The Hanley Report

gaf1983

Does anyone know much about it, like what are it's main recommendations?

From what I've heard about it much of it involves downgrading smaller hospitals in the country, or putting them out of existence. I think this is crazy. The other night on RTE news the Irish Nurses' Organisation were talking about how on that night there were around 400 patients who'd have to sleep on chairs/trolleys that night because there weren't enough beds for them. So the government's solution to this chronic lack of capacity is to reduce the capacity even further. From what I know about my own region there are plans close Ennis Hospital in 2007 - this will mean that all the patients currently using that hospital will have to come into the currently overcrowded Limerick Regional Hospital, and to add to that some patients from West Clare will have journeys of about 1 and a half hours to their nearest hospital. They must be delighted with the thought.

Another recommendation I've heard about in the report is that due to the fact that currently, about 20-25% of the patients using the public hospitals are VHI covered patients - the report is now recommending that private hospitals be built on the same grounds as the public ones to treat these patients. Now, given the fact that the public hospitals are crying out for funding, I don't see the logic in taking away the VHI-covered patients, who must go some way to subsidising the services they provide. Also, I'd imagine there might be logistical difficulties down the line - say for instance that a VHI-covered patient with appendicitis comes into the public hospital at 3am - will he say "no, I wanna be treated by the private hospital" will the private hospital and doctors be willing to be on standby for cases like this?

If anyone knows more about the report I'd be glad to hear your opinions on it.

EDIT/damn I spelt that wrong. Should be "Hanly Report" not Hanley Report.

oscarBravo

gaf1983 wrote:

From what I've heard about it much of it involves downgrading smaller hospitals in the country...

Yep, that's all the report suggests: reducing hospital capacity. :rolleyes:

It's about consolidating services in such a way as to provide higher-quality services in specialist hospitals. I'm pretty sure I've mentioned here before that I'd rather have a state of the art air ambulance whiz me to a specialist trauma unit in Galway than have an underfunded A&E in every small town in Mayo. I recognise that I'm in something of a minority, though.

ishmael whale

gaf1983 wrote:

From what I've heard about it much of it involves downgrading smaller hospitals in the country, or putting them out of existence.

Here it is in all its glory. The trigger was the European Working Time Directive . I’ve quoted the bit of the report of most relevance to your apparent interest.

http://www.dohc.ie/publications/pdf/hanly.pdf

… There is convincing evidence2 that the best results in treatment are achieved when patients are treated by staff working as part of a multi-disciplinary specialist team, and that better clinical outcomes are achieved in units which have the required numbers of specialist staff, high volumes of activity and access to appropriate diagnostic and treatment facilities.

Studies have shown a statistically significant link between ‘high volume’ surgeons in ‘high volume’ hospitals and lower death rates in hospital, and vice versa. Much of the research also highlights a relationship between the volume of procedures performed by individual hospitals or specialists and the outcome of that treatment for the patient. Hospitals or specialists without a sufficient level of activity find it difficult to provide safe, high quality care. Without sufficient numbers of patients and volume of procedures, specialist staff can miss audit and competence assurance targets and risk becoming de-skilled….

The thinking in Hanly is that every region should, as far as possible, be able to meet its own needs. Seeing in terms of people going from Ennis to Limerick is far too narrow an approach. It has more to do with people being able to obtain a service and level of expertise in Limerick that they would otherwise need to go to Dublin for. This means that they need to see enough patients to keep up their skill levels.

It’s ironic that the Hanly idea, which would actually be good for regional development as it would decentralise health service provision in a meaningful way, came a cropper because of the lack of vision of local campaigners. But there looks to be some hope that the essential approach will be taken up by the HSE, which would mean we might actually get to see some benefit for all the money we’re spending on health.

Captain Trips

oscarBravo wrote:

Yep, that's all the report suggests: reducing hospital capacity. :rolleyes:

It's about consolidating services in such a way as to provide higher-quality services in specialist hospitals. I'm pretty sure I've mentioned here before that I'd rather have a state of the art air ambulance whiz me to a specialist trauma unit in Galway than have an underfunded A&E in every small town in Mayo. I recognise that I'm in something of a minority, though.

The problem with that, nice as it sounds, is that it will never happen. Look at the end result of health board policy: a massive reduction in acute hospital beds, reduction in services in peripheral hospitals and a doubling of adminstration staff in the last 10 years. This is what was wanted by the successive ministers and governements.

Talking about consolidating specialist services is utter nonsense: who is going to triage that emergency when you are being airlifted? The newly trained paramedics and physician assistants which DON'T EXIST!??. What do you mean by "specialist" trauma unit. Specialist in rock climbing traumas? No, trauma units are called A/E, ER or whatever you like. They are all the same, and the bottle neck for reducing the waiting in A/E/trauma units/ER is the ability for the patient to then get to a specialist to be treated, but those beds in the public service have been *reduced* over the past decade.

It's part of the privatisation of the health service, as is going on in the NHS in the UK. The result, which is what was intended despite all the hiffing and puffing of patient services and so on, is that private contractors will provide the health service as in UK and US.

There can be a million reports, and talk of specialist centres, but the centres *will be private*. Look only at the results, as the reports have been produced for years and the only ongoing change is reduciton in public service capacity and increasing private hospitals and health insurers. Next step is managed care like US. Ignore the reports, they are fantasy to keep people dreaming.

Cork

This government has ploughed massive resources into the system. Value has not been achieved because of inefficency.

The recent example of the Mid Western Hospital was a good example.

In the Health System we have many vested interests. eg. Consultants & public Sector Unions.

But the patient has got to be central. Vested interests have to be taken on.

This is not easy as they have the right to strike.

The disasterous Healh Boards are no more. Having parish pump politicians on Healh Boards was crazy.

Efficency has to be obtained.

doubling of adminstration staff

So what? Admin Staff are needed. More are needed to control inefficent work practices and monitor costs so value and services be obtained.