Simple reason for our health crisis – a lack of beds and staff

By March 3, 2017 No Comments

Since some of our current politicians were in their happy teens, successive governments have spent much time, sweat and resources in trying to explain to us that we have plenty of hospital beds. And while there was certainly merit in some of their arguments, their conclusions were just nonsensical. A couple of decades ago, they had a point when they told us that we didn’t need to go to hospital for every little ailment that befell us, that when we did go, we didn’t need to spend so much time there and that while we might like a high tech hospital in every county, that was neither advisable or feasible.

Being largely an unwisely compliant people, we listened to what was said, looked after ourselves at home as best we could, went to our GPs when we couldn’t quite manage that and reserved our hospitals for the really serious matters. It took us a bit longer to agree to the transfer of acute services from a number of hospitals to larger centres.  But again, we finally agreed that it was better and safer for us to be cared for in centres with all the latest diagnostic and treatment equipment by consultants whose high volume of work meant that they had top-level expertise in their specialty. We expressed concerns about the time factor in getting ourselves to these shiny new centres of excellence as we travelled down rutted boreens and windy roads with the wind blowing and the rain pelting against us. But as I say, we are an acquiescent people and by and large country people are used to having to travel for most things and it made little difference to those living in the major cities.

All the time the politicians were telling us how forward thinking we were and complimenting us on moving into the brave new world where we would get much better healthcare.

Mavericks in the medical profession and the media who warned that even if more people were getting their treatment elsewhere we would still need more beds if we were to continue to provide a decent health service for an expanding and ageing population were dismissed out of hand. When they began to get too troublesome the problem could always be kicked over to a committee for an examination and prognosis, which would long finger it until another Minister or government arrived on the scene. Then came the economic crash and what had been pursued by governments as a mix of commonsense and pragmatism became a sudden dire necessity.    Hospitals were closed, beds were closed, not because it made medical sense but because we just did not have the money to keep them open.

But the mantra remained the same – not only had we sufficient hospital beds, we had too many, we were not just using them properly. Well now, we know the sad truth. We do not have sufficient hospital beds, we do not have sufficient ICU beds, we do not have sufficient theatres, we do not have sufficient consultants, we do not have sufficient nurses, we do not have sufficient allied health professionals.  And the result is that we have over 600,000 patients waiting for diagnosis and/or treatment on public treatment lists.

When you take into account the number of people in the country who have private health insurance, this probably equates to about one in six of our public patients now on hospital waiting lists.

And these are not patients who think it might be nice to go and see a consultant or spend a few days in hospital, they are people whom GPs and consultants have decided need consultant and/or hospital expertise and treatment.  These are people in urgent need of care, many who will die without it in circumstances more reminiscent of third world than our first world country.

And no matter how many explanations we get and no matter how many reports are commissioned, the stark fact is that they are on waiting lists because we do not have sufficient hospital beds.   We do not have sufficient hospital beds to cater for those on waiting lists and we do not have sufficient hospital beds to enable our current consultant staff to work to their optimum. There are myriads of statistics to show how short we are of beds compared to other countries.  I will pick just one OECD statistics show that in 2013 we had 2.8 per cent 1,000 population, down from 5.3 in 2006.   This compared with for example Austria with 7.7, Belgium with 6.3 and Hungary with 7 and Japan with 13.3. So please can everybody in authority stop trying to think of reasons for our health crisis.   We know the reasons – lack of beds and lack of staff.

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