Sir, – The following from an HSE spokeswoman, quoted in Paul Cullen’s lead article on the most recent scandal on Thursday, was certainly redundant: “It would be unfair of us as an organization to to nominate one or more identifiable individuals” (“Kerry mental health service concerns should be referred to Garda”, News, January 27).

Sounds familiar.

The quote is preceded by the following statement: “The very fact that there are 35 recommendations shows that the issues are many and varied.

The only sense I can make of this is that the HSE is saying things were so bad in the service they provide that it couldn’t be one person’s fault.

Unfortunately, I suspect the HSE are right. – Yours, etc.,

Pat O’Brien,

Rathmines,

Dublin 6.

Dear Sir, With reference to the recent HSE review of Child and Young People’s Mental Health Services South Kerry (CAMHS), the inability to fill the post of Permanent Consultant in Child and Young People’s Psychiatry appears to be one many causal factors. I have completed the Higher Specialist Training (HST) program in child and adolescent psychiatry in Ireland, and have received excellent training and supervision in the pharmacological and non-pharmacological aspects of child and adolescent psychiatry. child and adolescent in a multidisciplinary setting. The HST program in Ireland compares well to postgraduate training in child and adolescent psychiatry in the United States in terms of academic and experiential rigor. It is reasonable to conceptualize the shortcomings highlighted in this report as the product of a health system that does not sufficiently retain those who complete TVS, nor provide adequate resources to the highly qualified consultant psychiatrists who remain to work in the service. – Yours, etc.,

Doctor MARGARET

McCARTHY,

Oyster Bay,

New York.

Dear Sir, – The recent healthcare controversy in South County Kerry once again highlights the complete lack of management oversight of the HSE. Are we as a nation going to blame a young doctor or are we finally going to question the management of the HSE who receive 21 billion euros a year from the Irish taxpayer but who are unable to attract qualified medical staff in sufficient number?

We currently have 748 unfilled hospital consultant positions. The inevitable consequence of this is long waiting lists and more errors. Combined with this, the HSE’s implementation of the Department of Health’s ‘refuse and delay’ approach to medical negligence means lessons can never be applied in a timely manner and repeated mistakes are a consequence. inevitable.

The financial costs of the HSE’s failure to attract enough consultants was demonstrated last year with the doubling of medical negligence costs to €4 billion.

It is a complete abdication of the responsibility of politicians and permanent senior health management to try to blame doctors or nurses. The reality is that errors and failures are an inevitable consequence of Department of Health policies which are implemented by the HSE.

It is welcome that the complete lack of management control in our health service has now been exposed. We have a system in our health service where doctors and nurses can face claims from public regulators for failings, but HSE and Department of Health managers are never subject to any level of independent monitoring.

In the case of the HSE, the “Your Service” department takes complaints and forwards them to the various departments for them to investigate themselves!

Independent regulatory oversight of HSE management and the Department of Health is long overdue. HSE and Department of Health officials cannot be expected to push this; it must come from politicians, and in particular from the Minister of Health. Politicians are ultimately accountable to the electorate and doctors and nurses to their regulatory bodies. We urgently need a functional level of independent oversight and accountability for the ongoing management of health services.

Even before recent pay rises, permanent managers in the Irish health service were paid exceptionally well. One would expect them to at least take responsibility for the consequences of the policies they themselves have implemented over the past few years. Politicians, especially former health ministers, should refrain from feigning outrage at the events in south Kerry and reflect on the fact that they are a direct consequence of the policies they themselves have put in place implemented. Patients and highly qualified medical staff have had to deal with the consequences of Irish health service policy for years, and it is high time that health service officials and permanent politicians do so. – Yours, etc.,

RUARY MARTIN,

Sandyford,

Dublin 18.