being used to engineer the effectiveness of particular hospitals (ie; lack of / cut funding) and in others it is management decisions and their implementation.

Infection Control is one of my biggest concerns. See Blog by me 'Zebedee' on this site entitled Lack of Action. This blog also has a notable lack of response from anyone in HSE management too!

The issue of safety can and only will be addressed when the motivations of the senior personnel running the Dept of Health and the top level running of HSE are different from those in place. We do not want 'career politicians and civil servants' who are more interested in 'putting across the right image' and 'manipulating perceptions' than actually making real changes, implementing best practice (that's proven best practice, not what appears to be the best for your own agenda).

Of course, I am biased here, but feel the first place to start is by replacing Europes Highest Paid Health Minister with one who is

A) is competent

B)has the right mandate

C) is motivated by making real improvements

D)does the job for far less money

I could go on and on...and so could many others. The question really is what can and are we, the masses, going to do to bring about change at the top?

Zebedee

I think the minister and the HSE have got it all wrong. On the occasions when i have been to hospitals the a and e is cluttered with people who could easily see a gp and the wards are cluttered with old people. (Nothing against old people, but there could be a better solution as they occupy beds for long periods of time). I think the minister and HSE should turn their attention to 1st level care. It is not as expensive to sort out. Work with GPs (Dentists etc) to set up small clinics in every town. The GPs can share resources and provide a more comprehensive service. This will take some of the load off the hospitals. I have lived in other countries where this worked exceptionally well. The other thing is doctors in other parts of the world are more pioneering. I think litigation has made them stick to very restricted rules. The minute something is slightly complex you have to see a consultant. I long for the olden day GP who was able to do so much more!!! The HSE is a fat empire. Perhaps they cold be retrained to work on the front line where they are more useful.

A letter in today's Irish Times today (Wed 15th April 09) makes the same polnt as many of the above contributors i.e. HIQA is a quango whose real remit is to reinforce Mary Harney's own policy of a centralised and privatised health care system. It is heartening to realise that so many people can see behind the spin.

Plus they were reporting on a situation which was purposely engineered to provide the authorities with ammunition to close these hospitals. There is no mention of all the adverse medical events and mistakes in the larger hospitals - what about closing them down too. Why not - it will create more markets for the private investor, except that some of the private facilities would likely not pass the 'safe test' either.