Privatisation

Do you wanna be in my bed, my bed, my bed…

Need I say more about the so-called ‘reform’ of our health service?

The Sea Stallion

Today I’m breaking with the usual format of this blog to write about something that has nothing to do with medical matters. Actually, if you really want to know, I’m writing this for my good friend, Grannymar who earlier today on her blog, put in a request for a Viking. Never one to disappoint, I set off on a journey to see what I could find.

I left the port of Howth this morning in the company of some good friends who were kind enough to invite me and the hubbie to join them on their 32ft sailing boat, to sail around into Dublin Bay to watch a Viking replica ship leave Dublin Port en route to Denmark.

The 30 metre long “Sea Stallion from Glendalough” is the world’s largest Viking ship reconstruction. The remains of the original ship which was constructed out of Irish wood nearly 1,000 years ago, were found in 1962 following excavations in the Roskilde Fjord in Denmark. After many years of hard work, a replica was reconstructed to resemble how the ship would have appeared all those years ago.

On 1 July 2007, the Sea Stallion left Denmark to travel to Dublin on an expedition to recreate the epic Viking voyages made from Scandinavia to our land generations ago. On arriving in Dublin in August 2007, the Sea Stallion went on public view for the winter months, at Collins Barracks. Today marks the start of it’s journey back to Denmark.

We had a fairly lively sail in Force 6-7 winds, arriving at the mouth of Dublin Port just in time to see the Sea Stallion emerge under sail. The ship was closely followed by a large flotilla of boats having had a big send-off from Dublin docks. Luckily, the wind ebbed at this stage and the sun came out to turn the event into a magnificent spectacle. We accompanied the Viking ship as it sailed around the Baily lighthouse (pictured above) and on past the island, called Ireland’s Eye (off Howth), before we parted company to drop anchor ourselves and enjoy lunch in the shelter of the island. It was a fantastic day-out.

I counted 44 ‘Viking’ heads onboard the ship today. I’m hoping that this ‘catch’ will be enough to satisfy Grannymar’s wishes.

I did my best Grannymar… honest!

Photos thanks to my husband, Jaimie

Anyone for Tennis?

Yes, it’s that time of year again. For the next two weeks, I shall be glued to the television screen at every available opportunity, watching the Ladies Singles draw unfold. This year, my money’s on the Serbian player, Ana Ivanovic to win the title. She’s the top seed and the world No. 1 player having just won her first Grand Slam at the French Open, so she’s got it all going for her.

I’ve been hooked on Ladies tennis for as long as I can remember. I used to love playing the game myself but my funny joints (EDS) put a stop to play so these days, I merely enjoy it as a spectator sport. Last year, I made my first ever trip to Wimbledon to see the real thing. I booked the flights in advance of my operation in March so that I’d have the trip to look forward to after the surgery. It was a fantastic experience but now that I’ve done it, I’m happy to watch the Championships from the comfort of my own home. In all of the many years I’ve had surgery, I’ve never managed to time it right so that I can really put my feet up to enjoy the tennis. My family always groan when Wimbledon fortnight arrives as meals have to wait their turn. Even blogging is likely to suffer so don’t say you weren’t warned!

I’ve just dropped my daughter off to the airport for an early morning flight to the sun. She’s knows better than to stick around when Wimbledon is on. It’s every man for himself for the next two weeks. Perhaps my marriage vows should have read “For better or for worse, in sickness and in health, and for Wimbledon.”

Design and Dignity

I attended a public lecture in Dublin last night as part of the Hospice friendly Hospitals (HfH) programme. The subject matter was ‘Design and Dignity’ the case for renewing our hospitals. The Irish Hospice Foundation has launched a unique national programme to mainstream hospice principles in all areas of hospital practice relating to care for the dying and bereaved. The lecture while enlightening, succeeded in emphasising the major deficiencies that exist in Irish hospitals but it was good to hear that attitudes are changing.

Professor Roger Ulrich, Director of Centre for Health Systems and Design in Texas, delivered a long lecture outlining the evidence based design principles that should be incorporated into all future hospital developments. Steps such as improving visibility of patients, providing single bed rooms, reducing noise levels, and introducing nature and art to the hospital environment, have all been shown to reduce stress for the patient. This is all very laudable stuff but it seemed a million miles away from the reality of the Irish Health Service where patients consider themselves lucky to even get a hospital bed and where cross-infection is a major problem due to overcrowding. Janette Byrne, spokesperson for ‘Patients Together‘ took to the floor and told the audience that what Prof Ulrich was talking about was “just a dream for Irish patients.” Janette, who is herself recovering from cancer, stated “I live more in fear of the Health Service than I do of my cancer” and for me, that really said it all last night.

We have a long way to go to make our hospitals more user friendly in this country. Irish hospitals are a very long way off meeting the needs of patients, families and staff in relation to dying, death and bereavement. The HfH programme aims to change the culture of care in our hospitals so that people can die with dignity. This programme is not about blaming and shaming, it is a challenge to us all to ensure that a better service will be provided. The chairman of the night, Gabriel Byrne, challenged us all to “imagine” a future where our hospitals would provide dignity in dying, and to “have hope.”

A Gift of Time

The Irish Cancer Society has launched a new initiative to make sure that cancer patients do not miss their appointments because of transport difficulties. A pilot scheme Care to Drive began three weeks ago with volunteer drivers transporting patients from their homes to hospital appointments. The scheme has been devised in response to an anticipated greater need for transport when cancer care is centralised into the eight designated specialist centres established under the National Cancer Care Strategy. The hope is that it will go some way towards allaying the fears of cancer patients who face difficulties in travelling to appointments.

The new pilot scheme was launched on 16th June 2008, by Prof Tom Keane, the director of the State’s new Cancer Control Programme and is modelled on the successful Canadian Cancer Society Transportation Service which is already well established. It is providing a free transport service for cancer patients from south Dublin, Wicklow and north Wexford who are attending St. Vincent’s University Hospital in Dublin. The patients are pre-selected according to the criteria of the programme, to receive a personalised service on a one-to-one basis. The Irish Cancer Society has recruited and trained 111 volunteer drivers who will provide transport in their own vehicles to the hospital. A petrol allowance is included in the arrangement so that no volunteer is left out of pocket but time is given for free. One of the hidden benefits of the scheme in Canada is that many of the volunteer drivers are former cancer patients so the system works very well by providing social support and shared experience for patients and drivers.

The pilot phase will run for twelve months and once it has been evaluated, it is hoped that it will be possible to roll out the service nationally during 2009. The Care to Drive scheme is not intended to replace the transportation service already provided by the HSE but rather to provide a more palatable service for those patients who do not feel well enough to travel by public transport. It is an excellent concept and the Irish Cancer Society deserves great credit for getting such a well-supervised scheme up and running. We tend to live very busy lives these days where time is a precious commodity and volunteer services have suffered the consequences. This scheme is a fantastic opportunity for those people who are in a position to help, to give back something to society. Your time has the potential to become a precious gift and I would anticipate that the patients will not be the only ones to benefit from a lift.

For more information about the scheme, click on the Care to Drive link above or contact Dorothy Thomas, Patient Support Services Coordinator at the Irish Cancer Society at 01-2310596.

Hole in the Head

When it comes to medical emergencies, it could be said that I’m a bit of an old-timer. You see, I have a long history of emergency admissions to hospital and friends and family tend to joke me about it. I never quite know what lies around the next corner but as the saying goes, “if you’ve gotta do it, at least do it in style.” I do my best.

No one pays much attention to their sinuses until they start to hurt. I’ve suffered from sinusitis all my life so headaches are commonplace but pregnancy really exacerbated the problem. The hormones of pregnancy can have a direct effect on the lining of the sinuses and in my case, it left behind a real legacy. Having successfully delivered my second child after a pregnancy fraught with difficulties, I continued to have severe sinus headaches. A CT scan revealed that an abscess had developed in the frontal sinus, very close to the base of my brain. Endoscopic surgery was carried out to drain the abscess and the relief was instantaneous. However some months later, the pain began to slowly return again until one day I awoke in so much pain, I knew I was in real trouble. On calling our family GP to the house, he immediately decided that emergency treatment was required and contacted the surgeon who had previously operated on my head. The surgeon was in the operating theatre at the time but the hospital he was in, did not have the surgical instruments he required for my head. He recommended that I should be transferred to another larger hospital by ambulance to await his arrival. I was duly rushed to hospital and taken straight to theatre to be prepared for emergency surgery on my skull. Despite being in severe pain, I have a vivid memory of lying on the operating table while one of the theatre nurses took a call detailing the ETA of the surgeon and his anaesthetist as they both rushed across the city to come to my rescue. The drama of the occasion resembled a scene from Casualty except that there was nothing fictional about this episode.  It was all too real.

I awoke several hours later feeling decidedly frail having had several holes drilled in my skull to relieve the pressure. The surgeon appeared looking totally exhausted and announced that he’d needed my emergency operation about as much as “a hole in the head.” I knew exactly how that felt. It hurt to laugh but it was hard not too.

My ‘Puter

When I was expecting my first baby, my husband’s two young nieces came to Ireland for a week’s holiday, in anticipation of seeing their new little cousin. I was already one week overdue when the girls arrived so the excitement was mighty. As luck would have it, nothing stirred all week and the two little girls went home disappointed. At 42 weeks plus 2 days, I was admitted to the maternity hospital to be induced the following day. Shortly after midnight, I went into labour spontaneously and as the sun came up on a beautiful morning in June, our son, Robin arrived into the world.

Robin was an exhausting baby. The image of having a peaceful sleeping baby, very quickly dissipated. He would sleep for very short periods of time and then be awake and alert for hours. Life it seemed, was too exciting to waste time sleeping. Robin wanted to see the world. Our early days of parenthood are blurred from lack of sleep. We took it in turns throughout the night to walk the floorboards with babe in arms to allow one another some sleep. By day, I would walk for hours pushing the buggy around our locality in an effort to get Robin to sleep. I would arrive home with him sleeping peacefully but as soon as I put the key in the door, his eyes would spring open again and I would almost weep from exhaustion. Things improved when Robin became mobile enough to reach for toys to keep himself entertained. By nine months, he was already practising his mountaineering skills by scaling the side of his cot and falling onto the floor in the process. There was no stopping him. The breakthrough came at almost two years old, when we went to stay with friends who had two children. Their older child had a Tomy toy computer exactly like the one above and Robin was completely captivated by it. We bought him one for his second birthday and ‘My ‘Puter’ as it became known, was a lifeline. He still didn’t sleep much but he was happy in his own little imaginary world as long as he had his ‘Puter for company. Little did we know then what lay ahead in terms of Robin and his computer.

Robin went through school with one purpose in mind. To spend as much time as possible learning more about computer technology and design. And he didn’t waste any time either. All the promises we’d been given by the experts that he’d sleep once he became a teenager, never materialised. He of course, had a ‘real’ computer in his bedroom at this stage and spent every available hour surfing the net. Before long, he began to win awards for his design ability and he’s gone from strength to strength ever since. His powers of innovation, design and enthusiasm know no bounds. While in college studying for a degree in Digital Media Engineering, he launched his blog ByteSurgery which charts his success story to date. Robin’s other big interest in life, is outdoor adventure sports so when he’s not in front of a computer screen, he can be found planning and executing his next expedition. His blog Team Geared Up is testament to this. He is presently based in Chicago putting the final touches to a new niche technology service he’s designed, called ‘Decisions for Heroes’. He plans to take the world of emergency services by storm with a brand new concept based around decision-making. The next chapter of his life is about to begin.

Today is Robin’s 25th birthday. He’s packed more into that quarter century than most people could hope to achieve in a lifetime. All those sleepless nights have more than paid-off. HAPPY BIRTHDAY old fella! We’re hugely proud of you. You were well worth the wait, all those years ago!

Value for Money?

A new set of draft standards for infection prevention and control, has been published by the Health Information and Quality Authority (HIQA). HIQA was established in May 2007 as an independent Authority, with broad ranging functions and powers, reporting to the Minister for Health. It was set up to drive safety, quality, accountability and the best use of resources in our health and social care services. Our present health service is neither efficient nor cost effective, it swallows up vast sums of money with poor return. HIQA aims to correct this imbalance and deliver value for your money.

The new standards once finalised, will provide a national framework to improve the performance of healthcare settings in order to reduce healthcare associated infections (HCAI’s). These standards are a key component in ensuring quality and safety. As Eithne Donnellan reports in the Irish Times today, “the standards cover accountability, hand hygiene, reducing infection from medical instruments, surveillance of infections, having appropriate multidisciplinary infection-control teams in place which reflect the size and specialities of a facility, informing patients immediately of their infection status, and management of outbreaks“. HIQA now wishes to consult with interested parties and the general public before drawing up a final set of standards to be published later this year. Everyone has a right to have their view considered and submissions can be made online here to the Authority until the 18th July, 2008. HIQA envisages having the standards finalised and ready for ministerial approval by September.

I’m really pleased to see that the Department of Health is taking infection prevention and control extremely seriously but I’m not convinced that we’re getting value for money. You see, I’m aware that the HSE published an updated set of comprehensive guidelines back in 2005, called “A Strategy for the Control of Antimicrobial Resistance in Ireland ( SARI)” but these guidelines, which have a marked similarity to the new standards drawn up by HIQA, were never implemented. It was publicly acknowledged by the HSE at the time that the guidelines failed because of inadequate resources, sub-optimal infrastructure and a lack of access to relevant expertise locally. Has anything changed in the interim, I ask? Forgive me if I’m wrong, but it seems to me that there’s very little new about the report published yesterday other than the change of name. I’d love to know how much it’s cost to date. Meanwhile, the health service continues to struggle on with it’s inadequate resources and sub-optimal conditions. HIQA faces a hard task ahead.

Your Wealth is your Health

Having recently reviewed my annual subscription for private health insurance, I considered reducing my level of cover in an effort to reduce the cost. However, having watched the second programme in the 3-part series Surgeons I’ve decided against making any changes. Our Minister for Health is determined to implement new changes in the Consultants’ contract of employment, to meet the needs of our health service. Has anyone ever heard her mention the needs of the patient? Her continuing plans to reform the health service by encouraging privatisation, makes private health insurance cover seem all the more important. And that’s exactly what the Department of Health wants!

The programme featured the work of two neurosurgeons, Donncha O’Brien and Ciarán Bolger in Beaumont Hospital. It was riveting stuff offering a unique insight into the lives of the doctors and patients featured whilst at the same time revealing the workings of a public hospital. Ciarán Bolger certainly doesn’t mince his words about the public health service. “The system is shite!” he says.

The HSE aims to employ 1,500 new consultants many of whom will be limited by the new consultant’s contract, to working in public practice only. There will also be strict monitoring of private practice. At the moment, public patients gain because they have access to the top specialists but this could soon become the preserve of private patients if the HSE continues to dictate to the consultants. Ciarán Bolger believes that a lot of the consultants will vote with their feet and go into the private sector so that we’ll end-up with an exacerbation of the 2-tier system. He believes that many of the existing highly trained consultants presently working in the public health service but who are also running a limited private practice, will opt to work fully in private practice. He says “WW3 would break out if nurses were told they couldn’t do agency work, or teachers couldn’t give grinds, or Gardaí couldn’t do bouncer work for night clubs”. He considers the new consultants’ contracts to mean that “you’re signing over a profession to be controlled by an organisation that can’t organise anything at the moment.” He says that it doesn’t matter how many consultants the HSE employ as it’s not going to make any difference if they don’t have places to work. “We need more beds, more resources, more surgeons, less administrators, and less people telling us how to do our job.” The proliferation in the development of private hospitals around the country at the same time as services in our public hospitals are being cutback, is no coincidence. Private health insurance is rapidly becoming a must.

The title of this post is a hard pill to swallow. It’s particularly offensive to those who cannot afford to ‘buy’ their healthcare. Our government wants to privatise healthcare in Ireland at the expense of the public health service. They want to scare as many people as possible into taking out private health insurance so that they can relinquish their duty of care. Healthcare in this country, is fast becoming a lottery. If you’re not in (insured), you can’t win!

This week’s ‘Surgeons’ programme, the final week in the series, looks at two revolutionary and radical surgeries being performed on children: cochlear implant surgery and limb-lengthening surgery. If the rest of the series is anything to go by, it promises to be excellent.

Thursday June 5th on RTE 1 @ 10.15pm