EDITORIAL

CLARE Local Development Company (CLDC) celebrated its 21st anniversary in fine style this week with a major showcase exhibition in Ennis. The Banner Rising event at the West County Hotel featured more than 120 stands from small companies and community enterprise schemes assisted by CLDC over the years.

 

There is certainly cause to celebrate the fact that almost 1,200 local businesses and community projects have benefited from the organisation’s community-led development funding, totalling €86.5 million, since the first LEADER contract was awarded in Clare in 1992.

Is it any wonder then CLDC is one of 50 companies around Ireland vehemently opposed to Minister Phil Hogan’s proposed local government reforms, which would see new county council-led bodies replace local development companies as the organisations responsible for LEADER and other programmes.

The company also rejected what it claimed were efforts by the minister to discredit the contribution made by local development companies and their staff across the country.

It’s working well in Clare anyway and the facts are there to prove it. There’s scarcely a parish in the county that LEADER, or other schemes, haven’t reached.

Since 1992, 1,550 jobs have been created or sustained and training provided to 3,000 people in this county. Currently, the company employs 68 people on a wide range of programmes, including LEADER, Local Community Development Programme, Rural Recreation Local Training Initiatives and community work schemes.

This year, the company will be responsible for the employment of a further 312 people on a variety of schemes around the county.

Doirin Graham, CEO of CLDC, in a strong rebuff to the new proposal, said, “What Minister Hogan wants to do is discard community-led development and replace it with the State. Our organisation has 21 years experience of bottom-up development, a huge voluntary input, strong relationships with communities and people on the ground and provides better value for money.”

She noted how in sharp contrast to Minister Hogan’s failure to back up his contention that a local authority-led model would deliver a better service to the public and save money, the European Commission and the OECD have praised Ireland’s local development organisations strongly for their ability to deliver EU supports and policies on the ground.

Given the storm of protests that have been attached to the Household Charge and water charges, the last thing Minister Hogan needs is another major controversy blowing up in his face. If he has learned anything from his tunnel-vision approach to the introduction of charges, he should stand back and engage in constructive dialogue with representatives of local development companies.

Minister, before making any decision on the future administration of local development companies, consider the old adage, “if it ain’t broke, don’t fix it”.

Which hospital?

TWO reports prepared for the Department of Health in relation to future hospital structures and services have caused angst and confusion among the general public. The Report on the Establishment of Hospital Groups as a transition to Independent Hospital Trusts and The Framework for Smaller Hospitals document published this week, have raised a lot of issues as regards to where patients present for treatment or hospitalisation.

Health Minister Dr James Reilly, in a number of interviews, has said rather than close them, small hospitals would provide more day care, diagnostic and other services. He said the new system would result in safer services for patients.

“This is about providing safe services to patients, not about cutting services to save money,” Dr Reilly said.
Needless to say, Ennis General Hospital is again a pawn in an elaborate game of chess being played by the Department of Health. Ennis comes into the frame as one of 10 hospitals where some services will transfer to bigger facilities; while smaller hospitals are due to gain other more routine services. Nenagh and St John’s in Limerick are also on the list. The three hospitals will remain linked to the Mid-Western Regional Hospital at Dooradoyle.

Most of the smaller hospitals have already seen an end to their 24/7 emergency departments and the loss of major surgery, on grounds of safety. They will develop more day surgery, chronic disease management, medical services and diagnostics and will provide more services, rather than fewer, according to the report.

It further outlines the need for smaller hospitals and larger hospitals to operate as a single hospital group. It defines the need for the smaller hospital to be supported within the hospital group in terms of education and training, continuous professional development, the sustainable recruitment of high-quality clinical staff and the safe management of deteriorating and complex patients.

The problem with this is that the families of people who fall ill or sustain injuries won’t know where to turn for help. Is it Ennis or Limerick? They won’t be interested in systems when they need medical attention.

According Minister Reilly, the successful implementation of the Framework for Smaller Hospitals, within the context of hospital groups, provides the opportunity to deliver safe and effective care at the lowest level of complexity and closest to the patient’s home.

The logistics involved in implementing the plan present a massive challenge for the health service. Can it be done? If there are gaps in some areas, can it still work or will the entire plan unravel?

These are the kind of questions being asked in Clare in light of the fallout from the hospital reconfiguration process, the loss of the 24-hour emergency department and the emergency ambulance bypass in recent years.

Public experience of the health system in general and hospital services, in particular, has not been good, so it’s litttle wonder that people are somewhat sceptical about the plan. The delivery of the plan could well prove to be a defining point in Minister Reilly’s political career.