Finger on the Pulse

May 18, 2009

Right now this country lacks leadership. George Lee, the well-known economist, has thrown in a well-paid job with RTE to put himself forward for election. There’s no doubt that he has the expertise needed to sort out the financial mess in the country. I’m reassured by his knowledge and feel sure that given half a chance, he’s the right man to iron out the problems in our economy.  Now wouldn’t it be good if some more bright sparks were to declare themselves willing and able to sort out our ailing health service? Harney and Drumm have clearly lost the plot. New blood is desperately needed.


Here’s a viewpoint from someone who does have a finger on the pulse. I’ll be back soon.

Overcrowding in A&E

Madam, – Can anyone explain why the persistent and dangerous overcrowding that afflicts Irish emergency departments remains unsolved and ignored? This Government moved very swiftly to deal with inadequacies in cancer services in the past two years when clinical errors, which had been highlighted in the press, made it obvious that improvements in service organisation and delivery were essential. Key elements in that improvement process were: a political will to sort it out, an analysis of the service as it was, a redirection of funding to key areas, reorganisation of services and, most importantly, co-ordination of all of this by the cancer tzar, Prof Tom Keane.

Emergency departments in the UK were the victims of overcrowding with in-patient boarders for many years, but the public outcry and the media’s persistent reporting on it was enough to stimulate Tony Blair, the then prime minister, to demand an improvement. What followed was a process that was a mirror image of what we have seen with cancer services here and, under the guidance of their emergency services tzar, Prof George Alberti, the problem was largely solved within two years.

What do we do in Ireland? Yes, we recognise that there is a “National Crisis” (Mary Harney 2006) and we set up a taskforce which produced an excellent document on changes required to improve matters (June 2007), but we fail to appoint a credible co-ordinator/implementor and we ignore all of the recommendations of the Taskforce Report.

Such inertia has not just led to a retention of the status quo, but to a gradual and serious deterioration of the care of patients presenting to emergency departments. There is ample evidence internationally that overcrowding of emergency departments with admitted patients puts them at a significant risk of medical complications and death. In that regard they are no different to the plight suffered by cancer victims in the past. Why then do the HSE, Professor Brendan Drumm and the Minister for Health and Children, Mary Harney, continue to obfuscate on this matter? – Yours, etc,


Consultant in Emergency Medicine, Beaumont Hospital, Dublin.

Source: Irish Times online

Aychessee Sinking?

July 21, 2008

What’s that about? It took me a while before the penny dropped.

The “Aychessee” is a sinking ship according to Prof John Crown. “A suitable alternative needs to be launched before it sucks our health service and our economy down with it into Davy Jones’ Locker.”

You can read all about it here.

If you’re still confused as to what this is all about, it may be because you pronounce “H” as “Haych” in keeping with Irish ways.

Aychessee = HSE. Geddit?

It remains to be seen if Captain Harney and First Mate Drumm, will stay with the sinking ship.

Tighten your Belt

July 8, 2008

Well, it’s finally happened. The economic downturn is upon us, our public finances are under severe pressure and major cutbacks in healthcare spending are anticipated. Our already ailing health service is set to suffer even further and it almost goes without saying that patient care will be compromised.

Brendan Drumm, the HSE chief, believes that in the present economic environment, the health service could face five years without any extra funding. He also believes that there is no reason why the standard of health service provision should suffer as a consequence. Our Minister for Health, Mary Harney has warned that hospitals must operate within budget and must do so without impacting on patient care. We’re told that the way our hospitals are being run is both ineffective and inefficient. I turned on the news last night to hear that hospitals across the country are facing a scaling back of services with staff cuts and ward closures. One hospital has already accused the HSE of gross neglect of patients and claims that the cutbacks are being done at the expense of patients. A spokesperson for the HSE insisted that patient care will not be compromised by the cutbacks. Who do they think they’re fooling?

My biggest fear is that patient’s lives will be put at risk by these further cutbacks in spending. There is already a serious problem in our hospitals with the level of healthcare associated infections (HCAI’s) such as MRSA and Clostridium difficile. Poor cleaning, overcrowding, inadequate facilities, lack of infection control staff, poor management and a lack of accountability have all contributed to unacceptable levels of infection and death within our health system. There is also growing public disquiet. We are constantly promised that improvements are “planned” or “under way” but how can this be so when cutbacks in basic front-line services are being simultaneously requested. This is not the time to talk about cutbacks and the necessity of hospitals staying within budgets. The HSE has lost sight of the needs of the patients. It increasingly prioritises bureaucracy and finance rather than health, with numbers and budgets taking precedence over real people and care.

We are once again being asked to tighten our belts. Brendan Drumm says that it is the duty of everybody, including the health service, to use taxpayers’ money more effectively. This is all very well and good but could someone please explain why this situation has arisen after a whole decade of unprecedented economic growth? Is there any Government accountability left in the area of healthcare?

UPDATE: In case anyone ever thinks I’m exaggerating about the state of our health service, have a look at this post which can also be found over at Irish Election. It details the experience of bringing a child to A&E and is a classic example of how the system is failing to provide emergency care. This post completely mirrors my thoughts.

Paying the Price

May 8, 2008

Today, I came across an article at which lifted my spirits. It was refreshing to find such a well-balanced look at the multiple problems within our health service. Claire O’Reilly, a former nurse, spent a night in A&E last year because of complications following an angiogram. She has decided as long as she has the choice, never to return to an A&E department again. You can find Claire’s article here.

I was delighted to find another patient and former healthcare worker, who is prepared to stick her head above the parapet and ask pertinent questions about our health service. Claire blames the nurses, her own profession, for failing to speak out and take action about the conditions endured by patients. She believes that Mary Harney and Brendan Drumm are not listening to advice given and have forgotten about the patients in their determination to reform the system. She accuses them of constantly talking about the cost of running the health service and asks if they cannot see that it is the patients who are paying the ultimate price!

Patients are suffering and will continue to suffer as long as they remain silent. The time has come for everyone to join forces and make their voices heard. Please don’t wait until another scandal happens. Our new Taoiseach was installed yesterday. What better time to start?