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
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
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?