Enough is Enough

March 27, 2008

If you’re sick of our health service, or lack of one, here is your opportunity to campaign for better healthcare. A march and rally has been organised in Dublin to demonstrate public dissatisfaction with the health service. The time has come to show the Minister for Health that enough is enough!

An umbrella group of health unions and patient campaign groups are urging the public to come out in large numbers next Saturday 29th March, and support the march. The rally will assemble from 2.30pm at Parnell Square, Dublin where it will be addressed by speakers, before proceeding to Molesworth Street.

The following speakers will address the rally:

Prof. John Crown, Consultant Medical Oncologist

Conor MacLiam – husband of the late Susie Long

Representatives from the following groups will also contribute:

Doctors Alliance for Better Health Care

Irish Nurses Organisation (INO)


Health Services Action Group

Patients Together

MRSA and Families

Recent cutbacks in government spending have resulted in further suffering for Irish patients. Our government has failed miserably in it’s commitment to deliver an equitable health service based on need. The bureaucrats within the Dept of Health and the HSE should be shamed for the long litany of dysfunction within the health service. Patients have suffered for too long without the basic healthcare they deserve. It’s time for change.

Please support this march to show you care. I’ll be there – will you?

The Health Debate

February 22, 2008

Well, actually it was more of a discussion than a debate and even though I didn’t succeed in getting to have my say, I’m glad I tuned in to Your Call on Newstalk106 yesterday. As was predicted, both our Minister for Health and the CEO of the HSE, declined the invitation to take part in a live debate on the health service. Not one to be easily dissuaded, Brenda Power went right ahead and chaired a lively discussion with a panel of experts which included a well-known retired cardiac surgeon, a GP, a health economist and Newstalk’s own economics editor plus contributions from various phone-in callers. While the opinions of the panel differed at times, everyone was in agreement that morale within the health service is at an all-time low.

The following is a brief synopsis of the opinions expressed during the programme: “We do not have a health service – we have a dysfunctional, immoral state system. Services are not joined-up and are hampered by a dysfunctional transport system. The health service is a black hole with €15 billion spent on it last year and further massive cutbacks in health spending are inevitable. The GP’s have not been consulted on hospital development plans and funding has been pulled from GP training schemes and out-patient services. Management problems within hospitals are directly affecting vital services such as cleaning. The prevalence of MRSA and other superbugs, has caused a widespread fear amongst patients of going into hospital. Over 52% of the population take out health insurance because of the rationing in the system. The National Treatment Purchase Fund (NTPF) is ‘like a finger in the dyke’ and is not cost-effective. The NTPF pays more than private health insurance schemes to secure treatment for public patients in private hospitals and in the process, is denying access to patients who pay for top health plans. Emergency departments (A&E) are unfit for purpose. Bed capacity is a big issue and few are in agreement with the HSE’s opinion that more beds are not needed. Rehabilitation facilities are almost non-existent throughout the country. Psychiatry has been badly neglected as a service. The plans for co-located hospitals are a joke. It is immoral to have one standard of care for public patients and another (better one) for private patients. Focus should be put on the public service but there is no incentive in place at the moment. Numerous reports have been produced on the health service but they have not been acted upon. The hallmark of quality service is ‘morale’ and the present ethos within the health service is one of low trust, low morale and no sense of direction.”

So, while nothing particularly new or startling came out of this discussion, it did provide a good overview of the problems that exist. The bureaucrats within the Dept of Health and the HSE should hang their heads in shame at this long litany of dysfunction. Patients have suffered for too long without the basic healthcare they deserve. The general consensus of opinion from the panel was that trust has broken down and a change of mindset is needed if a way forward is to be found. Many feel that our Minister for Health should resign as the level of confrontation has become too great for co-operation. Progress will only become possible if the powers-that-be learn to engage with the people on the ground, and listen to their views. We can only hope this process started yesterday.

Money Talks

February 1, 2008

I listened with interest yesterday to an interview on Newstalk radio about in-patient services for acute psychiatric patients. This interest soon turned to outrage when I heard about the latest insult inflicted on psychiatric care in this country.

St. Ita’s Hospital in Portrane, Co Dublin was built in 1902 to cater for long-stay patients with intellectual disability. It is also the centre for acute psychiatric in-patient care in Dublin north. These facilities have been massively ignored by successive governments over the years and allowed to deteriorate to the point of neglect. It is no coincidence that the complex is on prime development land. Negotiations were started with the Dept of Health as long as 20 years ago, to agree a plan to move the acute psychiatric unit to a new purpose built facility in the grounds of Beaumont Hospital in Dublin. Dr. Richard Blennerhassett, clinical director at St. Ita’s has personally been fighting this battle to improve services since he took up his post in 1998. Agreement was finally reached, the plans were drawn-up and planning permission was obtained for this unit to proceed. It has recently emerged that the plot of land allocated for psychiatric services at Beaumont Hospital has been re-allocated to the building of a new co-located private hospital on the site. St. Ita’s now has to return to the drawing board to start the process all over again.

Frankly, I think this matter stinks. Yet again some of the most vulnerable members of our society are being disadvantaged in favour of private (for profit) health care. Our Minister for Health is insistent on driving forward a 2-tier health system in this country while the public health service continues to crumble. The concept of building co-located hospitals on the grounds of public ones is a recent one. The plans to move services out of St. Ita’s have been on the agenda at the Dept of Health for over 20 years. I’ll let you draw your own conclusions.

The Minister’s off her trolley

January 9, 2008

Today we hear that the number of patients waiting on trolleys for admission to hospital around the country has reached similar levels to last year when the Minister for Health announced a national crisis in A&E. And the HSE is still trotting out excuses.

Has anyone else noticed that there’s been an ominous silence from Mary Harney since Christmas. What ever happened to the consultant’s contract which she insisted would be signed and sealed by Christmas? Where are the 2,000 extra beds promised for the public hospitals to alleviate the problems in A&E. Have you heard anything recently about the plans to develop a system of co-located hospitals to move private patients out of public beds? The HSE wheeled out a spokesman this evening to defend the inaction of the organisation. He was full of excuses as to why the problems are ongoing – even the winter vomiting bug was blamed. “It’s been difficult to find agency nurses to work in A&E”. “Home-care packages are coming on stream to enable old people to manage better in their own homes”. “Step-down beds will be available in a ‘few weeks’ for patients categorised as ‘delayed discharges’. This will release beds for acute patients”. All measures to relieve the crisis are always in the future. What about now?

Well, frankly Mr. HSE I’m not one bit impressed as we’ve heard it all before. A whole 365 days has gone past, very little has changed and today 365 patients are lying on trolleys awaiting beds. The backlog in A&E is a symptom of the failure in the whole hospital system. More beds are urgently needed and the HSE has no immediate plan in place to alleviate the shortage. Working conditions in A&E are so horrendous due to the overcrowding that only the most dedicated, or the most desperate, will work there. Is it any wonder that agency nurses are difficult to find? Why are we still waiting for the funding for home-care packages to happen? The recent Department of Health cutbacks in spending have curtailed any efforts to get this system up and running. There are long-stay beds available in nursing homes around the country but the HSE hasn’t put out to tender to secure these as step-down beds for the ‘bed blockers’ in our acute hospitals. Thousands of bed days are being lost in acute hospitals because of the failure to free-up beds. Improved primary care such as GP services, would greatly relieve the burden on our hospitals but again this invaluable resource is being ignored by the HSE.

It’s becoming patently obviously that the Minister for Health has lost the plot. Even the dogs in the street know that the HSE is failing to steer the health service in the right direction. It’s like a ship without a rudder… if only it would sink.

A Long Time Waiting

January 6, 2008

I listened to a radio interview today where it was stated that nothing has changed in A&E despite the Department of Health’s insistence that patients no longer have to wait long hours on a trolley for admission to hospital. My blood is still boiling.

Dr James Binchy of the Irish Association for Emergency Medicine, which represents A&E consultants, stated that Irish patients are dying unnecessarily due to delays and overcrowding in A&E. Many A&E departments continue to be unfit for purpose despite a damming report last year. Dr Binchy talked about feeling despondent when he arrives into work each day to face a backlog of patients still waiting for admission from the day before. He described how he endeavours to avoid eye contact with these patients, such is his despair at the conditions they must endure while they await a hospital bed. I’ve personally observed this avoidance tactic in A&E and I know exactly what it feels like from the patient’s perspective.

A year ago, my elderly father was rushed to hospital by cardiac ambulance from the nursing home where he resides in full-time care. He suffers from acute short-term memory loss and needs constance reassurance as to his whereabouts. Thankfully, his collapse was not as serious as first suspected but in order to ascertain this, he had to spend three days and nights on a hospital trolley in the busy A&E department of a large general hospital. He was thoroughly investigated and monitored but his surroundings caused him great anxiety and he became hugely confused during his stay. He was eventually discharged back to the nursing home, not because he was well but because they could no longer care for him in such an acute hospital setting. Luckily, my father is physically none the worse for this experience but to this day, he remains traumatised from having felt so lost in that A&E environment. He still phones me regularly to report “I’m in hospital for the night in case anyone is looking for me”. It’s sad and it sickens me to think of all the elderly people who are suffering this sort of abuse because of our third world hospital system.

Little or nothing has changed despite the urgent recommendations of the task force set up in 2006 after our Minister for Health, Mary Harney declared A&E overcrowding a “national emergency”. Dr Binchy makes the point that the delays in A&E are due to the backlog caused by a shortage of beds in the public system. He quantified this with figures which show that no patient in the hospital where he practices, had to wait overnight on a trolley for admission during the Christmas period. This is simply because elective admissions had been cancelled over Christmas thereby temporarily alleviating the bed shortage crisis.

And the moral of this story is? If you’re going to get sick and need emergency care, make sure you do it during a festive period unless you’re willing and able to rough it out in A&E.

The Mary Harney Debate

November 27, 2007

Today is the day that the Dáil debates a motion of ‘no confidence’ in our Minister for Health for her handling of the health service. They have it all wrong – it’s not about Mary Harney – what we need is a proper debate on the way forward for our health service.

Whatever way you look at it, the Irish health service is in melt-down. For far too long the “ah, sure it’ll do” mentality has been allowed to continue and now the cracks have really begun to show. Every week another story emerges about a failing in the system and it’s likely that what we’ve seen is only the tip of the iceberg. How many more lives are to be lost before the penny drops that our health service is letting us down? There is no doubt that heads should roll for mistakes made but this is not just about accountability – the whole system is in disarray and we need agreement on a plan to put it right.

We’ve all heard about the opposition faced by the Dept of Health and the HSE in their efforts to sort out the problems in the health service. Mary Harney was a brave (many might say foolish) woman to take on the job – she’s proved her worth in politics over the years and let’s face it, as long as Fianna Fáil remain in power we don’t have much choice. However if progress is to be made, we need to take the politics out of health. It’s patently clear that as long as there are vested interests in the running of the service, it doesn’t stand a chance. It appears that the majority of people in this country are happy to sit back and allow politics to determine the future of our health service. Almost everyone is in agreement that a 2-tier health system is not the way forward and yet we continue to allow our government to push forward a strategy of co-located hospitals with an emphasis on private healthcare insurance. Studies of successful healthcare practices in other countries have clearly demonstrated that a single-tier healthcare system based on a universal health insurance scheme is the way forward. This issue is crying out for debate and yet the opposition’s only priority appears to be one of accountability.

The health service holds all our lives in it’s hands. Irish patients deserve equity of care and a better healthcare service. The time has come for Irish people to wake-up to the reality of what’s happening before it’s too late. The late Susie Long, a cancer patient, did her utmost to bring about change by highlighting the inequalities in the service. Sadly, the system failed Susie but we owe it to her memory to unite to become a force for change and to continue her fight for proper healthcare reform. It’s become abundantly clear that we cannot rely on our government to do this for us.

Health Service Exposed

September 25, 2007

I’ve long been a fan of Prof John Crown, Consultant Medical Oncologist, for the manner in which he speaks out to expose the faults in the Irish health system. John Crown does not mince his words – he says it as it is and in doing so has managed to rattle cages to shame the Department of Health into doing something about the disastrous health service in this country. He writes a regular column in the Sunday Independent which exposes the chinks and cracks in the system, and helps to paint a clearer picture of the problems involved. Last Sunday’s article was no exception where he likened the bureaucrats in the HSE (Health Service Executive) to the dinosaurs taking over in Jurassic Park, and named it ‘Burassic Park’.

In a week when the HSE announced a freeze on recruitment leading to health service cutbacks, they simultaneously announced a scheme of performance bonuses for senior HSE administrators. As John Crown so rightly pointed out, this clearly shows where the priorities of the HSE lie. This latest action by the HSE is a complete insult to those who are expected to continue to work in an already under-resourced and over-burdened health system. I personally feel very uncomfortable about the way in which our Minister for Health, Mary Harney, has reacted to the events that have happened at Barringtons Hospital recently concerning cancer care there. She is insisting that the Dept of Health has no authority over private hospitals and thus she says, it has no authority to take action to intervene. This does not bode well for the future of our health service which will have many more private hospitals coming on stream as the Minister insists on pressing ahead with the co-location debacle. Who will take responsibility when things go wrong in these private hospitals?

John Crown also clarified the problems involved in the stand-off that continues between the Dept of Health and the Irish Hospital Consultants Association (IHCA) over consultant contracts. To his credit, he actually criticised the consultants (his colleagues) for their increasingly unseemly row over private practice rights of their as yet, non-existent colleagues. He believes that the IHCA should concede the inevitable and accept that the new consultants will have to have new contracts which the Dept of Health will ultimately decide upon. He encouraged consultants instead to “channel their energies into the good fight, which is the fight for healthcare reform, universal health insurance and single-tier healthcare”. At last common sense has spoken!

Irish patients deserve equity of health care and a better healthcare service. We owe a great debt of gratitude to John Crown for the role that he plays as a doctor to advocate on behalf of all patients. He is a voice of reason in a world where common sense is sadly lacking. May he long continue to fight the good fight on our behalf.