Medical Correspondent Dr Muiris Houston assesses the impact of the doctors' strike on patient care and waiting lists
With potentially thousands of patients affected by the strike in Tullamore and Waterford hospitals, what are the practical effects of the junior hospital doctors' action for those patients whose surgical operations have been cancelled?
And how long will it take for people to be seen in re-arranged out-patient appointments?
For a patient due to have a routine hernia repair carried out yesterday, the downside in waiting even longer can be measured in terms of inconvenience rather than medical harm. True, while hernias [a protrusion of abdominal contents through a weakness in the muscle wall] can strangulate, leading to an acute emergency, such a complication is relatively rare.
However, such patients are likely to have waited weeks for elective surgery - and probably months since being referred to hospital by the family doctor. And one cannot underestimate the worry associated with the "will I, won't I be admitted" scenario which such patients faced since last week.
They also will have planned time off work, family members will have made arrangements to nurse them on their return home, and, in certain cases, alternative care arranged for a handicapped son or daughter will have been made. So the broad physical, psychological and social effects of the dispute on a patients' lives will be significant. What about the woman waiting for a D and C operation to investigate abnormal vaginal bleeding of a possible sinister nature?
Her consultant will, of course, prioritise her to the next available operating list after the dispute ends, but delays such as this are potentially a lot more serious.
A delay in making a diagnosis of cancer is not only medically unacceptable, it is cruel for the patient who is forced to remain in a limbo of uncertainty.
The one element of good news for all those affected is that they will not have to go to the back of the queue. Both medical and health board sources confirmed yesterday that patients would be given priority on both out-patient and surgery waiting lists.
While a spokeswoman for the South Eastern Health Board pointed out that the longer the dispute goes on, the more difficult it will be to fit the cancellations in, it is expected that those affected will have to wait weeks rather than months for another appointment.
The board also said it would work closely with consultants to prioritise patients according to clinical need.
There are 495 patients waiting for elective (planned) surgery in Waterford hospital. This is down from 592 a year previously, but with 74 operations cancelled on the three days of the dispute so far, it will not take long for waiting lists to deteriorate, with a potential knock-on effect lasting for months.
Yesterday alone, 164 outpatients were affected by the dispute. While there are no figures available for the total number waiting for out-patients appointments at Waterford, the cumulative impact of the strike will be significant.
In Tullamore around 400 outpatient appointments will be cancelled during the three day strike there.
Clinics for patients with cancer and chemotherapy treatments are not affected by the current strikes. Full maternity services still operate and junior doctors remain on duty in coronary care units, intensive care units, neonatal and dialysis units.