Public or Private?

Do you have private health insurance? I do, as does over 50% of the Irish population. I have no problem in admitting that it offers a welcome safety valve in an otherwise chaotic system of healthcare. I can think of lots of other useful things to do with the money I spend on health insurance but I choose to make healthcare my priority. It’s not a decision I take lightly. I firmly believe that the way forward for our health service is a system of universal health insurance, funding a single tier health delivery model which promotes equity of health care. However as our health service is in such complete disarray, I feel I’ve no other option other than to continue to invest in health insurance. I’ve certainly had reason to be thankful for it over the years though it has proved at times, to be a bit of a double edged sword.

In late 2004, I was told that I needed some complex surgery carried out to arrest a chronic frontal sinus infection. I was under the care of a consultant surgeon who operated a private practice as well as a public service contract. With my health insurance policy, I’m fully covered for surgery in a private hospital with accommodation in a single room. However, my choice of doctors and hospitals is limited as I have a complicated medical history. On this occasion I was informed that the surgery would have to be carried out in a large public hospital where the necessary back-up facilities would be available. I was duly given a date for surgery and booked for post-op recovery in a high dependency ward. Two days before the operation, the hospital phoned to ask me to report immediately for admission. I initially protested at the stupidity of taking up a bed for two days pre-op but was told that a bed could not otherwise be guaranteed. I had no option but to agree to this crazy plan. By the time I had my overnight bag packed, the hospital phoned again to say that the bed was no longer available due to an admission from casualty. This process was repeated several times over the following two days until eventually, my surgery was cancelled due to the failure to secure a bed. The surgeon was furious as an operating theatre and a surgical team had been booked solely for my lengthy operation and it all went to waste that day. Frustrated by the restrictions imposed, the surgeon suggested that a stop-gap procedure be carried out in a small private hospital. I was duly admitted the following week and underwent some relatively minor surgery. However, this action also backfired as the surgery was unsuccessful and within months I had to return to discuss the bigger operation. The surgeon again insisted that the surgery should be carried out in the large teaching hospital and in order to secure a bed, he put special arrangements in place to allow me to be transferred to the nearby private co-located hospital, to recuperate. This was only possible because I had health insurance. It should not have been necessary.

I duly checked into the co-located hospital early on the morning of my operation and within hours, was whisked away to the operating theatre in the main hospital where I remained for the rest of the day. When I next came to, I was back in the private hospital in a shared room with three other women. I now had a sophisticated stent in my skull to facilitate drainage and a surgical wound over my right eye. I received good post-operative care and was discharged home feeling extremely lucky that all had gone so smoothly. About two weeks later, my post-operative pain began to worsen and I developed severe swelling around both eyes. I was asked to report to the busy A&E department in the main hospital where I was assessed and admitted. My health insurance again secured a bed for me in the private hospital and I happily settled into a 5-bedded room, secure in the knowledge that I was lucky to have a bed at all. Three days later, it was discovered that my surgical wound was infected with MRSA and thus began a lonely journey which continues to this day. The following week while I was longingly gazing out of the window of my isolation room, I spotted a woman I recognised in the car park. I’d shared a room with her in the private hospital a month previously, immediately following my operation. I waved frantically to attract her attention and she came over to chat to me through the open window. That’s when I learnt that her problem had turned out to be an MRSA infection and that’s when the penny dropped!

The airwaves are constantly buzzing these days with sad stories about the failures within the public health service but private hospitals are not the answer to the problem. They are selective and only serve to perpetuate the upstairs downstairs model of healthcare in this country. They do no offer A&E services which means that all patients requiring emergency treatment must be processed through the chaotic system in the public hospitals, regardless of their insurance status. Those with complex medical/surgical conditions generally cannot be treated in private hospitals because the medical back-up there is too limited. And anyone who takes out health insurance in the belief that they’ll be entitled to a single room, is in for a big shock if they are hospitalised. There is a huge shortage of isolation facilities across the country and single rooms quite rightly, have been prioritised for infectious patients and those who are dying. Our public health service is expected to provide all these service yet it’s on it’s knees through years of neglect and inadequate funding from the Government. Unfortunately, our Minister for Health continues to believe that the way forward is to promote the present unsatisfactory public/private mixture of healthcare by encouraging the development of co-located private hospitals. You have to question the wisdom of backing a policy that further perpetuates inequity of healthcare. We have a booming economy in Ireland but our health service is failing the most vulnerable people in our society. This is not about public versus private healthcare, it’s about saving lives.

7 Responses to Public or Private?

  1. Grannymar says:

    Steph I totally agree with you, it should be about saving lives.

    The disgrace is that no matter whether you can afford to pay or not, the risk of MRSA and other infections remains so high.

  2. Steph says:

    You’ve hit the nail on the head there, Grannymar.

    People think that hospital acquired MRSA is only a problem in the big hospitals but the reality is it’s everywhere where sick people are, including the best of private clinics!

    btw Do you like my fancy IBA banner in sidebar? You know who helped me with it!
    You are welcome to borrow it if you wish and I look forward to meeting you at the event – Yes! I plan to be there! Your temptation worked and I finally plucked up the courage to register yesterday! 😀

  3. Grannymar says:

    Yippee I’m delighted! 😀 We can hang out together and I will introduce you to my Toyboys.

    My eyes were green with envy when I saw the IBA Logo. I guessed who helped with it. I might steal it tomorrow. I’ll try talking my offspring into photocopying it! 😆

  4. Dr Thunder says:

    I’m with you on this one, Steph. Private medicine kinda grates against my leftie ways, but I have VHI cover. Wouldn’t be without it. All my family has it too.

    BTW, sorry bout the extended leave of absence. Our blog is now back in action 😀

    Dr. Thunder

  5. Steph says:

    Heh! Welcome back, Doc Thunder. Good to hear from you again.

    I am in no doubt that the best medicine is found in the large teaching hospitals. However, unless your case is very urgent, it’s nigh impossible to get into them so people are forced to take out insurance for cover in private hospitals.

    I have a real problem with the fact that the facilities in private hospitals (accommodation, food etc.) differ so much from those in the public hospitals. We should have one standard that’s good enough for everyone.

    Though I will admit, when I got offered a transfer from the MRSA isolation unit in the public hospital to a single en suite room in the private, I was one happy camper! The difference between the two in terms of the level of dignity afforded however, was outrageous and I felt very uncomfortable with that discrepancy.

  6. Baino says:

    Steph I’m a bit confused. Can’t you be a private patient in a public hospital? You can here. When ClareBear was young, she was hospitalised a couple of times for asthma. Both through the emergency department of a large local hospital. The first time, she was in a bad way and I had no time to properly book her in so they assumed she was a public patient. I kept mum and wasn’t charged anything. The second time, same hospital, same room, she was less distressed and I formally admitted her and that I had private cover. The three day stay cost around $3,000 for exactly the same treatment. As for MSRA, it doesn’t appear to be as widespread here. We hear of ‘breakouts’ now and again in specific hospitals but they seem to go into lockdown as soon as it appears. I’ll have to do some research.

  7. Steph says:

    You’ve opened up another whole can of worms there, Baino.

    We have huge shortages in the public hospitals (not enough beds, staff, facilities, funds etc) and those with no insurance suffer terribly as a result of long waiting lists. Rightly or wrongly, health insurance means faster treatment but not necessarily in a public hospital. Many of the consultants who work in the public system also have a quota of beds in the same hospital for their private (insured) patients but they are being squeezed out due to the demand for beds for sick patients patients from A&E departments. That’s what happened to me though I was lucky in the end. Public patients may have their operations cancelled repeatedly. Operations are cancelled frequently due to bed shortages/budget cuts etc leaving surgeons twiddling their thumbs and operating theatres sitting empty despite the huge waiting lists. The consultants with a public/private case mix have been asked to increase their public duty contract with the lure of a nice pay hike but they ain’t happy ‘cos this means restrictions imposed on their lucrative private practice. We’ve had stale mate on this for years and in the meantime, patients continue to suffer (and die) on waiting lists. I could go on and on!

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