TOO MANY COOKS…?

18 May 2012 No Comments by The Northern Standard

The sharp political exchanges at Tuesday night’s meeting of Monaghan Town Council over the latest threat of a significant removal of services from Monaghan General Hospital (see story, page one) shows that this long-running issue is still one that can raise the passions of our local politicians.
Partisans of Fine Gael and Sinn Féin, the main participants in this occasion in the verbal volleys generated by the topic, may derive satisfaction from what they perceive as the successes of their representatives in delivering telling blows in the course of the repartee.
The more neutral, and, perhaps, more cynical, reader might be tempted to look upon the content of the debate as more hot air impotently expended far from the concentration of the decision-making power that ultimately determines the level of health services we enjoy in this county.
There is a degree of accuracy in that assessment, but Tuesday night’s debate, and the one which preceded it at Monaghan Co Council level last week, are insightful of the confusion and conflicts that contribute to the sorry state of local health provision – and often cloak it in a camouflage of contradiction when it comes to the assignment of ultimate responsibility.
There can be no doubt that proposals that seem to be in train to remove kitchen facilities from Monaghan General Hospital and St Mary’s Hospital in Castleblayney and assign these functions to St Davnet’s Hospital in Monaghan Town, from where food will be distributed to the other centres, are, in the bald way they have been presented thus far, patently ludicrous as cost-saving measures.
It is easy to see why some might assign more sinister motives to the stratagem, and fear that the ultimate closure of the Monaghan and Castleblayney hospitals is what is really on the cards.
There is a degree of comfort to be derived from the indication given by Monaghan Town Council Cathaoirleach David Maxwell that the proposal might only be in the preliminary stages of consideration.
The local political furore and the publicity it has generated might be of some ultimate purpose if it concentrates the minds of those contemplating this step on the inherent fallacy as well as the inevitable unpopularity of its implementation.
But who ultimately makes that decision?
Some strong emotions were stirred by the statement in correspondence to Monaghan Co Council last week by Fine Gael Deputy Sean Conlan that the Minister was unaware of this proposal, and that it had been conceived at local management level by the HSE.
It is plausible and understandable that a degree of responsibility for implementing efficiencies is devolved to those on the ground in health service administration.
They, after all, have the local knowledge and the detailed information at their disposal to at least posit recommendations in this regard.
Given the perception that much of the damage inflicted on health services in our region has derived from distant diktat by shadowy and unaccountable figures secreted in the labyrinth of HSE bureaucracy, it is hard to question the principle of local determination in this regard – even if, in this specific instance, the measure under consideration appears fundamentally misguided.
But it is equally hard to accept that the Minister himself would not have his finger firmly on the pulse of such local deliberations and, in light of the acute sensitivity of further proposals to diminish services at hospitals in this county, would not have his political antennae attuned to detect any measures likely to incite controversy.
That the Minister apparently had to be told by the political representatives of his party in the locality that this measure was being contemplated seems eloquent of what is fundamentally wrong in our health services.
Most reasonable thinking people would assume that the Government Minister is, in Colr Robbie Gallagher’s description on Tuesday, “the boss man”, and would probably concur with Colr Gallagher’s plainly put assertion that he “bloody well should know” of such decisions if he was in contact with his officials.
This gross level of disconnect, as Colr Sean Conlon put it, is troubling.
The impression of decision-making in health matters being outside the purview of the person in whose ministerial responsibility the governing determination should lie has been abroad long before Dr Reilly took office.
But Dr Reilly took on the Ministerial mantle with the mandate to change this situation – and his declarations prior to the last General Election and in his early days in office promised a fundamental overhaul of health administration that has so far had only superficial manifestations.
The Minister appears to be a sincere and decent man, and not one to eschew the delivery of hard truths to a potentially unreceptive audience, as his recent addresses to conferences of health service professionals illustrated.
We would respectfully seek to prevail on him once more to come to Co Monaghan and in a suitable public forum tell the people of our county the plain truth about what the future holds for Monaghan General Hospital and health services generally in the county.
It is no more that our readers, many of whom voted for Fine Gael candidates in the last General Election with the hope that a change of government would see some level of service restoration at the hospital, deserve.
No matter how often and how passionately the hospital issue is debated at our local political forums, no determining clarity will emerge unless and until the Minister takes such a step.
In its absence, the suspicion of a malign covert agenda to bring about the ultimate closure of Monaghan General Hospital, and perhaps other long-standing health institutions in our county, will persist.

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