EDITORIAL

OUR health service continues to defy logic. Perhaps, at this stage, it would be appropriate to take the ‘service’ out of the Health Service Executive.
Recently, we highlighted how Clare patients, availing of day surgery and diagnostic procedures in UCHG and Merlin Park hospitals in Galway, could face a 290km return trip to Roscommon if a new proposal is adopted in a HSE reconfiguration of acute hospital services in the West.
In an effort to reduce long waiting times for procedures in Galway, it emerged the HSE is planning to use Roscommon Hospital as a diagnostic centre for the region.
This raised concerns that the needs of Clare patients were being sacrificed so that Health Minister Dr James Reilly could offer compensation to Roscommon for the loss of 24-hour emergency cover in August.
Clare people can empathise with Roscommon hospital’s predicament as the Mid-Western Regional Hospital in Ennis has experienced HSE reconfiguration and lost its 24-hour emergency service over two years ago.
However, the notion of Clare patients going to Roscommon would be a bitter pill to swallow. No amount of explaining could convince anybody in Clare that it would be acceptable to head to Roscommon for any kind of treatment or assessment.
In a strange twist, the psychiatric unit at Ennis hospital is now being earmarked to facilitate patients from North Tipperary due to the proposed closure of an acute psychiatric unit at Clonmel General Hospital.
This is also a non-runner, both from a Clare and Tipperary perspective.
Apart from the distance for Tipperary people to travel to Ennis, there is already a serious issue with the availability of beds in the unit. Staff cuts in the offing will compound matters there.
Also, there is a squeeze on community-based psychiatric services in Clare. If funding is cut further or more staff positions, whether contract or permanent, are lost, people with psychiatric problems currently living in the community could find themselves in no man’s land. They would be alone without support, some possibly having to leave HSE houses.
The least desirable option would be a return to a hospital environment for any out-patient but that might not even be an option if people with more pressing needs are brought in from North Tipperary.
Just as Clare people would be expected to rail against the proposal for patients from this county to bypass two Galway hospitals to avail of day services in Roscommon, you can expect a similar reaction from North Tipperary people being told that they must go to Ennis.
There are, however, two distinct differences from the Roscommon scenario.
The Tipperary patients would be in-patients in Ennis and secondly and most relevant, is the fact that Ennis can’t cope with the needs of its existing catchment area.

Small businesses under pressure

Small business owners in Clare and all over the country feel their operations are being curtailed as a direct result of banking restrictions, compounded by increasing delays in being paid for goods and services.
Yes, we’ve heard it over and over again since our economy took a nosedive but the latest figures from the County and City Enterprise Boards’ bi-annual Business and Banking Confidence survey come as an unwelcome reminder.
Of the 1,700 sole traders and small business owners who took part in the July survey, 45% consider the effect of current banking situation on trading and business operations to be “serious”.
Difficulties in getting overdraft facilities or bank loans continues to have a detrimental effect on smaller businesses, according to the survey, which found that over a third of small businesses nationwide felt the availability of credit has deteriorated since January 2011, representing 37% of those surveyed.
There is a disturbing pattern in that comparable figures emerged from the January 2011 and July 2010 surveys, which also found that over a third of businesses felt that access to credit had worsened during the previous six months.
A greater number of respondents also felt their business was being curtailed by bank restrictions this year, when compared to last year. In July 2010, for example, 44% of small businesses felt their business was being curtailed by banking restrictions, compared with 48% in July 2011.
Clare County Enterprise Board CEO, Eamonn Kelly said the survey shows the lack of access to credit is hurting many small businesses in Clare and all over the country.
“Without access to cash flow and credit, many viable businesses are going to lose sales, customers and jobs,” he warned.
A majority of those surveyed have indicated support for a small business loan scheme proposed by the County and City Enterprise Boards. Nearly seven of out 10 respondents (69%) felt such a scheme, to provide loans of up to €20,000 to support working capital needs, would be both “helpful and desirable”.
Despite the negatives in the survey, quite a number of respondents have a positive outlook in regard to the immediate future. Nearly a third (32%) expect turnover to be better over the next six months, when compared with the January to June period this year. There is also a slight improvement in people’s experiences of the business environment.
The number of business owners who feel the current business environment is either poor or very poor, is down from January 2011 (53%), compared with a figure of 48% in July 2011.
Whatever about people who see improvements on the horizon, there can be no question that in the greater scheme of things we have a mountain to climb before our small business sector is back to full health.
With large companies continuing to close in favour of transferring to cheaper economies, the Government will need to seriously consider smaller firms, especially home-grown, as providers of more stable employment.