A good day?

I like it…

On Tuesday, Olivia O’Leary shared some thoughts on International Women’s Day.

Then yesterday, our new Taoiseach, Enda Kenny revealed his new Cabinet.

And, guess what?…

The Labour deputy leader, Moan Joan Burton, the party’s Finance spokesperson for the past nine years, did not get the portfolio with responsibility for public sector reform, for which she had been widely tipped. Instead, she was given Social Protection.

Also… two prominent female Labour TD’s, Roisín Shortall and Jan O’Sullivan were not promoted.

Add to that… there are fewer women in this new Cabinet than in the outgoing government.

Progress… eh?

As far as I can see, the only concession made was that a woman was appointed to the position of Attorney General…

Labour’s Máire Whelan, is the first woman to occupy the post of legal adviser to the government. Hur…ray!

Apart from all that, the good news is… this new coalition government has promised major health reform. The new Minister for Health, Dr James Reilly, is committed to developing a new universal health insurance (UHI) system which aims to end 2-tier healthcare and give everyone equal access to GP and hospital treatment based solely on medical need.

Bring it on!

Dear Joe

Three years ago, cystic fibrosis (CF) campaigner Anita Slowey first contacted Joe Duffy on Liveline to stress the need for a purpose-built CF unit at St. Vincent’s Hospital* which would provide en-suite single rooms, to prevent cross-infection from other patients.

In October 2010, having endured a further 3 years of broken promises from the HSE, Anita again emailed Liveline to describe the hospital conditions that she was still in. Her deeply moving email was highly successful in drawing attention to the plight of CF sufferers in Ireland.

Anita wanted to be a journalist, she lived as normal a life as she could but the odds were stacked against her. She died in St. Vincent’s Hospital last Monday, aged just 24 years.

The conditions in which Anita was treated, directly contributed to her death. Cross-infection and multiple infections resulted in the bugs that caused the infections in her body, becoming stronger and harder to fight.

Out of the hundreds of antibiotics used to treat her disease, she ended up only sensitive to one. This is as a direct result of being exposed to other patients and their germs.

The HSE’s abject failure to provide proper isolation facilities, directly cost Anita her life. Yet another failure of our grossly mis-managed health service yet no-one in the HSE will ever be held accountable.

The contract to build a €20m specialised CF unit at St Vincent’s Hospital, with en-suite single rooms for 34 patients, was finally signed last October and the promised unit is due to be completed in April 2012.

While this is too late for Anita, her brave decision to campaign on behalf of CF patients, has ensured that others will not have to suffer the conditions which she endured.

May she rest in peace.

Below is an extract of the email that Anita read out on ‘Liveline’ last year, which has now been put to a piece of music that she loved…

*St. Vincent’s University Hospital, Dublin  is the national referral centre for adult patients with cystic fibrosis.

Checking-In

My bum hadn’t even touched the seat when I heard my name being called out. It seems not everyone was prepared to brave the elements today as there was no queue and I was in and out of the hospital in double quick time. If only the health service worked like this all the time!

I struggled through the slush and biting easterly winds this morning to get to my hospital appointment. Having examined my head endoscopically, my surgeon was pleased to report his findings. While the three-times-daily sinus wash-outs are not a lot of fun, they seem to be doing the trick. There is no evidence of infection in my sinuses at the moment.

We then discussed the recent swab result and it’s consequences for me. As I’m clinically well right now, I do not require antibiotic treatment despite my positive MRSA status. However, should I develop an acute infection, I’ve been instructed to report to A&E as I’m now resistant to so many antibiotics, I can only be treated with hospital-prescribed antibiotics.

I left the hospital with a prescription for an antibiotic nasal ointment which is an effective topical treatment for methicillin-resistant Staphyloccus aureus (MRSA) and also instructions to continue doing the wash-outs.

I’m now officially on holiday from the hospital until after Christmas. Fingers crossed please, this holiday doesn’t get cut short.

A National Disgrace

I can’t remember when I last felt so passionate about something.

I don’t have cystic fibrosis (CF) nor am I related to someone who has, but that hasn’t stopped me feeling very angry about the lack of government commitment to the cystic fibrosis community in Ireland. While the Celtic Tiger roared in this country, young adult CF patients were left to suffer in conditions which continue to be described as dangerously inadequate. Many have died prematurely because of the failure of our government to provide them with the care and facilities needed. The plight of the adult cystic fibrosis sufferers in Ireland, is a national disgrace.

Ireland has the highest incidence of cystic fibrosis in the world and should have facilities and services that reflect this unenviable position. Instead of being a world leader in CF care, we fall way below the European recommended standards. The average life expectancy for a CF person in Ireland is the lowest average in a first world country.

The needs of the CF community are straight forward. They need funding to be provided for a dedicated cystic fibrosis unit with fully-trained staff who are knowledgeable about the disease; they need isolation in en-suite rooms where they don’t have to worry about the risk of cross-infection; but perhaps most of all, they need reassurance that when they require hospital care, they will be provided with the means to survive. Is this not the right of every citizen of Ireland?

Cystic fibrosis sufferers are some of the pluckiest people you will ever meet. Why? Because they have been born with a life-threatening inherited condition which leaves them fighting to breathe. CF primarily affects the lungs and the digestive system and becomes more severe with age. They are very susceptible to serious infection and as a result, they require frequent hospitalizations for treatment.

In other countries, CF in-patients are treated in single en-suite rooms to reduce the risk of cross-infection. In Ireland, adult CF sufferers risk potentially life-threatening infections every time they are admitted to hospital as we do not have a purpose-built unit in which to isolate them from other patients, as well as from each other. CF patients are not supposed to interact because of the risk of cross infection.

The plight of adult cystic fibrosis sufferers was laid bare on Liveline last week as outrage mounted about the appalling services provided for those affected. One CF patient after another and their relatives, described the appalling conditions to which they are subjected while waiting for a specialist unit to open at St. Vincent’s Hospital in Dublin, the national adult referral centre for CF patients in Ireland. A common thread to all the stories was that while CF patients are receiving excellent medical and nursing care at St. Vincent’s hospital, the conditions are far from ideal. They are being admitted to 6-bed wards where the nurses are not specifically trained in CF care and where they are exposed to cross-infection and constant exhaustion from being in a shared room. Rest and sleep are paramount when fighting a serious chest infection.

An independent review of CF services in Ireland by Dr R.M. Pollock, published in 2005, found that most adults with CF were being treated in facilities that were understaffed and dangerous. The Health Services Executive (HSE) responded by establishing a multidisciplinary Working Group to undertake a wide-ranging review of the current infrastructure for CF in Ireland. It took the Working Group until 2009 to publish it’s own Report on Services for People with Cystic Fibrosis in Ireland which simply endorsed many aspects of the Pollock Report.

Five long years have now passed since the conditions for CF patients were described as dangerously inadequate and very little has changed. Is it any wonder that they are demoralised about their plight and cynical about the many false promises from the HSE?

Following the public outcry last week, it was announced that building work on the long-delayed cystic fibrosis unit at St Vincent’s Hospital, is expected to start next Monday following the signing of the contract on Friday. The unit, which will be in a five-storey, 100-bed hospital block of which two storeys and 30-35 beds in individual ensuite units, will be developed exclusively for cystic fibrosis sufferers. It will be mid-2012 at least before the doors are opened. I won’t believe it until I see it happen.

Meanwhile, the wait goes on…

Further information:  The Cystic Fibrosis Association

Patients are a nuisance

Whatever savings and cutbacks are having to be made in these harsher economic times, curtailments in the treatment of sick children are not something that most of us are prepared to tolerate. As the HSE continues to push for efficiencies in the public system, many children in this country are being denied treatment and more and more problems are arising in terms of patient care.

Our hospital system is breaking down as the basics simply aren’t happening. The embargo on staff recruitment has resulted in operating lists (elective surgery) being cancelled without warning, out-patient appointments being cancelled and phones not being answered in many departments. Frontline staff are fed-up and disillusioned and many of the consultants are no longer advocating for their patients. The bottom line is… patients are suffering and it seems that even sick children, don’t count anymore.

If you think I’m exaggerating, have a listen to this interview with Professor Michael O’Keeffe, Consultant Ophthalmic Surgeon in Temple Street Hospital (a children’s hospital in Dublin). Thankfully, he’s not afraid to speak out.

Interview Credit:  ‘Today with Pat Kenny’ on RTE Radio 1.

Photo: Steph’s theatre gown, captured on mobile phone.

Failure To Diagnose

Headaches are a common symptom of many conditions and almost everyone will experience headaches at some point in their lives. Normally the average headache is nothing to worry about, despite the discomfort you might be experiencing. However, if you get a severe/sudden headache unlike any you have had before, you should always seek medical advice. Sometimes, a headache can be a warning of something serious that needs to be investigated so don’t delay in seeking help.

As I have a long history of chronic sinus infection, I’m well-used to getting headaches. I don’t panic when a headache occurs as I’m familiar with the signs and symptoms of acute sinusitis and have the necessary prescription medications to relieve the pain. However, if I develop a severe headache that I’m not familiar with/it continues to worsen, I will always seek medical advice. If the headache is considered a cause for concern, my GP/specialist will refer me for an urgent CT/MRI scan in order to rule out any serious cause. As I hold private health insurance, I rarely have to wait longer than 24 hours to undergo a scan. If, however, I had no health insurance and was a patient in the public health service, the story could be very different…

THE HSE has apologised before the High Court to the family of a young woman over deficiencies and failures which led to her death from a massive brain haemorrhage. The apology was part of a settlement of court proceedings.

“Louise Butler (21), Cappa Lodge, Sixmilebridge, Co Clare, died at Limerick Regional Hospital on November 16th, 2006, from a large subarachnoid haemorrhage, the court heard. She had worked as a security guard at Shannon airport.

Her family claimed the HSE had failed to properly diagnose she was suffering from the condition when she presented at the hospital just weeks earlier suffering with a serious headache.

Had she been properly diagnosed and referred for treatment after being admitted on October 6th, she would probably have survived, they alleged.

As part of the settlement yesterday of the family’s action for mental distress, the HSE apologised for the anguish and distress caused to the Butlers due to Louise’s tragic death.

The HSE also acknowledged there were failures and deficiencies which led to Ms Butler’s death and accepted her family did everything it could in the circumstances.

The settlement also includes a payment of €40,000 to Ms Butler’s family and was approved yesterday by Mr Justice Michael Peart. The action was brought by her brother James, Cappa Lodge, Sixmilebridge on behalf of the family.

They claimed they suffered mental distress and injury arising from their older sister’s death due to the HSE’s alleged negligence and breach of duty of care. The HSE had denied the claims.

The family claimed Ms Butler’s attended the hospital between October 6th-12th. It was claimed she was ill with a very substantial headache, which she had described as like “a hammer blow” to the back of her head, and photophobia.

She was discharged on October 12th without a CT scan being carried out. She was due to have a CT scan subsequently as an outpatient.

Despite the best endeavours of Ms Butler’s mother and the family GP it was claimed the scan was not arranged until November 13th. It was claimed Ms Butler never got the results of that scan as she collapsed the following day. The scan revealed she suffered a massive bleed in the brain and she died two days later.

It was alleged the HSE had delayed a CT scan which would have alerted medical staff to the existence of her condition. The family claimed their experts would argue, in October 2006, Ms Butler was suffering from a “sentinel” or “herald” bleed, which was a precursor to a large bleed.”

Information Source: The Irish Times 13/07/10

It’s not rocket science

Everyone has heard of the hospital superbug MRSA and many have a view on how to stop it. MRSA is a serious problem in Ireland. A new report released this week has found that MRSA is costing Irish hospitals more than €23 million every year. Ireland ranks fourth in Europe for MRSA bloodstream infection rates with only Portugal, Greece and Italy ahead. Much of the media coverage on reducing the incidence of MRSA tends to concentrate on hospital cleaning and poor hygiene. This latest report addresses the whole story about MRSA.

The MRSA in Ireland: Addressing the Issues report, was conducted by a multidisciplinary advisory group including microbiologists, hospital pharmacists and patient advocates, and sponsored by healthcare firm Pfizer. The report found that the cost of dealing with healthcare associated infections (HCAI) totalled €233.75 million a year, with the MRSA cost representing 10 per cent of the overall figure. The main factor contributing to the cost is the increased length of stay by patients in hospital. Patients with MRSA spend, on average, 2.5 times longer in hospital.

Commenting on the report, Dr Edmond Smyth, Consultant microbiologist at Beaumont Hospital and chairman of the MRSA group, said that we need to “improve patient staff ratios; have laboratories on hospital sites that provide rapid diagnosis for MRSA and other infections; be able to isolate patients; ensure that doctors and nurses and healthcare workers generally wash their hands before and after any contact with a patient; ensure that we use antibiotics appropriately; discharge patients home earlier.”

“It’s the simple things,” Dr Smyth says. “There’s no rocket science here, we just need to do all these simple things at the same time.”

It may not be rocket science but at a time when the health service is facing over €1 billion in cutbacks and with the present economic downturn, I can’t really see all this happening, can you?

Cartoon by Chris Slane

Information source: TV3 News and The Irish Times.

An Unholy Mess

No, not my poor old head. I’ll tell you about that another day.

I’m talking about the latest controversy to rock the Irish health service. Yet another systems failure has emerged which directly impacts on patient care and safety. Am I surprised? Sadly, not one bit.

News emerged earlier this week that almost 58,000 x-rays taken over a 5-year period at Tallaght hospital in Dublin, were never reviewed by a consultant radiologist. Today, we hear that many thousands of GP referral letters lie unopened and unanswered somewhere within the bowels of the hospital.

Now everyone’s fighting over who’s to blame for these astounding revelations.

Consultant radiologists at Tallaght hospital say that over the past three to four years, they have written more than 40 letters to hospital management seeking extra staff to cope with the volume of work. They also say they warned management that there was a growing delay in reporting on X-rays but nothing was done.

The new CEO at  the hospital says that he only became aware of the problem when he was appointed in Decemberof last year.

The GPs in the area say that they’ve been aware for a long time of a major problem with regard to referral letters sent to Tallaght hospital.

Our Minister for Health is conveniently out of the country at a time when the health service is falling apart.

The Health Service Executive (HSE) is floundering around trying to restore public confidence in a health service that is on the verge of collapse from years of mismanagement and under resourcing.

There have been heated exchanges in the Dáil this morning over the lack of accountability for the mess.

The whole situation beggars belief. Patient care and safety have undoubtedly been compromised by this latest health scandal. The sad reality is that what’s emerged from Tallaght hospital this week, is only the tip of the iceberg.

‘Cos you deserve better

Have you noticed the sudden upsurge in radio and TV ads for private healthcare? Frankly, they sicken me.  “Because you deserve better” quotes one ad for a state-of-the-art private hospital. Because who exactly deserves better? Answer: Those who can afford private health insurance. But what about those who can’t, I ask? Don’t they deserve better too?

I hold private health insurance and I make no apology for it. I’ve a complex medical condition which requires regular medical supervision. Unfortunately, I cannot rely on our public health service to provide the care needed. Our health system has been so stripped of services that ‘public’ patients face long delays in accessing out-patient appointments and treatment. Privately insured patients can access care faster by paying for it. Such is the inequity of a 2-tier health service. Emergency care is different, it’s provided on the basis of need only. The delay in the public system, is putting people’s lives at risk. Remember Susie Long? I’m not prepared to risk my health because of our government’s failure to provide an equitable health service for all. I therefore see my health insurance as a priority, not a luxury. I choose to do without other non-necessities in life so as to afford the health insurance. I’m lucky to have that choice. Many don’t.

In these difficult times of recession, many people are struggling to maintain a roof over their heads/to afford enough food to feed the family. The advertisements for private healthcare appear very inappropriate in the circumstances. Of course, the real reason why these companies are advertising, has nothing to do with your welfare or mine. They are desperately trying to survive too.

Our Minister for Health has gone terribly quiet!

Held To Ransom

Having spent the best part of the last month undergoing treatment in a semi-private ward of a large public hospital, I’ve seen first-hand how our health service operates. It’s the same old story. Once you get through A&E and into the system, the care is excellent. But it’s not all a bed of roses.

In Ireland, we have a 2-tier public health service with a unique mix of public/private patients and public/private consultants. Approximately one third of hospital consultants work in public-only practice. That leaves 70% of consultants allowed to practice publicly and privately. These consultants enjoy the best of both worlds. They do not have a boss, their hours are not monitored and many enjoy extraordinary salaries. Granted, our Minister for Health, Mary Harney has tried to exert control over hospital consultants by introducing new contracts (terms and conditions with the State) and new posts of clinical directors (about 100) to manage and monitor hours. However, having watched the consultants do their ward rounds over the last month, I’ve come to the firm conclusion that we’re all being held to ransom. It’s time someone blew the whistle.

I witnessed consultants reassuring elderly patients that there was no hurry for them to go home. I’m talking here about patients who had very obviously recovered from the acute illness that brought them into hospital. These patients had homes to go to with family in support, they were not waiting to be allocated a nursing home bed. We hear so much about the shortage of beds in our acute hospitals. Why are the consultants not working hard to free-up beds?

I saw the look of disbelief on the faces of the junior doctors (NCHDs) as a consultant announced further tests on a young girl who’d been in hospital for many weeks and whose tests had all come back normal. This girl appeared very well to me so why was she occupying a hospital bed? Why were her investigations continuing as an in-patient?

Could it be that hospital consultants choose to have a proportion of beds occupied by patients who require minimal input of care/time? Patients whose health insurance will continue to reimburse both the hospital and private consultant as long as they occupy a bed? Is this the realistic truth? I presume that the NCHDs remain silent on this issue because their jobs depend on pleasing the consultant?

I don’t know about you but my conscience finds it very difficult to accept that ‘well’ patients are occupying hospital beds when I know that acutely ill patients are lying on trolleys in A&E?

We have some fantastic consultant doctors in this country who are totally dedicated to their profession and I’ve no wish to tarnish their reputation. However, as a patient, I feel a need to protect our health service. The fact is, I depend on it.