Skip to content

News Analysis

New data from nationwide survey sheds light on understanding of dementia

By sa | Sep 19, 2018 |

Every September, World Alzheimer Month raises awareness and challenges the stigma that surrounds dementia. Internationally, two out of every three people (67 per cent) believe there is little or no understanding of dementia in their countries. The ‘Dementia: Understand Together’ campaign, led by the HSE in partnership with The Alzheimer Society of Ireland and Genio, has been working to increase awareness and understanding of dementia in Ireland since 2016, and recently released the results of a nationwide dementia survey conducted earlier this year.

Survey

The survey of more than 1,000 adults offers a number of insights into changes in dementia awareness, understanding and attitudes among the population at large in Ireland since a similar survey was undertaken in 2016. The results highlight the success of the campaign and identify areas where additional work is needed. They also offer an insight into the impact and direction of the broader implementation of the National Dementia Strategy, published in 2014.

Early diagnosis of dementia is crucial so that people can access the appropriate services and supports and can help with making decisions about care and support for the future. More than three-quarters of respondents (78 per cent) understood the importance of being diagnosed early. However, a quarter (24 per cent) of respondents to the survey said that they would delay seeking help if they had concerns, highlighting that stigma and fear still exist as barriers to early diagnosis.

A visit to the GP is usually the first step for people who have concerns about their memory or cognition, with patients usually referred to a general outpatient clinic or a specialist memory clinic for further investigation.

A number of education programmes and resources have been developed to support GPs and members of the primary care team in this role and a dedicated primary care website — www.dementiapathways.ie — provides education, resources and signposting for clinicians. The National Dementia Office is also leading on a project which aims to develop a national diagnostic framework to ensure everyone has equitable and timely access to diagnostic services.

Support

Receiving a diagnosis is only the first step for a person living with dementia and it is essential that there are post-diagnostic supports available immediately after diagnosis and throughout the course of the condition. While there are still gaps in the availability of post-diagnostic services nationally, a number of new initiatives are addressing this.

‘Memory technology resource rooms’ are being established around the country to provide information and advice on the assistive technologies that are available to support people living with dementia to continue to live as independently as possible. The project aims to establish one memory technology resource room in every county, and 23 rooms will be open by the end of the year.

A number of grants were recently awarded to facilitate the provision of cognitive rehabilitation, cognitive stimulation and psycho-educational programmes around the country as part of a post-diagnostic support project being led by the National Dementia Office. The project is working towards the development of a national post-diagnostic support framework, which will provide guidance on the pathway of care after a diagnosis. In addition, The Alzheimer Society of Ireland provides a highly responsive and individualised information and signposting service through a network of dementia advisors who cover 11 counties nationally.

Over half of respondents (52 per cent) in the survey were aware that there are things they can do to potentially reduce their dementia risk — up from 46 per cent previously. Healthcare providers play an important role in highlighting the importance and benefits of staying physically, mentally and socially active, not only for general health, but as strategies for reducing the risk of developing dementia.

While health and social care services play an integral role in supporting a person with dementia and their families, a ‘whole-society’ approach is needed to ensure the person can live as well as possible, for as long as possible. Increasing understanding and reducing stigma is needed for this, and the results of the survey show progress, in that one-in-three (33 per cent) respondents described themselves as knowing a lot about the disease — up from 24 per cent in January 2016. Over half of respondents (52 per cent) recognised that people with dementia participate in a wide variety of activities and interests, and three-in-five people (59 per cent) who saw the ‘Dementia: Understand Together’ TV campaign said that they were impacted in some way as a result of the personal stories featured.

Next phase

The next phase of the ‘Dementia: Understand Together’ campaign is building on this increased understanding, creating inclusive communities, empowering individuals, businesses and service providers to raise awareness and take action to support people living with dementia and their families. The campaign is calling on people to become ‘Community Activation Champions’ and information, resources and supports are available at www.understandtogether.ie.

Taking a closer look at therapeutic-use exemptions in Irish sport

By sa | Apr 12, 2018 |

Diabetes and asthma were the most common indications for approved therapeutic-use exemption (TUE) applications to Sport Ireland in 2017, according to data released to the Medical Independent (MI) following a Freedom of Information (FoI) request.

Last year, there were a total of 27 approved TUE applications, stated Sport Ireland’s Anti-Doping Annual Review 2017. This compared to 40 in 2016.

Five applications were incomplete at the end of 2017 and a further 49 were ‘not relevant’ (for reasons such as, the medication was used out of competition; the medication was not on the prohibited list; the application was for a threshold medicine where the athlete was below the threshold; the medication changed to an alternative; and the medication was given by a route not prohibited). The total number of applications (81) represented an increase of 10 on 2016.

A TUE allows an athlete to use a prohibited substance or method included on the World Anti-Doping Agency (WADA) Prohibited List, subject to certain defined conditions. Athletes can apply to Sport Ireland, or in the case of an international-level athlete, the international federation. The athlete must have “a well-documented medical condition supported by relevant and reliable medical data” for the TUE to be granted, according to Sport Ireland. The multi-specialty TUE Committee is chaired by Consultant Respiratory Physician Prof Sean Gaine.

Of the 27 TUEs approved by Sport Ireland in 2017, diabetes was the relevant indication in six instances.

The medications approved were insulin aspart in two cases; insulin detemir/insulin aspart in one case; and insulin glargine/insulin aspart in three cases.

Asthma was a relevant indication in five cases, including one combined case of asthma and rhinitis.

The medications approved were salbutamol, terbutaline, vilanterol in two cases, and vilanterol/terbutaline.

ADHD was the third-most common indication, representing three cases and involving the approval of methylphenidate.

Seven cases involved approval of a glucocorticoid, namely prednisolone in six instances, and fluticasone in one case. Glucocortioids were approved for a range of indications, including colitis, cerebral vasculitis and polymyalgia rheumatica.

Athletics and rugby

Last year, athletics and rugby accounted for the most TUEs granted by Sport Ireland — six in each sport. This was followed by shooting (three), rowing and cycling (two each). There was one application approved in relation to each of the following sports: Gaelic football, paralympic athletics, swimming, motorsport, equestrianism, triathlon, gymnastics and soccer.

Sport Ireland’s Anti-Doping Annual Review 2017 listed the numbers of TUE applications received and approved, but did not publish information on specific medications approved or relevant indications (this information was obtained under FoI, although not in a manner that could link the approved medications with a sporting category). Despite some calls for it to do so, Sport Ireland does not publish the names of athletes granted TUEs.

A spokesperson for Sport Ireland informed MI: “To confirm, TUEs are personal, medical records containing sensitive personal data, provided to Sport Ireland in confidence. Sport Ireland must ensure it respects certain privacy rights of the athlete. This assessment includes the possibility of singling-out and data-linking.

“This extends to the ability to single-out an individual from others by taking one or more pieces of information, which if viewed alone could relate to a number of individuals, but when linked together would narrow the scope of the individuals it would be applicable to and therefore identify them.”

Meanwhile, on the fact that valid and approved applications dropped from 2016, Dr Una May, Sport Ireland’s Director of Participation and Ethics, told MI there was “no clear or outstanding reason” for this.

Medical Council

Dr May also confirmed that work is ongoing on developing a memorandum of understanding (MoU) with the Medical Council, which would provide a formal mechanism to report concerns about the practice of registered doctors in respect of potential doping activity.

“The main purpose is about collaborating,” she said. “We feel very strongly about the importance of working in partnership and collaborating in sport. It is important to recognise it is not just the athlete [in terms of anti-doping]; oftentimes, there is more to what we see from a positive result and an adverse analytical finding — there is more to it than just an athlete taking something; sometimes there is somebody helping them to take that. So if we come across something, it would be appropriate that we share that information with the Medical Council. It has cropped up in the UK and a number of other countries, where it has been important to follow-up with the relevant medical authorities.

“Certainly, if we were to become aware of a doctor who was to be involved with doping, in some way, shape or form, we’d be very anxious to make sure the person is dealt with appropriately by the relevant medical authorities, as well as within sport… ”

Asked if Sport Ireland had, over recent years, any cause to contact the Council regarding a medical practitioner, Dr May said “no, we haven’t”.  In the absence of an MoU, she said, there would be “possible avenues” by which information could be forwarded to the Council if necessary.

“But the most appropriate way is to have a formal system in place for doing that, which fulfils totally any kind of criteria around data protection and everything else — that is what our vision is, that we have a strong system in place for doing it,” said outlined.

Dr May confirmed that Sport Ireland is working with the RCSI/RCPI Faculty of Sports and Exercise Medicine on developing ethical guidelines for medical practice in sport. This follows a Medical Council request to relevant medical bodies to produce specialty-specific ethical guides.

Last year, through the national testing programme, Sport Ireland conducted 989 tests of athletes. This included 318 blood tests and 671 urine tests. It undertook an additional 315 ‘user pays’ tests on behalf of 10 national and international organisations, marking an increase of 15 per cent on 2016. There was one positive finding from tests conducted last year and no further information on this has been released thus far. 

Supplements

Dr May advised that the issue of supplements “continues to be one of our bigger challenges”. In this respect, Sport Ireland has recently published a document titled Supplement use in Sport Guidelines.

According to Dr May, there has been an increase in the number of anti-doping rule violations globally that involve use of supplements, whether contaminated or otherwise.

She said Sport Ireland continues to work closely with the Food Safety Authority of Ireland (FSAI) and the Health Products Regulatory Authority (HPRA) on this matter. 

Last month, the FSAI announced it was recalling all Falcon Labs products due to the “presence of illegal steroids and stimulants that pose a serious health risk to consumers and also, as the location of the production site cannot be determined and traceability of the products is unknown”.

FSAI officers took possession of Falcon Labs products from food supplements and sports nutrition shops, gyms and online suppliers across the country. According to the FSAI, the products were sent to the State Laboratory for official testing for a range of illegal steroids and stimulants. The results showed that 1,3-Dimethylamylamine (1,3-DMAA) (also known as methylhexaneamine MHA) was detected in Falcon Labs Oxyburn Pro and Superclen products. Methasterone was detected in Falcon Labs’s Superdrive. According to the FSAI, 1,3-DMAA was not declared as an ingredient on any of the products and methasterone was misspelt on the label of the product in which it was detected. Nonetheless, neither substance is permitted in food.

The FSAI warned that 1,3-DMAA is a stimulant that can cause acute temporary increase in blood pressure, which may lead to shortness of breath, tightening of the chest and the risk of heart attack or cerebral haemorrhage. It was previously authorised as a nasal decongestant, but later withdrawn. Methasterone is anabolic-androgenic steroid which has been associated with a number of cases of liver injury. It has never been authorised as a medicine, but has been found previously on the black market under the name Superdrol.

There have been two publicly-reported rulings by Sport Ireland against athletes who tested positive for banned substances and who said they consumed Falcon Labs food supplements.

A need to know: Getting ready for the new data protection law

By sa | Apr 12, 2018 |

The General Data Protection Regulation (GDPR) is a new EU regulation and, as such, will have a direct effect in all EU countries, including Ireland.

The GDPR has been written to reflect the increasingly digital climate in which organisations now operate. It aims to enhance the current data protection rules by introducing a number of additional data protection obligations on organisations, increasing rights for individuals and allowing them greater control over their own personal data.

The GDPR will apply to all individuals and organisations that have day-to-day responsibilities for data protection. All doctors should consider, therefore, how the GDPR will impact on their practice. 

The Data Protection Commissioner (DPC) has published guidance titled The GDPR and You. This sets out the key changes, although it is by no means an exhaustive document.

The DPC has also launched a GDPR-specific website with guidance for both individuals and organisations, raising awareness of their respective enhanced rights and responsibilities under the GDPR.

Accountability

The GDPR introduces the principle of accountability and makes this mandatory. In short, as well as ensuring GDPR compliance, organisations must now be able to demonstrate this compliance. Organisations must maintain accurate records of all their data processing activities, including the purpose for collecting and holding personal data, how it was obtained, how long it will be retained, the security measures in place, and how and why data may be shared with third parties. 

It will also be important to document all advice provided by the Data Protection Officer (DPO) and any risk assessments undertaken.

All staff should be aware of their individual responsibilities and it is important to keep a log of staff training.

Lawful basis for processing personal data

Organisations need to identify their lawful basis for processing patients’ personal data (such as their name, address and date of birth). There are six lawful bases, which include patient consent; processing is necessary for the performance of a contract or provision of a service; processing is in the organisation’s legitimate interests, except where such interests are overridden by the interests or fundamental rights and freedoms of the patient; and processing is necessary in the vital interests of the data subject.   

Under the GDPR, certain ‘special categories of personal data’ — including data concerning health — cannot be processed (eg, collected, stored, used, disclosed or destroyed), unless one of 10 conditions is met. Organisations therefore need to establish this special category condition and ensure this, and the legal basis for processing personal data, is communicated to patients.  The most relevant conditions are patient consent; and that processing is necessary for the purpose of preventative or occupational medicine, medical diagnosis or the provision of healthcare or treatment that is done by, or under the responsibility of, a professional who is subject to an obligation of professional secrecy.

Consent 

The GDPR sets a very high standard for consent in relation to the processing of personal data. If organisations are relying on consent as a lawful basis for processing personal data, they must ensure that it is freely given, specific and informed.  It should constitute an unambiguous indication of the patient’s wishes, by a clear affirmative action to the processing of his/her data. Pre-ticked boxes will not count as consent and there must be a positive opt-in process, separate from other terms and conditions. Organisations will be obliged to demonstrate that the patient has given their consent. There must be an easy way for a patient to withdraw their consent.

Transparency and fair processing

As has always been the case under data protection legislation, organisations have an obligation to inform patients what they are doing with their data. However, the GDPR will bring in more detailed and specific rules on providing such privacy information.

Privacy notices should be used to inform patients at the time of collecting their data. A variety of communication methods could be used, such as posters, leaflets, letters and information on the organisation’s website.

The GDPR places emphasis on the importance of privacy notices being easily accessible to patients, including children and vulnerable adults. Information within such notices should be concise, truthful and written in clear, straightforward language. If your organisation has non-English-speaking patients, then privacy notices should also be translated into other languages, as necessary. 

The following information must be provided to patients within privacy notices:

The data controller’s identity.

The Data Protection Officer’s contact details.

The purpose of the processing.

The lawful basis for processing.

The categories of personal data processed.

The potential recipients of personal data.

How long the data will be retained.

The security measures in place to protect their data.

A list of the data subject’s rights.

Any safeguards that will be used if data is to be transferred to a country outside the EU.

In addition, patients must be informed that they can complain to the DPC if they believe there is a problem with how their data is being handled.

Subject access requests

The time scale for compliance with a patient’s subject access request will be reduced from 40 days to one month. Organisations will no longer be able to charge for the provision of copies of records, unless the request is ‘manifestly excessive or unfounded’ or is repetitive in nature. In these exceptional circumstances, organisations may charge a ‘reasonable fee’ based on administrative costs. If organisations refuse a subject access request, they must tell the patient why they have done that and inform them they have a right to make a complaint to the DPC. 

If a subject access request is made electronically, or if the patient requests it, information should be provided to the patient in a commonly-used electronic format.

The DPC advises that if an organisation handles a large number of subject access requests, the impact of the change could be considerable. Organisations may wish to consider whether it is possible to develop a self-service system that allows an individual to have remote access to their information.

Data breaches

In the event of a data breach affecting a patient’s privacy rights (for example, a breach of confidentiality), data controllers will be required to notify the DPC ‘without undue delay’, and where feasible, no later than 72 hours after becoming aware of the breach. Organisations will also have to notify the patient of the breach if it is likely to result in a high risk to their privacy rights. This is in addition to the duty of candour to inform patients of such breaches, outlined in paragraph 67 of the Medical Council’s Ethical Guide.

The DPC will have the discretion and power to impose higher fines for data breaches, as well any other infringement of the GDPR.

DPIAs

Data Protection Impact Assessments (DPIAs) are recommended as a way of assessing the level of protection in place to safeguard patients’ personal data. Whilst considered good practice in any case, DPIAs will be legally required where the processing of personal data is likely to involve high risks to the confidentiality of individuals. They are likely to be required when organisations introduce new technology, for example a new computer system or a new system of sharing data.

Data Protection Officer

Certain organisations will be required to have a DPO, including public bodies and organisations that process special categories of personal data (including health data) on a large scale. The DPC has provided further clarification  in this regard.

The DPO should have expert knowledge of data protection and their role will include advising on and monitoring compliance with the GDPR, providing advice regarding DPIAs and acting as an intermediary for patients and also the DPC.

Patients’ rights

Individuals will be given stronger rights under the GDPR, including the right to rectification, the right to erasure, the right to object to processing, the right to restrict processing and the right to data portability. These rights are complex and not absolute. Organisations should ensure that they understand when they apply and have a process in place to deal with them, should patients wish to exercise them.

Where to obtain further information

The DPC’s GDPR-specific website has a number of resources that you may find helpful. It is likely that over the coming weeks, there may be further clarification of the legislation and you should check this website regularly. The DPC has produced a checklist for organisations to prepare for the GDPR, available under the ‘Resources’ heading of this website.

Healthcare professionals can also contact their medical defence organisation if they have any concerns.

Patterns of presentation: Cancer diagnoses in EDs

By sa | Apr 12, 2018 |

Receiving a diagnosis as serious as cancer is never easy. However, ensuring the environment is appropriate for the diagnosis to be made and delivered is important for patients in order to start coming to terms with their condition and be properly informed about their future treatment plan.

One does not need to be a healthcare expert to know that a busy emergency department (ED) is not the ideal place to make such a sensitive diagnosis. This especially applies in the Irish health service, which has suffered from chronic ED overcrowding for more than a decade.

Another key point is that when cancer patients present at an ED, the cancer is invariably at an advanced stage. Therefore, the research into the subject conducted by the Irish Cancer Society and National Cancer Registry Ireland into cancers diagnosed as emergencies in Ireland each year, which was recently published, shines a spotlight on a neglected corner of the health service that is seldom discussed.

Main findings

According to the report, which examined patterns of emergency presentation of cancer in Ireland from 2002 to 2015, approximately 3,000 of the 22,000 invasive cancers diagnosed each year are diagnosed as emergencies. The figure does not include non-melanoma skin cancer. Overall, during 2010-2015, some 14 per cent of cancer cases presented as emergencies at the time of diagnosis. The report also compares Irish figures with those of the UK. It shows 16 per cent of all invasive cancers presented to EDs in the UK between 2006 and 2015. In Ireland, of the 24 individual cancer types examined, those with the highest proportion of emergency presentation during 2010-2015 were pancreatic; brain/central nervous system and liver cancers (all 34 per cent); leukaemia (27 per cent); ovarian (24 per cent); colon (22 per cent); and stomach cancers (21 per cent).

Demographics

For cancers presenting as emergencies, 30 per cent were in patients from the most deprived population quintile, compared with only 23 per cent for cancers presenting electively. According to the authors, cancer patients from the most deprived areas are 50 per cent more likely to be diagnosed via emergency presentation than those from the most affluent areas. There was also significant variation in relation to age. For cancers as a whole, 56 per cent of cases were diagnosed at ages 65 and over. However, for cancers presenting in EDs, 71 per cent were in patients aged over 65, compared with only 53 per cent for cancers presenting electively.

Expressed in a different way, cancer patients aged over 65 were twice as likely to present as emergencies (18 per cent) as patients under 65 (9 per cent). Age-related variation in emergency presentation likelihood was most marked for thyroid cancer (patients aged over 65 were 10 times more likely to present emergently than patients under 65) and least marked for multiple myeloma (no difference by age). Leukaemia was the only cancer group for which older patients were less likely to present in EDs.

Late presentation

One of the most concerning issues outlined in the report is that cancers presenting in EDs are invariably at a late stage. For cancers as a whole, about 58 per cent of known-stage cases were diagnosed at early stages (I or II), 42 per cent at later stages (III or IV). However, for cancers presenting in EDs, about 77 per cent were diagnosed at later stages, compared with only 38 per cent for cancers presenting electively. Stage-related variation in emergency presentation risk was most marked for breast cancer (late-stage cases 14 times more likely to present in ED than early-stage cases, adjusted for age) and least marked for pancreatic cancer (late-stage cases 1.3 times more likely to present in ED).

Positives

There are some positives to take from the report. Over the period 2002 to 2015, the overall proportion of cancers presenting emergently fell from 20 per cent to 14 per cent, the biggest decline occurring between 2005 (19 per cent) and 2009 (14 per cent), with little change subsequently. Of 24 cancer types examined, nine (colon, rectal, liver, pancreatic, breast, prostate, kidney, thyroid cancers and multiple myeloma) showed trends of significant decline in the proportion of cases presenting emergently over the whole period (2002-2015).

Only cancers of the brain/central nervous system showed any significant recent increase in emergency presentations (2009-2015, following a significant decline during 2005-2009, respectively).

Recommendations

The National Cancer Strategy 2017-2026 aims to reduce the proportion of cancers diagnosed in EDs by 50 per cent by 2026. In order to support this aim, and to achieve further reductions in emergency presentations, the document makes a number of recommendations for diagnoses to be made at an earlier stage. Chief among these is to allow GPs to have direct access to diagnostics at secondary care level. An Irish Cancer Society-commissioned report from 2016, Access to Diagnostics Used to Detect Cancer, highlighted that there were long delays for GPs accessing diagnostic tests for a suspected cancer; a lack of access to direct diagnostic tests; lack of community diagnostics; and a lack of access to rapid investigative tests for suspected cancer. Often, because of these problems, GPs are forced to send a patient directly to ED to access urgent diagnostic tests. The report also calls for the development of diagnostics in primary and community care settings and targeted public awareness campaigns on the signs and symptoms of cancer.

It also says that the development of a rapid-access pathway to treatment is necessary for people diagnosed in an ED, as is a significant incident case review for these patients. The report calls for further research to better understand the causes of emergency presentation.

Reaction

Speaking at the launch of the report, Director of the HSE National Cancer Control Programme (NCCP) Dr Jerome Coffey said the recommendations echo those contained in the national cancer strategy.

“I will commit to continuing the conversation between the [National] Cancer Control Programme and the [Irish] Cancer Society on sequencing and implementing these recommendations,” said Dr Coffey.

“If you look at the headline news, the headline news is that there has been progress. In 2005, presentations were at 20 per cent; by 2015, it was 14 per cent. We want to get down to 7 per cent. We want to get down from eight presentations to emergency departments per day, down to four in the lifetime of the strategy. That is doable; it is not too ambitious, it is appropriately ambitious.”

Dr Coffey said it is important to consider the biology of different cancers when it comes to emergency presentations.

“Cancers are different,” he said. “There is consistency in the numbers between this jurisdiction and our neighbours across the water. “So pancreatic cancer at early stage will present with obstructive jaundice or back pain. It is aggressive biologically. That does not mean the person has metastatic disease. It just means that this is a unique cancer. So some of the issues we are dealing with here are international issues.”

Dr Coffey said there is a need to consider regional factors.

“We need to take populations, go deeper into the data and look at the geography,” he stated.

“Which parts of the country are seeing more emergency presentations? Where are we seeing all the lung cancer presentations? We need to support GPs even more. We have had guideline referrals on our website for a number of years, we have electronic referrals, that is all done, so when we come back and look at this data again in a couple of years, we want to make sure there is a full impact from the work that has been done and the work that has only started this year.”

He said the funding released as part of the cancer strategy will support the implementation of the recommendations.

Dr Coffey concluded by saying the report is the most valuable public health initiative he has seen for some time.

“This fits with the cancer strategy, it fits with Sláintecare, it fits with other countries who may have started this project,” noted Dr Coffey.

“So it is great to have national data on an international issue. A lot of projects I get involved in, the first thing that’s asked is, ‘where is the data?’ Here, we are starting with the data, that is a huge step forward; it is a huge competitive advantage.”

Also speaking at the launch, Director of the National Cancer Registry Ireland Prof Kerri Clough-Gorr said the report was an example of what can be achieved through collaboration.

“What I want to focus on is partnership,” said Prof Clough-Gorr. “We can do more when we do partnerships like this. We are delighted to be involved in this type of research because it brings all of us forward. We are delighted to work with the National Cancer Control Programme, because with our funding from the Department of Health, together we can do a lot more for patients.

“We are all chasing the same goal here. We all want the best possible cancer patient experience. And when we come together for reports like this, we are able to see where more work needs to go, where policy needs to be focused. We can work with the National Cancer Control Programme to get at those targets. Our data is the basis of all that… when we do it together, we do it much better.”

Overtime payments for NCHDs under attack

By sa | Jan 24, 2018 |

Paul Mulholland reports on recent disputes on overtime payments for NCHDs

Doctors and the Eighth Amendment

By sa | Dec 20, 2017 |

With a referendum planned on abortion next year, David Lynch tests the stance of medical bodies and delves into some medical evidence from the recent Oireachtas committee

2017: The year that was

By sa | Dec 20, 2017 |

Paul Mulholland selects some of the major stories reported in the Medical Independent this year and the notable occurrences in the health service

GMS talks- going nowhere fast?

By sa | Dec 5, 2017 |

Fifty years ago GPs were negotiating the first GMS contract, and its long-awaited successor appears mired in a protracted and frustrating process. Niamh Cahill and Priscilla Lynch report

A better future for primary care?

By sa | Nov 23, 2017 |

Priscilla Lynch highlights the key points in a major new report on primary care in Ireland and the reaction from the GP community and Minister for Health Simon Harris

The flight of Ireland’s young consultants

By sa | Nov 2, 2017 |

The departure of young doctors from Ireland and their reluctance to return was a major topic at the recent IHCA Annual Conference. David Lynch reports

Stress and burnout rife among Irish interns

By sa | Nov 2, 2017 |

Priscilla Lynch reports on a new Irish study showing high levels of stress and burnout among Irish hospital interns, with over half planning to leave Ireland due to their experiences

IHCA 2017 Annual Conference Preview

By sa | Oct 4, 2017 |

As the IHCA prepares to meet in Limerick for its 29th Annual Conference this weekend, David Lynch previews the key healthcare issues that will occupy delegates

Dodging the medicines bill

By sa | Sep 21, 2017 |

As HSE spending on ‘high-tech’ drugs continues to soar, Niamh Cahill investigates reports of an emerging practice whereby hospitals are encouraging inpatients to access expensive medications in the community instead of through hospital pharmacies

samplempu2

Related on the site

Influenza A(H3) predominant strain in European sporadic influenza detections

Dec 1, 2021

Most people support removal of private care from public hospitals – PHA research

Nov 25, 2021

NOCA launches five-year strategic plan

Nov 25, 2021

Career structure needed for future general practice, says ICGP President

Nov 24, 2021
Scroll To Top