The proof is in the pudding

However, a major new report commissioned by the HSE’s Primary Care Division to inform the development and planning of the new GP contract, <em>A Future Together: Building a better GP and Primary Care Service</em>, has now provided the ‘proof’ that the sector is poorly funded, at about 4.5 per cent of the overall health budget, with very low levels of practice staff, relative to other health systems, but very high patient-satisfaction rates.

The report maintains that a decisive shift to GP-led primary care is an essential component of healthcare reform and that significant transitional funding is needed, both in the short- and longer-term, to achieve this. Both Minister for Health Simon Harris and HSE Director General Mr Tony O’Brien agreed with this basic tenet at the report launch and the Minister committed to increasing funding to the primary care sector over the next decade.

Of course much lip service has been paid to the need to shift more care and funds to the community over the years, and as one commentator at the report launch put it; ‘we agree what we can and should do so show us the money’. Now that the evidence is clear on what needs to be done, let’s get doing it.

Speaking of evidence-bases, the Department of Health announced two years ago that it was developing a policy on a trauma network for Ireland. The current fragmented arrangements for dealing with trauma in hospitals in Ireland have long been a subject of debate and frustration.

The steering group set up to develop the policy has made a number of key evidenced-based recommendations on the organisation of HSE national and regional specialist trauma services in its final report, completed many months ago.

However, the report remained unpublished at the time of going to press, despite a number of media leaks.

The report is said to recommend establishing two major trauma centres nationally – one at Cork University Hospital and another in Dublin – which will be supported by a network of local trauma units.

Under the policy three Dublin hospitals will cease their current major trauma care service, while many hospitals outside the capital will also stop taking trauma patients.

If implemented, this policy will represent a major overhaul of our acute trauma services, hopefully meaning a better service for patients and trauma staff, but it will not be easy, with turf wars likely.

Selective leaks and the worry caused by the great unknown and the dreaded ‘downgrading’ headlines are not helping. While the tradition of testing the waters on suggested health service changes is long established politically in Ireland, have we forgotten the anxiety and political battles caused by the lack of initial transparency on the regional hospital and cancer services reconfigurations?

The Minister has committed to publishing the report before the end of the year. The public and health staff deserve to know what is being planned, as soon as possible.