Same January, same miseries: Time to turn the pages on failure

Getting things done in a democracy is difficult.

Same January, same miseries: Time to turn the pages on failure

Getting things done in a democracy is difficult.

Bureaucracies move slowly; there’s little that can be done without consultation, vested interests want a say, establishments of one kind or another don’t welcome inconvenient change, introducing new laws or updating existing ones takes time, and when money or lack of it is the issue, the tempting solution is the establishment of an inquiry or an Oireachtas committee charged with making, somehow or other, the problem go away.

Yes, it’s all very difficult, which is why the salaries paid to politicians and top administrators are significantly higher than those handed out to, for example, nurses, hospital cleaners, and the people whose job it is to restore power lines knocked out by storms, known these days as weather events.

But surely not everything our public services and the men and women who manage them have to handle requires the skill levels of brain surgeons and rocket scientists. There are, of course, events that can’t be predicted and planned for.

What has become wearily predictable, year after year, is the abject failure of those who run this country to deal with occurrences entirely predictable in, for example, January.

Occurrences such as a surge in demand for hospital services and violent weather events powering in from the Atlantic.

We don’t need Mystic Meg to warn us about the bad stuff that can happen as the year turns, but here we are again. Last year’s patients-on-trolleys count in Ireland’s hospitals was 612, a stark enough statistic to have hand-wringing ministers and HSE officials churning out bromides and commitments of the ‘never again’ variety. Never again?

Yesterday’s count was 656, according to the Irish Nurses and Midwives Organisation, the highest number recorded — and the worst of the winter flu outbreak has yet to be felt.

Once again, there are the same platitudes from our elected officials. Health Minister Simon Harris says hospitals are facing a “difficult few weeks”, he’s in regular contact with the HSE, there will be “exceptional measures”, increased bed capacity, and, he promises, health service reform.

The proverbial man in the street — or, in this case, the patient on the trolley — would be more than justified in asking why, when government spending on health has been increased, we are in this mess yet again.

Why is Mr Harris promising more beds now, when — as the Irish Hospital Consultants Association points out — acute hospital in-patient bed numbers have been cut by 1,400 in the past ten years?

Given that the overcrowding and waiting time figures vary significantly across the country, what has become of Mr Harris’s promise last year to make individual managers responsible for their hospital’s performance?

If they are not be held accountable — doubtless there are legal problems in making that change — should we look instead to Mr Harris and the people at the top of the HSE to pay the price of failure?

As ever, it seems, they are all responsible, yet none can be blamed. One of the reforms to which Mr Harris refers is his plan — yet to be examined in parliament — to put the Health Information and Quality Authority in charge of licensing hospitals, and giving it the power to close those that do not meet patient safety standards.

It sounds good, provided it does not result in fewer hospitals than we have now, but as the proposal was made some 11 months after last year’s crisis, patients would be unwise to hold their breath.

The same pattern of complacency and inaction can be seen as the country is visited yet again by storms, high tides, and floods; the only thing that’s different, as homes and businesses are hit by power outages and floodwater, is that each storm has a new name.

Again, the reaction is one of surprise, as if this island found Atlantic storms utterly unfamiliar; something quite new for which no central or local government could possibly have foreseen and planned for proactively in infrastructure spending designed to protect power supplies and strengthen sea defences.

Storm Eleanor hits Lahinch.
Storm Eleanor hits Lahinch.

Agriculture — and the number of deaths in the sector — is yet another environment in which little, if anything, changes for the better, despite the time and money spent on organising conferences, workshops, safety initiatives, and publicity drives.

The Health and Safety Authority reports that there were 24 deaths in agriculture in 2017, four more than in 2016 and the eighth successive year that farming had seen the highest number of work-related fatalities, a toll higher than the average across Europe.

Its chief executive is right when he says everyone involved in farming must aim to make whatever changes are necessary to work practices.

Farm work can never be made completely risk-free, but perhaps fine words from the authority are no longer sufficient when faced with this unacceptable but seemingly unchanging death toll. Intrusive inspections and prosecutions are needed.

In all of these areas, 2018 must be the year in which things that are not entirely impossible or unpredictable get done.

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