HEART BEAT: SOME FANTASIES are dangerous. Our wise men in the HSE are going to evaluate the provision of AE services in the State, particularly in Dublin and Cork. This is not to increase them and improve their facilities. Rather it is to curtail them. This is where fantasy abuts upon reality and they are incompatible bed fellows.
We have had a colder winter than in recent years and we have also had a flu epidemic. It wasn’t that severe a flu and we’ve had worse winters but the result this time was to paralyse AE units and hospitals throughout the State.
Record numbers of patients lay on trolleys across the Republic, effectively crippling the service. There were more than 400 such patients on many days. There was no capacity in the system to accommodate the cold and the flu. If either had been more severe, the system may have collapsed completely.
The mandarins of the HSE tell us blithely that it is not as bad as the nurses and doctors tell us and that, furthermore, plans are in train to bring primary care teams up to scratch in order to deal with such situations.
They ignore the fact that in those few areas lucky enough to have such a team, the trolley traffic jam is also a feature of the local hospitals.
I might suggest that if jobs are to be culled from the HSE, that a start could be made with the spin doctors who peddle the message that all is under control when the world and his wife know that it is not.
We will pass over the effect that this has upon the routine hospital elective work. Everything is paralysed by the situation in the emergency departments. This is hardly surprising when one realises that 3,000 beds were removed from our hospital system at a time when we had 750,000 fewer people. Only fools could think otherwise but sadly that is one commodity that we do not lack.
How can we keep MRSA, Clostridium difficile and other pathogens out of this witch’s brew engendered by overcrowding compounded by inadequate facilities and overworked staff? Add in the noroviruses “winter vomiting bug” and you would wonder how the hospitals manage at all.
The answer is barely, and only by postponing the elective but equally important part of their functions, eg the diagnosis and management of cancers, heart disease, neurological disorders, etc.
I spoke to doctors from the paediatric AE units in Dublin who were singled out for such deranged “rationalisation”. They could not understand how their units situated in Our Lady’s Hospital Crumlin, in Tallaght Hospital and in Dublin’s inner city at Temple Street were deemed overstaffed for purpose or have it suggested that they frequently had little to do.
They readily conceded that there were quiet nights but these were not common. On many occasions, the converse was true and they were extremely busy. You can well imagine that there is little as demanding in emergency practice as a seriously ill child.
Fewer beds, day surgery, five day wards, discharge plans – these are all part of the delusion that illness can be rationed and constrained to moieties of time.
Human beings and sickness are not the stuff of cold accountancy. Let us have an end to this nonsense about further reducing our emergency capacity.
It was not only over the emergency units that the birds of fantasy flew. For some entirely baffling reason, the HSE seems proud of the successes achieved in the northeast. If you measure success by overcrowding, shutting services for inpatients and outpatients, closing beds and units and going off call for emergency admissions, then I concede it has a point.
Drogheda and Cavan headlined for overcrowding within one week of each other, Monaghan, Dundalk and Navan rendered dysfunctional; that’s progress HSE style!
The promised centre of excellence to replace them all is still in dreamland with no prospect of its realisation in the foreseeable future. Money saved by failing to look after our sick in order to look after our ailing bankers; these boys have different priorities to the ordinary people.
The hospital service in the northeast has been wrecked. The people have been lied to; in so much as they were promised that nothing would be run down until better options were in place. This did not happen.
Now the bird of fantasy is flying over the midwest and dropping the same message on those below. That’s all it is, in polite parlance, a dropping.
The people in the region should cast an eye on what happened to the services in the northeast and remember the old adage “fool me once shame on you, fool me twice, shame on me”.
A writer to this newspaper castigated me recently for writing sarcastically about the Department of Health choir. They either missed or ignored my point that in this small impecunious Republic we cannot afford both the department and the HSE at a time when patient services are being curtailed everywhere.
Those in the health service will simply, like everybody else, have to sing for their supper. As for the writer’s opinion that my article departed from the high standards of this newspaper, I would simply point out that The Irish Times has always stood for reality and truth; unpalatable as this may be for some.
Maurice Neligan is a cardiac surgeon