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It is four months since the then Taoiseach Leo Varadkar stood outside Blair House, Washington DC, and told the nation he needed to speak to us about the coronavirus and Covid-19. That speech and the one to follow five days later, on St Patrick’s Day, marked a fork in the road of most people’s lives as we travelled inexorably towards the ‘new normal’.
In the latter address, the now Tánaiste spoke of the apprehension felt by healthcare workers as they watched other healthcare systems become overwhelmed by the virus and staff getting sick. “Not all superheroes wear capes,” said Mr Varadkar memorably, “some wear scrubs and gowns.”
The Covid-19 pandemic has not overwhelmed the Irish healthcare system to date, but it has had an overwhelming effect on many healthcare workers.
The recent RTÉ Investigates programmes Inside Ireland’s Covid Battle, which documented the experiences of patients and staff at St James’s Hospital, Dublin, showed the remarkable commitment of staff. They demonstrated this commitment in very difficult professional and personal circumstances.
This was evident in the tears of a young nurse, fearful of bringing the virus home to her parents and the concern etched on the face of an ICU consultant when, despite precautions and three negative swab tests, a patient in the non-Covid ICU tested positive for Covid-19. It was also evident in the worry of staff who were then tested for the virus.
In this edition of the Medical Independent (MI), Niamh Cahill documents the experiences of older GPs, many of whom returned to or remained at the frontline of delivering care, despite significant personal risks. With the crisis under control for the moment, accelerated retirements are a distinct possibility and, in some cases, already a reality.
And as Paul Mulholland describes in our main feature on hospital overcrowding, there are now unprecedented demands on staff to resume services in an already overstretched system, which must deal with the complexities of ‘Covid’, ‘suspect Covid’ and ‘non-Covid’ patient streams, and implement other extra protective measures.
Employment terms and conditions in Irish healthcare have presented a recruitment and retention ‘challenge’, to use official parlance, and this is intensifying in the context of Covid-19. Many frontline workers are now exhausted.
Disturbingly, former IMO President Dr Ray Walley recently tweeted that he was “hearing that ICU nurses and ICU medics are finding it difficult to access much-needed holiday leave”.
Dr Walley wrote that he was aware of two ICU nurses whose leave was “declined because of shortage of replacements — these individuals have worked average 50-60 hour weeks and are emotionally exhausted — both now looking for career change — abysmal HR management — staff need to be valued.”
Last month, Consultant in Public Health Medicine Dr Marie Casey tweeted that public health in Ireland was at a crossroads. “We are in the midst of what is likely to be long slog with Covid-19. This pandemic has shone a harsh light on the chronic lack of investment and neglect into our division.”
She said numerous reports had recommended that specialists in public health get a consultant contract and reforms be implemented to create multidisciplinary teams.
In this edition of MI, Dr Gabrielle Colleran writes that the consultant recruitment and retention crisis is a touchstone issue for many frontline healthcare workers and signals a decade of broken promises and loss of trust and confidence.
In recent months, the former Minister for Health Simon Harris excelled at his strongest skill when it mattered most — communication. But he and his Government colleagues, including Mr Varadkar, were ineffective at implementing healthcare reform and improving the system for patients and staff alike.
Taoiseach Micheál Martin and Minister Stephen Donnelly now have an opportunity to exact changes. Plaudits and applause are all well and good, but are simply not enough.
Editor Paul Mulholland is on annual leave.
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