Challenging Times Ahead

Last month, I was admitted to the day ward of the hospital for some minor surgery on my head. When my husband came to collect me in the evening, the nurses asked him to come back in an hour as I was still sleeping off the general anaesthetic. When he returned, I was awake but very groggy and sore. The other patients had already been discharged home and as the unit was about to close for the day, I was transferred to one of the main wards of the hospital to be monitored overnight. By the following morning, I had recovered sufficiently to be discharged home. Why am I telling you this story?

I heard on the news the other day that in an effort to reduce healthcare spending in 2010, acute admissions to hospital are to be reduced by 54,000 in the coming year. The HSE wants to transform the way hospital services are run by moving healthcare out of the hospitals and into the community.

It’s proposing to do more day surgery procedures so that the costs of overnight stays in hospital can be avoided. There were 900 bed closures in acute hospitals across the State in 2009 and the HSE is proposing to close at least another 1,000 beds this year. This inevitably means that more people will be waiting longer for surgery. It also means that there will be no spare beds available for when day surgery unexpectedly results in an overnight stay.

But it could also mean this…

6 Responses to Challenging Times Ahead

  1. magnumlady says:

    It is a joke. I ended up having to phone Sligo general the day Jono was having his surgery because they wanted to send Andy home.
    Andy couldn’t walk and was having to be helped wash and everything, but the hospital decided he could go home with my 14 year old daughter and my elderly mother…they can’t wait to get rid of people….sorry for the rant.
    Hope you are feeling better xx

  2. Grannymar says:

    They do more day surgery procedures here too, mind you patients are only allowed home if it is safe to do so. Look at the hip operations… now down to 2/3 days. I was ready as far as the hip was concerned to come home on day three, but my heart complications caused me to stay the full five days.

    There is evidence to show that patients recover far quicker at home in familiar surroundings and I would agree with that!

  3. Baino says:

    Closing beds is a worry but frankly, the day surgery idea is a good one. So many procedures really don’t need intensive nursing. Even after a radical hysterectomy, I was well enough to come home on Day 3 not the usual Day 7. Grannymar is right, for some patients it’s essential to get them mobile and up and about but not at risk to those who need longer stays and more intensive care.

  4. Steph says:

    magnumlady – Sadly, healthcare is no longer about people, it’s about budgets. You did well to stand your ground in the circumstances.

    Grannymar – I agree totally that home is the safest place to be after routine surgery. The problem here is that the HSE has adopted this new healthcare policy of shifting care from hospital to the community without first putting community care in place. You get turfed out of hospital almost as soon as you wake up from surgery and told to come back in six weeks for a check-up. Primary care services are simply not there for home visits, changing dressings etc. We also have a problem with a shortage of GP’s in the country.

    Baino – Hospital bed occupancy rate in Ireland is already over 100 per cent yet the HSE expects the hospitals to do more work with 1,000 less beds. I’m all for moving more in-patient work to day surgery but only when it’s done in the patients’ interest rather than in an effort to cut hospital budgets.

  5. Annb says:

    Closing beds is a false economy – sure it improves the balance sheet in a given quarter but it only kicks the costs into the next fiscal quarter, during which time the patient on the waiting list may have deteriorated and turned into a full blown admission rather than a simple day case. The problem is the manner in which the budgets are accounted: hospitals receive their budgets based on an estimate of future need without any bonus for improved productivity or penalty for waste.

    Each patient that enters the hospital is seen as a drain on resources rather than a client. With proper universal insurance, the patient has the option to select the best performing hospital for their illness, hospitals have to compete for patients and are therefore compelled to improve their productivity, cost effectiveness, patient outcomes and generally pull up their support stockings or lose revenue. In our system they are compelled to lumber from one crisis to the next by cutting front line services to tax paying patients who get no service even though they have already paid for it.

    But hey at least the weather has improved 🙂

  6. Steph says:

    Ann – Well said! What really gets me when I’m admitted to hospital from an overcrowded A&E, is when I end up in a busy ward that has a ward next to it, lying empty! Patient need should dictate bed capacity, not hospital budgets!

    I await with interest to see the reaction of the medical profession to the HSE telling them who they can/can’t admit to hospital!

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