Hospital Consultants again

My 26/1/07 blog "Breaking the Consultants Stranglehold", published in the Indo (and Examiner) produced three published responses, including one from the IHCA (who also sent a hard copy to my home address). My riposte, below, was published in the Independent on Friday 2nd Feb 07.

Dear Sir - My attack on hospital consultants (Letters, January 30) has resulted in several hostile responses from the profession, doubtless a very small sample of those you received. A common theme of those responses is that hospital consultants are much maligned and made the scapegoats for all the problems in the health service.

I think they have only themselves and their IHCA to blame if their own PR has failed to convince the public. However, the public does recognise that problems within the health service are multifactorial, as stated by Brendan O'Hare, medical director of paediatric intensive care at Our Lady's Hospital, and that consultants are only part of the problem.

Hospital consultants are the most highly educated, highly skilled and highly paid group in the Health service. Their salaries equate to those enjoyed by very senior executives in business, probably far more than those paid to the much-maligned hospital administrators, and they should be providing active leadership at local level to help sort out the variety of operational issues which plague their hospitals.

Instead, the most powerful of the many vested interest groups working within the health service are perceived, rightly or wrongly, to be standing back from those local operational issues.

Rather than waiting for the "big strategy" which will solve all problems, they must adopt the maxim "think globally, act locally." In other words, each individual consultant and group of consultants must be seen to tackle those problems within their own span of control, accepting that some of their solutions will be temporary and/or sub-optimal.

The Government (and the taxpayer) is rightly reluctant to simply pour more money into a dysfunctional Health system when far too much of it seems to end up in enhanced salaries rather than enhanced services.

If hospital consultants took a visible leadership role in achieving change, they would greatly influence the other vested interest groups, including HSE and Government, to actively participate in the process.

In such a changed environment, the Government would also be prepared to invest more money in the health system. I am sure that taxpayers would support that investment. Yours etc