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!

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.

It’s Just Not Fair

It is a disgrace and a source of national shame that in 2010, in the country with the highest rate of cystic fibrosis (CF) in the world, we still do not have a purpose-built adult CF unit. 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 dangerously inadequate. In reality, very little has changed since then for CF inpatients. The average life expectancy for a CF person in Ireland is a full 10 years lower than in Britain or the US, largely because of the failure to provide specially trained staff and sterile, en-suite hospital facilities. It’s just not fair that people with CF should be spending so much of their already short lives waiting for the most basic of services.

St Vincent’s Hospital, Dublin is the national adult referral centre for CF patients in Ireland. Last year, the HSE said that it didn’t have the money to go ahead with building a special 120 bed facility, with 30 en-suite rooms to cater for these patients. The public outcry that resulted, led our Minister for Health to declare that an alternative funding approach involving builders and banks, could deliver the facility as promised. This latest hold-up has come about as a result of a failure on the part of the Department to award a tender to construct the €40 million unit.

Orla Tinsley is a young woman with cystic fibrosis. For the past five years, she has campaigned vigorously for the provision of a dedicated CF unit. While receiving urgent medical treatment at St. Vincent’s hospital last week, she wrote the article below about her frustration that the designated site for the new facility remains empty…

“OPINION: The news that there has been further delay in the cystic fibrosis unit at St Vincent’s hospital in Dublin is disheartening, but hardly surprising, writes ORLA TINSLEY

Five years ago this month, my first article was published in this newspaper. I wrote about being an 18-year-old with cystic fibrosis treated in the national referral centre, St Vincent’s hospital. It was my first experience of sleeping in a room with senile and confused women who coughed, pooped and died in the room in which I slept.

I didn’t understand how the rules on cystic fibrosis care could change so much from a children’s hospital to an adult hospital. As a child I was not allowed to share a room with someone who had cystic fibrosis because of cross-infection.

In Vincent’s, sharing a room with another CF patient was a common occurrence until two years ago because there was no other space. I shared a room with a girl who also had CF and we became great friends over the summer months we were in there. We stood outside the hospital on the June bank holiday eating cool-pops and watching the mini- marathon go by. A month and a half later she was dead.

It was the first time I fully realised that CF is something you cannot control, although it takes a while to accept.

I ran the mini-marathon two weeks ago and finished in high spirits. When I sprinted past Vincent’s, I thought briefly of that day and was glad to be running. The next day I flew to Barcelona and lay on the beach, relaxing for five days. I had gotten over the previous rough summer of spontaneous lung bleeds that halted my life and made it impossible to plan anything. I had gotten over the collapsed lung last year and I started work, like any 23-year- old, which feels so great.

Then I got some shoulder pain: my lung had collapsed again. Had I trained too hard or done something wrong? My consultant said it was just one of those things that happens with cystic fibrosis.

Admitted to Vincent’s a week ago, I was put on 100 per cent oxygen to try and reinflate my lung and given painkillers. My medical team were incredible and I got a bed immediately.

For the first two days I shared a room with five other women on a ward where the staff did not specialise in cystic fibrosis. I was exhausted and filled with painkillers; I was not as aware as I needed to be. When I had to go for an X-ray, the nurse looking after me said I didn’t need oxygen to go along with my wheelchair. My oxygen saturations were good and it was a short trip.

I explained she was wrong, the oxygen was flushing the nitrogen oxide out and encouraging the lung to reinflate. We argued but I left without oxygen. I waited there without oxygen among patients who were coughing.

The ward sister apologised that I had been left without oxygen.

The distressing element of this scenario is that if I was in a unit with nurses specially trained in CF, this would not have happened.

I am just one person with cystic fibrosis and each person’s story is so individual. When I am not sick I work as hard as I can and I love my life. I know some day that that will end, things will get slower, I will spend more time lying in beds with various tubes.

I will be unable permanently to make that choice to get up myself and walk away from a screaming room-mate or a dying woman or drag all my medical equipment and tubing with me to sleep in the corridor, as I have done on previous occasions.

Not being able to access a single en-suite room when I needed one was not surprising, but it was frustrating. The lack of sincerity in the Government commitment to our dedicated CF unit is disheartening and degrading to the 1,300 people living with CF on this island.

There has also been no commitment to the number of beds that would be specifically ring-fenced for people with cystic fibrosis in the 100-bed unit that will treat many other illnesses.

We need 34 beds to deal with the daily intake of patients with cystic fibrosis. These beds cannot, as it has been suggested by those in charge, be given to other patients if people with cystic fibrosis are not there to take them.

We need cleanliness and exclusivity. We’re not asking for gold-plated oxygen tanks, we’re just asking those in power to help us stay alive in rooms that comply with international standards.

This litany of broken promises is embarrassing for Ireland. When I talk to patients or parents of young children abroad they are continuously shocked by the standard of care for CF patients here.

They have offered money to sort out our Irish mess.

I do not want to die in our Irish mess.

The eight single en-suite rooms at the national referral centre are not enough. We deserve single en-suite rooms when we present at hospital with a mild exacerbation or a painful, collapsed lung. It is the only way to get full quality treatment for most patients with multi-faceted cystic fibrosis.

People waiting on the transplant list deserve to be in single en-suite cubicles.

This time coming into hospital, I didn’t have to go through AE, but I will have to again. This time, no one used the room I slept in as a toilet or had MRSA or screamed throughout the night, forcing me to sleep in the corridor.

But it will happen again and is happening to other people with cystic fibrosis around Ireland who are exposed to life-threatening cross-infection as you read this.

The Pollack report was published in 2005. It  In reality, very little has changed since then for CF inpatients. When building eventually starts on the unit, it will take 14 months to complete.

We live in hope with a heavy dollop of cynicism, as always.

I walked by the site in the sunshine the other day during physiotherapy. It sits there, decanted and waiting, just like the rest of us.

If there’s such a thing as campaigners fatigue, I may be experiencing it. I have been writing the same thing for five years. It’s a depressing thought that I will be doing it for another five”.

I salute Orla Tinsley for writing this courageous article. It’s a damning indictment of our government’s appalling lack of commitment to CF patients who continue to be exposed to life-threatening cross-infection. The Irish political system is rotten to the core if it can allow this issue to continue. It’s just not fair!

Information Source: The Irish Times 25/06/10 and 26/o6/10 and The Cystic Fibrosis Association of Ireland.

The Buck Stops Here

For anyone who has ever been diagnosed with a missed miscarriage, I expect that this week’s news about miscarriage diagnosis may well have proved somewhat unsettling. This latest health scandal only emerged when a woman who was wrongly diagnosed with a miscarriage, decided to go public with her story to encourage women in similar situations to get a second opinion if they have any doubts.  About a dozen women have subsequently come forward with stories of having been wrongly told by maternity hospitals that they were carrying dead babies, only to give birth later to healthy infants. More than 150 people have contacted emergency helpline numbers since yesterday. Health Minister Mary Harney is continuing to refuse to comment on the issue, claiming that it is a matter for the HSE.

*”The HSE has been forced to instigate an investigation into all suspected miscarriage misdiagnosis cases over the last five years in an attempt to uncover the true scale of the growing terminated pregnancies scandal. The review will focus specifically on women who were recommended drug or surgical treatment (D&C) to remove what was in reality a perfectly healthy foetus. The nationwide examination will focus initially on complaints by the expectant mother at the time of the incident. It will also examine a growing list of new cases which have come to light this week, and further disputed cases which may or may not involve miscarriage misdiagnoses. The review will be confined to the past five years. ”

Many moons ago, I was diagnosed with a missed miscarriage at the end of the first trimester of my 2nd pregnancy, having contacted the maternity hospital for advice as I’d noticed ‘spotting.’ An ultrasound scan was carried out by my obstetrician at the hospital and I was told that the pregnancy had failed. Apparently, there was no heartbeat visible, just an empty embryonic sac with a diagnosis of a ‘missed miscarriage’ and a referral for a D&C the following day. At the time, a missed miscarriage was medically referred to as a ‘missed abortion’ and the subsequent D&C was referred to as an ‘evacuation of the retained products of conception (ERPC). Having arrived at the hospital as an expectant mother, I left in tears with those horrific terms reverberating around in my head. When I returned to the hospital the next day, no further scan was done to confirm the diagnosis prior to the D&C being carried out under general anaesthetic. Following this week’s awful revelations, I’m amazed that I never thought to question the diagnosis. I suppose times were different then.

Mary Harney should know better than to pass the buck to the HSE. After all, she is the Minister for Health and Children.

* Information Source: Irish Examiner

Stranded

Dying to get home. It’s no fun getting stranded especially when you’re on your own. Just imagine it…

You’ve spent an exhausting day anxiously waiting for news. It seems no-one can tell you how long the wait will be. You try to pass the time by reading but the constant level of activity around you, makes it impossible to concentrate. Each time you visit the toilet, you risk losing the cramped space you’ve made your own.

Night time comes but there’s no prospect of getting any rest. Sleep is impossible in the noisy, brightly lit environment. You lie there exhausted hoping that tomorrow will be a better day.

Yes, I did feel sorry for all those people stranded in airports last week but not half as sorry as I feel for the many patients stranded every day in our overcrowded emergency departments while awaiting a hospital bed.

Four years have passed since our Health Minister, Mary Harney declared A&E overcrowding a national emergency yet still the number of patients on hospital trolleys continues to reach record highs.

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.

A Bitter Pill

I don’t know about you but I’m finding the expenses revelations very hard to swallow. At a time when the country is in financial crisis, the idea that somebody who’s on more money than the Taoiseach, should get a bonus is highly questionable but it’s all the more outrageous when you consider the current state of the health service. Add to this, the revelations about expenses accrued by Mary Harney as Minister for Health and it becomes a bitter pill to swallow…

The Sunday Tribune has revealed that Mary Harney ran up the highest departmental bill in terms of ministerial costs and expenses. Granted our Minister for Health is a busy woman but you have to question why it was necessary for her to travel by the ‘€7,000-an-hour’ Government jet for her business trips abroad.

“Health Minister Mary Harney and her husband Brian Geoghegan ran up a bill of nearly €65,000 on hotels, limousine hire and accommodation in the space of just three years. That figure does not include the massive bill for the Government jet, which Harney used on almost every occasion she travelled abroad and which cost the taxpayer more than €735,000.” The Sunday Tribune, October 2009

Next, we are told that the HSE board has awarded it’s CEO Prof Brendan Drumm, a bonus payment of €70,000, based on his performance in 2007. This bonus is being awarded at a time when the HSE is making plans to reduce spending on the health service by up to €1.2 billion!

Here’s what Dr James Reilly, opposition Health spokesperson, had to say on the subject…

Morning Ireland – RTE News

My thanks to The Sunday Tribune, to Dr James Reilly and RTE radio, for exposing this outrageous carry on.

‘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!

Catch It. Bin It. Kill It.

A new health warning has been issued in Ireland. Public information leaflets and posters have been distributed to ports and airports. You have an important role to play in stopping the agenda of privatisation and for-profit medicine. Stop the spread of this pandemic disease now.

Radical health reform, in terms of creating a universal system of healthcare which offers equality and accessibility, is one of the greatest challenges facing Ireland today. Play your part.

Stop the spread of privatisation.

Podcast credit to PoliticalThicko and You Tube.

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.