End the crisis…
Decent public health service now!

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Michael Murphy

The slaughter of cancer services in local hospitals around the country has begun! Professor Tom Keane, the interim director of the state’s new national cancer programme, has said that cancer services will be removed from Tralee, Sligo, Castlebar, Wexford, Kilkenny and Drogheda by the end of the year. In the case of Drogheda, the announcement to close the Dochas centre has already been announced.

The Dochas centre at the Lourdes hospital has since its opening in August 2004 provided a valuable service for patients, operating as a one stop centre of breast cancer  excellence for the whole north east region and its closure is a body blow to cancer patients in Drogheda and the entire region.

The news of these cutbacks and closures coincided with the delivery of the cancer reports into the debacle in Portlaoise where women given the all clear where then on review diagnosed with cancer. These reports are a white wash, where no blame was attributed nor has anyone taken responsibility except to blame faulty equipment which in itself is an indictment of the health service.

It has also been revealed that despite the tragic death of Susie Long late last year, that patients are still waiting up to 18 months for a colonoscopy. Susie died because while awaiting a colonoscopy on a public waiting list, her cancer had spread and Susie tragically died a number of months later. Bertie Ahern speaking after Susie’s death in the Dail said “the system did not live up to its standards in the case of Susie Long and it shouldn’t have happened.”

However, in the Irish Times (1/03/08) an unnamed 47 year old woman who has been waiting months for a colonoscopy at a Dublin hospital said she wondered if any lessons had been learned from what happened to Susie Long.

This woman experienced bleeding in November of last year and was referred for a colonoscopy, yet she still hasn’t been seen and won’t be until late April, a full five months from her initial referral. This woman could get quicker service if she had private health insurance or if she coughed up a massive €4,300 to pay for a colonoscopy in a private hospital.

This is the health service presided over by Bertie Ahern and Mary Harney – a service bedevilled by cutbacks, waiting lists, and cock ups that impact on people’s lives, a service where if you can afford it you can buy good health care, if you can’t, you can die.

These attacks on cancer services are only the tip of the iceberg. The government is intent on a massive spate of cutbacks in the next number of months and years under Harney’s so called “reform” agenda.

This government needs to be stopped. A mass campaign of patients, their families, health workers and health unions is now critical. The demonstration in Dublin on Saturday 29 March organised by the Dublin Council of Trade Unions can be an important step towards such a campaign. The Socialist Party is calling on all people who are concerned and angry at what this government are doing to our health service to get out on the streets on the 29th!

DEMONSTRATION Called by the Dublin Council of Trade Unions, Assemble 3pm @ Parnell Square, Saturday 29 March HEALTH CONFERENCE Saturday 19 April, 11am – 5pm, Liberty Hall Conference Centre, Dublin. More information contact Michael Murphy on 087 6762449

Breast cancer scandal
Government sidesteps responsibility in blame game

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Helen O’Connor

Three reports have now been published into the controversy at the Midland Regional Hospital at Portlaoise, in which nine women were falsely given the all-clear for breast cancer following mammograms between 2003 and 2007.

The reports strongly criticise the breast cancer service in the hospital. One, a clinical study of the mammography services, found that women attending the hospital suffered “a significant and avoidable delay in the diagnosis of their breast cancer because of low standards in the breast imaging service,” including the fact that the imaging machine was five years older than the normal lifespan of 10 years and that “the cornerstone of breast care services”, triple assessment, was not used at the hospital. As a result, “the safety, quality and standards of many aspects of the service fell well below achievable best practice”.

A second report, examining the management of events following the suspension of services in Portlaoise, highlighted the “systemic weakness of governance, management and communications within the HSE”. Despite these damming indictments of the breast cancer services, no one has been made accountable or taken any responsibility. System failure, poor governance, poor management, poor communications have all been blamed as if these were in some way separate from those who fund and run the service.

But ultimately it is Mary Harney who heads up this system, has done so for nearly four years as Minister for Health and has been part of coalition government with Fianna Fail for 10 years, during which there has been continual and deliberate underfunding of the public health system. She in turn is assisted by her appointee, Brendan Drumm, head of the HSE, which was established by that same government. 

Their seeming unawareness of the crisis in breast cancer care in the Midlands was shown to be completely false as it emerged that a request was made in 2000 to the then Minister for Health, Michael Martin, by the Midlands Health Board to appoint a breast cancer surgeon to the hospital and then in 2002 warnings were sent to the same Minister from a local surgeon highlighting a shortage of consultant staff for the breast unit. Mr Martin’s response to criticism about his lack of response to these warnings has been to describe it i.e. the criticism, as "outrageous". He has accused the opposition of showing "some neck" in calling for him to quit.

This mirrors the response of Mary Harney to the publication of the reports. She has said that she will not be resigning over the ‘controversy’ and has given her full support to Brendan Drumm and his management team at the HSE. Brendan Drumm in turn, while saying that he has “absolutely no disagreement with comments made in the reports”, said that he would not be resigning as “the report on the HSE's actions had not held any member of the management team to be accountable”.

Naturally the families of the patients who were misdiagnosed, some of whom developed cancer, have expressed their anger over the lack of accountability in the reports published. Michael Kennedy, the son of Joan Kennedy (79) of Dunkerrin, Co Offaly, who was given the all-clear for breast cancer but was later found to have the disease, said the report was a whitewash. “We want to identify who was responsible and make sure there is some accountability.” Mary Harney has said that mistakes will be learnt and patients will be the overriding priority in the future. But which patients does she mean?

The reality is that nothing will change while there is continued support of a two tier health system, where those in the public system join long queues and receive inadequate care, where the public system is being run down, with increasing cutbacks being announced by the HSE, directly impacting on patient care and where people’s health needs come in second place to a government determined to push ahead with the privatisation of the health service, while underfunding public health care. Only a properly funded public health care system, based on need and free for all, can properly provide for the health care needs of women and men.

Children's health and education
Government neglects autistic children's rights

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Fiona O'Loughlin

The recent public debate between the Minister for Education Mary Hanafin and parents of autistic children has highlighted the abject failure of the government to meet the educational entitlements of children with A.S.D, (Autism Spectrum Disorder).

The debate centres on parents having the opportunity to send their children to schools that have specialist teachers trained in Applied Behavioural Analysis (ABA). This is an intense form of teaching, backed by scientific studies, on a one-to-one basis. Children who have received this form of education from an early age have shown huge progress in dealing with their difficulties, behavioural, sensory, speech and comprehension problems.

Autism is an extremely complex condition with no two children having exactly the same level of difficulty or exactly the same behavioural patterns. That is why a variety of treatments is required. Colm and Lesley Feighery have a 9 year old son with autism. They explained to the Socialist how they have had to battle with the state in order to get what their son is legally entitled to. Early intervention was crucial to allow their son to cope with his disability. The waiting list for an assessment is two years, they like many other parents in the same situation had to go private and pay to have their son assessed. After this, they received a home tuition grant from the Department of Education and were told they had to find a specialist to teach their child at home!

The waiting lists for speech therapy are so long that Lesley and Colm had no choice but to once again go private as early intervention was essential. They had to campaign (with 11 other parents) for a year to get a school expanded, that provided ABA but only after they threatened to take them to court. Their son is now in second class in a mainstream school, happy and doing very well academically. However, the battle is not over. He is in need of occupational therapy and there is a shortage of occupational therapists so they are still fighting for his right to the treatment he needs. As an autistic child with special needs in a mainstream primary school, he has a Special Needs Assistant (SNA). There are no SNAs in secondary schools.

It is clear that more schools, teachers trained in the various specialist fields and supports such as occupational therapy and speech therapy is what is required to resolve this crisis. These services should be there as a right and the responsibility for providing these essential services rests with the government.