Sir, – Regarding the recent debate (Letters, July 16th; “Hospitals falling behind in performance face exclusion from funding for new consultants”, News, July 11th), I would make the following observations.
The British Association of Urologists estimates that 10 new patients per consultant is the number that can be dealt with safely without risk to the patient or doctor.
We should not be operating like unfortunate Amazon operatives dealing with vast numbers in a machine-like manner.
For example, dealing with cancer patients requires time, patience and empathy and not a “next” mentality, with fixed 10-minute consultations. Discussions regarding potential risks and benefits of treatment and surgeries with both patients and family cannot be dealt with in a hurried manner.
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Issues of communication, patient understanding and education and answering questions take time. In addition, many patients wish to be shown their scans, blood results, etc, all of which adds to a consultation. How often have we heard that the most common reasons patients complain and sue doctors are poor communication and inadequate consent processes for surgical procedures?
Consultants may have to supervise three to four sometimes very junior trainees of varying abilities and stages of training.
Consultants and trainees are dealing with some of the most antiquated IT systems in Europe, with, for example, no access to the innumerable scans that patients are being forced to have in private facilities, as there is no access to hospital-based radiology facilities. Patients are shocked to learn that their hard-spent cash has been essentially wasted, unless they have brought a disk which can be uploaded onto the hospital system, but then requires a further unnecessary visit to discuss the results. Interestingly, such scans are available to consultants in their private rooms but not in their public outpatient departments.
All clinic doctors then have to book whatever scans and tests are required on the same impossibly slow, outdated systems, adding to more wasted time. In a modern system, this would be dealt with by specialist nurses or administrative staff.
In some institutions server capacity is so poor that scans carried out in the previous six to eight weeks are no longer accessible to clinicians as they have been shifted to centralised storage. The delay and frustration this causes are unacceptable. I am aware of an instance when this was brought to a HSE IT committee, the individual was told to “get off his soap box”.
Finally, as many of our hospitals are no longer physically fit for purpose, with inadequate clinic space, there has been an increasing requirement to have three clinic sessions per day, as opposed to the old AM and PM structure, which has obviously increased access for new consultants, but curtailed clinic times. – Yours, etc,
GERRY LENNON,
Consultant Urologist,
Cabinteely,
Dublin 18.