Mother had been vomiting blood for 16 hours before GP came

The daughter of a woman with cancer who was forced to administer her mother’s medical treatment over the New Year’s bank holiday weekend, has criticised the Minister for Health for failing to provide sufficient out-of-hours services.

Siobhan Toibin's mother Maureen Marron (76) has small cell lung cancer and is receiving palliative care in Co Wicklow.

Unable to secure appropriate medical help over the bank holiday, Ms Toibin described how an acquaintance who worked in healthcare had to “steal” a device to help drain her mother’s bladder. On another occasion a visiting doctor left her with a syringe and a vial to inject medication herself as he would not be able to make a return visit.

In a scathing letter to Simon Harris, Ms Toibin accused him of “actively preventing palliative care from working successfully by not providing a full time care service and [instead] coupling it with such a pathetic out of hours GP service.

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“Do the job that you were elected to do, you are not a precious commodity.”

Raising her experience on RTÉ's Ray Darcy Show on Wednesday, Ms Toibin outlined how she was forced to improvise her own crucial homecare.

In her letter to the Minister, she detailed how her mother’s morphine prescription was increased on Friday, December 29th but was told the palliative care team would not be available again until the following Tuesday.

On Saturday December 30th her mother began to vomit blood and she phoned the out-of-hours GP service but could not secure a home visit due to demand.

Because of her illness, her mother had not urinated in 24 hours and she was advised by a nurse acquaintance that a doctor would be required to insert a catheter, a device used to drain the bladder.

Unable to source this by normal means, another acquaintance who worked in the medical field was able to get one while the nurse then drove to her home to insert it, immediately draining 1,750 millilitres of urine.

Stealing a catheter

“For anybody lucky enough to have an acquaintance prepared to risk their job by stealing a catheter kit from their place of work but don’t have anybody to call upon to insert it what do you suggest that they do?” she asked the Minister.

Ms Toibin said a GP eventually arrived at her home in the early hours of Sunday morning but only after she threatened to take her story to the media as her mother had been vomiting blood for 16 hours. He gave her an injection.

“The doctor has left,” she wrote in her letter, “my mother is so overwhelmed she is crying and asked me to get into bed and hold her hand.”

The following evening, Monday, a different doctor refused to inject her for nausea as she had not vomited for some time but Ms Toibin asked what she would do when she began to get sick again.

“He gives me a vial, syringe and needle and tells me to do it myself. He then leaves,” she wrote.

When palliative care became available again on the Tuesday, Ms Toibin’s mother was immediately taken to hospital by ambulance.

“This situation in its entirety was avoidable by providing palliative care that is accessible 24 hours a day, seven days a week,” she told the Minister, referring to a lack of such specialised services in north Wicklow where they live.

In a statement, the Department of Health said Mr Harris was "very concerned" by issues she raised and by the stress her family experienced.

"The Minister has been in contact with Ms Tobin and has sought a full report from the HSE on what happened," it said.

A national review of the need for access to 24 hour, seven day services is underway, according to the Department, and six new hospices are planned by 2021.