Editorial 23 Sept 2019

Striving to provide a more equal healthcare service

Our previous editorial ended by referring to Sláintecare’s commitment to equality of access for patients. This reference was in the context of removing private practice from public hospitals, which was the subject of the recently-published de Buitléir report. While the existence of private healthcare is the most obvious example of access inequality in the health service, it is not the only one. And there are varying degrees of inequality experienced by patients, even when they come off waiting lists and enter the public system.

Take foreign nationals who do not speak English as a first language. This was the subject of the main feature in the previous edition of the Medical Independent. According to experts, the lack of regulation and standardisation of interpretation services is adversely affecting this group’s treatment within the health service.

And in this edition, there is a feature on health services for people who are deaf. Again, access to good interpretation services is an issue for this cohort. Authors Dr Margaret du Feu and Dr Tara Rudd point out that interpretation services are important, as there is a danger that even common health problems could be missed as a result of communication barriers. There is also an increased prevalence of mental health problems within the deaf population, for a variety of reasons. One factor is the significant delay in the recognition and treatment of such illnesses.

It is worth pointing out that earlier this year, the Mental Health Commission published a report, which stated that people with severe mental illness in Ireland are being denied access to essential physical healthcare services.

According to the report, some patients with severe mental illness were being discriminated against, as they were being denied access to services such as physiotherapy, dietetics, speech and language therapy, and seating assessments. The report also found that physical health monitoring for people with severe mental illness fell below international best practice standards. Author of the report, Dr Susan Finnerty, said the findings amounted to a breach of human rights.

The provision of high-quality healthcare requires the acknowledgement that not all groups are the same, and some need more assistance than others. Our main feature in the current edition on perinatal mental healthcare shows the difference that can be made when a concerted effort is made to improve services for a given group. The model of care introduced to improve mental health services for these women has been a success, even if there are still some gaps in provision, two years after the new model of care was introduced. While society may be unequal, the onus on healthcare services is to strive to be as fair and accessible as possible for all groups.