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A completely expected unprecedented event

By Dr Neasa Conneally - 06th Feb 2023

unprecedented event

When will the health service learn from the hospital overcrowding crises that occur every January?

After a couple of years of a series of unprecedented events, the country has been hit by something so unusual and unexpected in recent weeks that it seemed to take the entire health service and the those in charge of running it completely by surprise. Apparently, for the first time ever, January followed December and, along with it, brought a completely unpredicted influx of winter
respiratory illnesses. Such an occurrence was totally unforeseen and, as such, absolutely nothing had been done to improve infrastructure and staffing to meet the overwhelming demand.

In the face of the politically unwelcome headlines of almost 1,000 people languishing on emergency department (ED) trolleys, the HSE and Department of Health heads sprang belatedly into action, in order to be seen to be finally doing something.

GPs were asked to run extra evening and weekend clinics, although, anecdotally for the most part, take up was low because cloning technology is still pretty primitive. It is already impossible to find enough GPs to address the current shortage, let alone find more people to work even more hours at short notice.

The caricature of the wealthy consultant away on the golf course is an easy one to reach for and politically expedient when trying to push through a new contract, and so they were also exhorted to work over weekends. The implication being that this was a completely new occurrence for them.

Yes, a seven-day service is a laudable goal to aim for. It absolutely is a fact that we do need more senior clinical staff on the ground making decisions after 5pm on a Friday. However, it isn’t just doctors and nurses that are needed to run a 24/7 efficient health service. It’s also allied health professionals, Fair Deal administrators, nursing home co-ordinators, public health nurses, the list goes on and on. It’s all well and good trying to discharge more patients, but not very helpful if there is nowhere to discharge them to or any supports in place once they leave the hospital.

As it stands, we just don’t have the staff to run such a service and so expect people to work the likes of 12 days in a row, completely in contravention of any laws around safe working practices. I already predict the headlines in a couple of months about doctors’ large overtime payments for all these long hours that they have worked.

Walking through an ED often felt like a horse wearing blinkers – you had to stay laser-focused on the one task you were doing because to take in the enormity of all around you would be overwhelming

A health system collapsing under so much strain is inhumane for patients, but it’s also inhumane for the staff. Walking through an ED often felt like a horse wearing blinkers – you had to stay laser-focused on the one task you were doing because to take in the enormity of all around you would be overwhelming. Leaving shifts knowing that, despite your best efforts, people were receiving substandard care is cruelty in itself and not what any of us signed up for.

Asking people to work long, difficult hours is just going to lead to even more burnout of staff that are already exhausted after long, traumatising pandemic years. There will be even more wringing of hands when staff continue to flee to the likes of Australia at the first opportunity they get. Every so often someone comes up with the bright idea of stopping doctors from leaving the country in order to ‘pay back their debt to society’. They conveniently forget that the taxpayer also funds teaching and engineering and English literature degrees, but no one suggests that we enter them into indentured servitude. The approach to healthcare staff in this country very much continues to be that the beatings will continue until morale improves.

A new approach is needed. There is always going to be a spike of illnesses in winter months, but the health service is now running in crisis mode all year round. I am always suspicious of people who claim to have the one solution that fixes all issues, as it is a lot more complex than that.

As the days are getting slightly longer and the spring bulbs emerge from the ground, the immediate crisis is thought to be over because now only around 500 people are languishing on trolleys rather than 1,000. I predict that the news headlines will quickly move on to the next big story and not a single lesson will have been learnt. I am already looking forward to next January when the same unprecedented crisis happens once again, just as before.

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