EDITORIAL

The more things change, the more they remain the same.

Long delays in consultations and admission to hospitals for public patients were one of the key issues that contributed to the downfall of the Fianna Fáil-led government. 
In the two years since the 2011 General Election, the Fine Gael-Labour Party Government has faced a barrage of criticism over the very same issue. If anything, Health Minister Dr James Reilly is taking far more flack than his predecessor Mary Harney. He’s under fire morning, noon and night and very much on the back foot in defending his decisions on capital projects and cutbacks in the health service; especially the vexed question of the 20% reduction in pay for newly qualified nurses.
Problems in the Mid-Western Health Service Executive (HSE) area are similar to those elsewhere but, in specific disciplines of care and treatment, they are worse.
Figures released this week by irishhealth.com reveal a serious crisis for people waiting for consultations at the Mid-Western Regional Orthopaedic Hospital in Croom. 
Also, there are considerable problems with consultation and admission delays at the region’s flagship facility, the Mid-Western Regional Hospital at Dooradoyle in Limerick.
Caught up in this are hundreds of Clare patients, a sizeable number in the middle age to elderly categories.
A staggering 40% of people on the outpatient lists for Croom are waiting four years, or even longer, to see a consultant in the first place before being placed on a treatment waiting list.
Translate the percentage into actual figures and you’re looking at a really frightening situation.  The Department of Health’s Patient Treatment Register (PTR) at the end of January shows there are currently 10,347 public patients on outpatient waiting lists at Croom. Of these, 4,109 have been waiting four years or more to see a consultant in an outpatient clinic to get assessed for treatment. In fact, Croom Hospital has the highest figure in the country in this regard.
The hospital with the second highest four-year plus waiting numbers for outpatients is the Mid-Western Regional Hospital, Limerick, which has 1,716 patients waiting over four years to see a consultant.
This, unfortunately, resonates with figures produced by irishhealth.com in mid-2009 when the hospital with the highest overall average waiting time among different specialties for an appointment in an outpatient clinic was Limerick Regional, where patients had to wait an average of 592 days or over 18 months. There was a three year (1,105 days) wait for an ENT (ear, nose and throat) outpatient appointment.
In 2009, the second highest overall appointment waiting time was University Hospital Galway, with a 420-day wait overall. There was nearly a two-and-a half years (888 days) wait for an ENT appointment at the hospital.
The enormity of the problem back then was best indicated by the statistic that the routine waiting time for an ear, nose and throat (ENT) outpatient appointment at Kerry General Hospital, Tralee was 2,248 days, just over six years.
While there have been significant improvements since then, we are not out of the woods yet.
Nationally, there are now 9,784 patients waiting over four years for an outpatient consultation in a public hospital.
A total of 8,989 patients nationally are currently waiting between three and four years for an outpatient consultation.
The total number of people on outpatient lists, according to the PTR figures for the end of January, is 386,643.
Minister Reilly has pledged that no patient will be waiting more than a year for an outpatient consultation by the end of this year. Looking at the current figures, the minister will need to wave a magic wand to sort things out. He may be a doctor with healing hands but he’s no magician.
Dr Reilly has no choice but to revise the timeline for the delivery of his ambitious plan.

A minute in time

With local government as we know it set for a major shake up in 2014, it is appropriate that an opportunity has arisen to reflect on how Ennis Town was administered in the 1870s.
The earliest surviving minute book of Ennis Town Commissioners, the precursor to Ennis Urban District Council and Ennis Town Council, has been restored and has gone on public display at Waterpark House. It was formally revealed on Wednesday at the original Town Hall on O’Connell Street, which is now part of the Old Ground Hotel.
Dating from 1874-1883, the minute book is of great historic value as it documents Ennis Town Commissioners’ first meeting as an Urban Sanitary Authority, a role assigned where the population exceeded 6,000. It gives a remarkable insight into life and general living conditions of the inhabitants of the county town over a 10-year period. It provides an accurate and contemporary record of discussions on health and social issues as well as a broad range of other aspects of Ennis life.
The first meeting documented in the minute book took place at the Town Hall in Ennis on October 5, 1874. This followed the passing of the New Public Health (Ireland) Bill, 37th -38th Victoria, which represented one of the first major steps taken by the Local Government Board (set up in 1872) to tackle the growth of population, the need to create authorities to administer public health and provide or regulate such services as sewerage, paving and water supply.
“The restoration of this book will prove to be a valuable resource for academics and historians both now and in years to come. It provides a detailed record of a transitional milestone in the development of Local Government in Ireland,” remarked Ennis Mayor Peter Considine, who has been involved in local politics for 40 years. His family’s involvement goes back to when his late father, Michael was vice-chairman of Clare County Council.
Everybody from Ennis, young and old, should applaud the town council’s decision to commission the restoration of the minutes through Clare County Archives Service.