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silver hill

Health Reform.

Back in 2005/2006 the Monaghan Community Alliance and the national body, Health Services Action Group (HSAG), informed the Government of the day and continued to inform the various Ministers for Health that more beds were needed as they continued on a reckless closure of beds all over the country. Now in 2018, after waiting for a group of experts to research and examine, they are being told by that expert group that up to 9,000 beds are needed in the system, 2,500 immediately and the rest in the following years. The HSE/Dept. Of Health has come up with the figure of €350,000 as being the cost of setting up each new bed!! and that it would take about €800 million to fulfil the current requirement.

In the meantime every effort will be made to make more beds available. How will they do this? If there was more availability for step-down to Nursing Homes and if that were affordable then a number of delayed discharges could free up some beds. If there were more community nurses and home-help available some patients could be, and some would prefer to be, maintained in their own homes, again freeing up some acute beds. If they had maintained services in hospitals like Monaghan General Hospital much more elective, non-urgent, and less serious surgical procedures could be carried out there but an in-patient ward would have to be maintained to facilitate this. They can still, at a relatively cheaper cost, re-develop Monaghan General to take the pressure off the Major centres and make more beds available there.

One of the ways they use at the moment to free up beds is to cancel ‘elective and non-urgent’ surgery in a hospital. This shows the lack of compassion in our health services and how the patient is not at the centre of the provision of care. No matter how serious or how non-urgent a surgical procedure seems for some manager, who is wanting to free up a bed, it is a major issue for the person who has to undergo the procedure. That patient has likely been waiting years to get this far, has likely suffered pain for years before getting this far, has had many sleepless nights worrying about the condition and when and if it can be solved, has worried about the procedure and how he/she will cope with it, has built themselves up mentally to have the strength to face the unknown, has looked  forward to the ‘new life’ they will have when the surgery is over, has made arrangements for time off work or whatever and THEN SUDDENLY, out of the blue, they get a call to say it has been postponed to a later date and a new date will be found and the patient will be notified. How uncaring is that? Should the patient feel delighted that they are giving up their slot, their bed, their relief, their cure for someone who has been deemed more important? I find it difficult to think that I might be so altruistic. No – this is not the way to solve this crisis.

So we need more beds and we need more money to purchase and set up these beds? I think there is one major stumbling block to this solution – getting the nurses and doctors to look after the patients in these extra beds. They cannot get enough to look after the existing beds not to mention getting more. Nurses and doctors are leaving and avoiding our health services because of the stress of working in it, the overcrowding, the inhuman demands being made of the staff and the lack of proper management of the services at most levels. I remember being told that when the HSE was set up they had to invent jobs for the overload of managers and non-medical staff in the system and the best way to get a person out of a job they were unable to do was to promote him/her. Things may have changed but I am told that there are still too many pen-pushers and brief-case carrying people walking about, except that the briefcase has been substituted and now it is supplied and maintained iPhones and iPads.

I still keep saying - make our nursing career one that is attractive to our graduates and to nurses from abroad and let’s increase our nursing numbers and work with their unions to do this. Let’s do the same with doctors. Let’s sit down with the Consultant Colleges and their Union and let’s see why we do not have enough consultants and how we can increase the number and let’s not take ten years to do it. Let’s see what better use we can make of hospitals like Monaghan General and get them working immediately. Let’s take the major traumas and serious injury cases to the major centres if we have to but let the Monaghan General Hospitals deal with the 85% who do not require tertiary services and keep the beds in the major centres for the patients who really need them. If we make all in-patients go to the same centre and cause overcrowding we are producing a minefield for patients and a playground for viruses and bugs of all descriptions. Smaller units are easier to maintain, to clean, to manage, and to staff and will be more patient friendly than the major impersonal, bureaucratic, soulless centres they are trying to develop.

Would you agree that all this sounds like ‘common sense’? If you do then ask yourself why there is so little common sense being applied to the problem or indeed ask – whose agenda is being followed and whose vested interests are being looked after – it is certainly not the patient’s?