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Patient frustration resulting in aggression towards GP staff

By Catherine Reilly - 01st May 2023

patient frustration

Patient frustration due to healthcare capacity deficits is manifesting in aggression towards GP secretaries and other practice staff, Co Cavan GP Dr Rukshan Goonewardena told a session at the IMO AGM.

He said people were understandably frustrated by unmet care needs, but this was increasingly resulting in abuse at GP practices.

“This was not common before Covid,” he told the session on 14 April. “But in the last six months the amount of calls I have had to make to patients to say, ‘you cannot talk to my secretary like that’… I am sure I am not the only one and that is the constant feedback from our GP groups in Cavan/Monaghan; the amount of abuse our secretaries face is increasing.”

Dr Goonewardena told the Medical Independent (MI) that patients’ frustration could relate to any aspect of healthcare, but GP practices were the easiest contact point. “They could be giving out about a long wait time in the A&E, so they left, or they could be waiting for an appointment they never got…. But, we are the frontline, so we get it in the face all the time.”

During the session on the impact of capacity deficits on patient care, Dr Goonewardena said current Government plans to expand GP visit cards to 500,000 people will increase waiting times and lead to poorer patient outcomes.  He told MI: “Everybody I know [already] has a waiting list for appointments. As for new patients, I don’t know many GPs who are freely taking new patients.”

He said he supported removing financial barriers to access, but this only made sense if patients could receive an appointment in a timely fashion.

The same session at the AGM heard that four linear accelerator machines for radiation therapy are closed due to staffing shortages, representing a reduction in treatment capacity of 120 patients per day. Ms Rachel Morrogh, Director of Advocacy at the Irish Cancer Society, also noted that the National Cancer Control Programme target for time to access radiotherapy was not being met. The target had not been met in the last five years which has a direct impact on outcomes and prognosis, she said.

Some 200,000 people were on radiology waiting lists, while rapid access clinics were only able to meet waiting targets for 75 per cent of patients, she outlined.

While there had been positive advancements in cancer care, Ms Morrogh emphasised that the national cancer strategy needed to be properly resourced. She said more action was required to retain and recruit healthcare professionals and researchers.

Consultant in Emergency Medicine Dr Mick Molloy, who presented on acute bed capacity, said there were 11,832 acute public beds when a capacity report was published in 2002. This report noted that the figure was approximately 6,000 lower than in 1980 and recommended an increase of over 4,300 beds by 2011. However, there are roughly the same number in the public system today as in the early 2000s, despite the huge rise in population.

Dr Molloy noted a UK study that reported one extra death for every 82 admitted patients whose transfer to an inpatient bed was delayed by six-to-eight hours from arrival at the emergency department. The figure was one extra death for every 72 admitted patients when delayed for eight-to-12 hours.

“Now, unfortunately, we [in Ireland] are way beyond that. We have people 20, 30, 40, 70 hours [without a bed] after the decision to admit; we are not even counting the first block of time before they get to that point, which could be 10, 12, 14 hours in some hospitals already.”

He said the requirement for more acute beds was “pretty obvious” and elective hospitals would also improve healthcare access.

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