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e need to make sure, for the first time ever, that during that period, radiology departments and laboratories will be open and working at full whack, that consultants will not be on holidays in the first week of the year, particularly those who work in emergency departments, and that nurses aren’t on leave in the first two weeks of January, because we need to make sure that every bed is open. That’s the kind of winter plan we need, not the kind we have had for years and years that does not work.”
These are the words of Taoiseach Leo Varadkar during a Dáil debate on 6 November. Unsurprisingly, they caused a furore, not least among doctors and nurses. His words were seen as insensitive, poorly-timed and ignorant.
The prime message heard by those listening was that doctors and nurses were responsible for the annual winter trolley crisis by virtue of taking their holidays collectively in the New Year. Which, of course, is nonsense.
Here are some of the reactions on Twitter:
“Been to Xmas morn mass wearing Santa scrubs before helping kids who had eaten decorations off the Xmas tree. Run ragged on 26 Dec on OOH GP duty when everyone else eating turkey sandwiches. My mother has worked every Xmas eve/Xmas Day/Stephen’s x 5 years+” — Dr Noelle Quann, rural GP.
“I’ve woken up many Xmas mornings in on-call rooms, I’ve rang in the new year with hospital colleagues, I’ve worked so many OOH Xmas shifts (& delivered a baby at the roadside on Xmas day!). @campaignforleo needs to stop taking cheap shots at front-line staff.”
— Dr Aideen Coleman, rural GP.
Meanwhile, Dr Paul Kelly, Consultant Radiation Oncologist in Cork University Hospital, told the Evening Echo: “It strikes me as a very ignorant thing to say. When the morale is already so low across the sector, for the leader of the country to come out and kick frontline workers like that shows the Irish healthcare system is in trouble.
“We’re seeing every day vacant posts that can’t be filled and it’s clear that this is the issue, not holidays,” he added.
“What’s next, blaming the people themselves for ending up on trolleys and telling them they shouldn’t be there? It honestly looks like it’s heading in that direction.”
Two days later, the President of the High Court, Mr Justice Peter Kelly, took the unusual step of publishing a month-old judgement concerning the case of a junior doctor he had suspended from the medical register following a Section 60 application by the Medical Council.
The detail provided by Mr Justice Kelly in the case underlines the major problem we have in recruitment procedures for junior hospital doctors. The doctor concerned graduated from medical school in an East European country in 2015. While the country was not named, if it was an EU state then the doctor is entitled to be registered to practice in Ireland without further examination of his competence. However, in some parts of Eastern Europe, it is possible to graduate with a medical degree with minimal ‘hands-on’ practical experience.
The suspended doctor has said he was never taught how to examine a pregnant woman. Within days of starting his ‘very junior’ job, two consultants raised concerns about his basic competencies — including history-taking, taking blood tests, insertion of intravenous cannulas, and how to prescribe drugs. In addition, junior colleagues said they witnessed “wild” clinical assessments by him, made without taking any history or examining a patient.
It’s unbelievable that someone with such poor competence would be offered a post in any hospital, anywhere. In this case, pregnant women and their babies could have been seriously harmed. Imagine if he was ‘on-call’. By definition, this means being called first to deal with medical emergencies at night. At a minimum, it requires competence to stabilise a patient by prescribing appropriate drugs and establishing intravenous access. The judgement suggests the doctor was incapable of these tasks.
Tellingly, the President of the High Court asked that his judgement be sent to the Minister for Health and the HSE.
We won’t hold our breaths for a meaningful response. But we must be told the truth about how difficult it has become to fill posts in our health system with competent practitioners. And, as doctors, we must highlight the real dangers to our patients if doctors of such poor calibre may be their first point of contact after referral.
Although tempted, I have not linked the two parts of today’s column. Would you have?
Let us know your thoughts at @mindo_news.