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HOSPITAL CONSULTANTS HAVE said Ireland’s acute hospital system is at “breaking point” due to staffing and resource issues – compromising the care patients receive and taking a toll on the mental health of staff.
The Irish Hospital Consultants Association (IHCA) yesterday launched its pre-Budget 2020 submission, calling on the government to urgently address record waiting lists and the “unacceptable” number of patients being treated on trolleys.
IHCA members at the launch also spoke about the impact staffing levels and conditions have on doctors’ wellbeing.
Dr Gabrielle Colleran, a paediatric radiologist at Temple Street and Holles Street hospitals in Dublin, said the stress of their job can take a “huge personal toll” on doctors.
She said burnout and depression are major issues among healthcare workers, noting that she has lost two friends to suicide.
“I personally have two physician friends who have committed suicide in their 30s. That has a huge impact, [medical workers] have a higher rate of suicide, we have a higher rate of depression, we have a higher rate of marital breakdown.”
Colleran said doctors often have to work very long hours, missing out on time with loved ones as a result.
“Last week, to give you an example I was in work until nine or 10 o’clock multiple nights, so I missed bedtime with my kids … I started working at half seven or eight those mornings.
So when you’re doing those kind of long days, it usually impacts on your ability to do simple things like get enough sleep, get the exercise you need, get the downtime and the family time.
Colleran said people who choose to work in healthcare “tend to be empathetic and caring” and can be deeply affected by the “profoundly dysfunctional” conditions they work in.
‘Horrendous’
Colleran previously worked in the US and said that while there are many issues with the healthcare system there, particularly in terms of inequality of access, she was better able to do her job there than in Ireland.
“Any patient who needed anything, I could do it for them straight away, the most they ever waited was a week. Whereas here, I’m doing prioritisation for MRIs and ultrasounds, and I see notes from parents saying, ‘child missing school because of this’, ‘mom is a single parent and works full time, but will take unpaid leave for any cancellation at any time’.
And I’m reading this, thinking this is horrendous, the stress this parent is under, what this child is suffering. I’m totally limited in what I can do about it just because literally if I could clone every consultant in my department, we’d just about have enough people to meet the demand. It’s hugely demoralising.
‘Accustomed to misery’
Dr Laura Durcan, IHCA Vice President and a rheumatologist at Beaumont Hospital in Dublin, also previously worked in the US and said when she returned home to Ireland in 2016 she was “astonished” by how many patients in Ireland are treated on trolleys.
“When I came home from America first I was just astonished and I apologised to every person that I saw on the trolley and I said, ‘This is not okay that I’m seeing you this environment’.”
Durcan said in the past three years she has “become accustomed to the misery” that is regularly treating patients on trolleys.
“We have kind of learned to accept that, but it’s not okay. We should be putting in incident reports every time we see one single person who’s been on a trolley for 24 hours, we should be doing that.
But the truth is that we’re all so busy moving on to the next person or sorting out that person, we just become accustomed to the culture that this is how it is. And it’s not okay, they should be treated better, we should do better. It’s miserable.
More than 9,500 patients across the country had to wait on trolleys for a hospital bed last month.
Colleran noted that some patients die while on a trolley, saying this is simply not good enough.
“For some patients, that’s their last journey. So when you talk to families of patients who died on trolleys in EDs, there is a real lack of dignity in that, and that stays with those families. And we have to we have to do better,” she said.
In its pre-Budget submission the IHCA noted that one in five consultant posts (500 positions) are currently vacant or filled on a temporary basis. The IHCA said this is having a huge impact across Irish hospitals and mental health services, namely:
In a bid to tackle this, the IHCA, which represents over 95% of hospital consultants, said the government needs to significantly increase investment in acute hospital and mental health services in Budget 2020 – which is due to be unveiled next month.
The Department of Health had not replied to a request for comment about the IHCA’s recommendations at the time of publication.
The government yesterday published the HSE’s spending plan for the next three years – 250 projects are due to be delivered at a cost of €2.1 billion, including 480 new beds.
An IHCA spokesperson said that while elements of the plan are welcome, “it will deliver less than promised under the National Development Plan, particularly on beds”. The NDP promised 260 new hospital beds each year from 2019 to 2021, totalling 780 beds.
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I know 2 Irish doctors personally who had to go on anti depressants because of their job. Our broken system is failing everyone.
@FacelessJuniorDoctor: likewise. I’ve had medical doctor friends just break down in tears sometimes, and it’s heart wrenching. A good friend of mine was devastated after his colleague had killed themselves, and I remember just holding him in the kitchen while he cried and cried.
Our health system is completely broken, and meanwhile Harris pisses away hundreds of millions on basically nothing.
I’m not surprised one single bit that a lot of our nurses and doctors leave after finishing college, there is no incentive to stay whatsoever.
@FacelessJuniorDoctor:
WTF!! Even though it’s not too surprising to hear that, it’s still quite sobering.
@Veronica: Its broken and do you know why its broken?, its because its so heavily unionized no needed change can be made, as long as the unions hold so much power of the public service we will always get shocking levels of service. Its nearly impossible to fire a person for poor performance, I have talked to a manager that works in the HSE and she said its riddled with pen pushers and wasters…..and she meant riddled. In the UK there are 2 admin staff per patient, in Ireland there are 5….enough said.
@Nollaig Elliot: the main issue for our health system was real reduction in health spending and capital investment following the banking guarantee ie the stripping of Irish public assets to European Banks. This was nothing less than Euro imperialism and we are being distracted from the reality by manipulative stoking of histories prejudices and Brexit.
The HSE is spending over 900,000 euro per day on agency staff to keep the public health service at the bare minimum level of functionality. Yet they won’t employ the staff needed to provide the service they are charged to provide.
It would be very interesting to find out what agency is used and who the directors are and who benefits.
@Dave Doyle: Hi Dave. It’s so much cheaper to employ agency staff— no maternity pay, no holiday pay, no pension contributions, no sick pay ( which is paid out in large amounts to HSE staff)
i have a neuro-muscular degenerative disease, i’m age 66 in a wheelchair. i spent from 2am to 11am the next morning – all night – on a chair in the A&E waiting area of St Vincents. due to my disease i could not hold myself upright. i begged, cried, pleaded to be let lie down. i was feeling utterly – close to death (wasn’t , but felt dire) – feeling awful. i saw a doctor at around 11am-12md the day after being taken by ambulance to the A&E. i was in a dreadful emotional, psychological, physical state by then. i complained only to be told the A&E consultant had written he was happy with the medical care i received. HE was happy that i suffered a god awful night (alone) in the waiting area after I called an ambulance at 2am. He was HAPPY. I wasn’t. The A&E was shambolic. there were very few doctors and the nurse i pleaded to was disinterested and ignored me, in fact she was angry and shouted at me. i was desperate and felt very ill. this is what happens to patients when the service is at breaking point. doctors JUSTIFY bad , awful, unacceptable treatment. if that consultant had confessed I had been treated badly the Minister might get a better picture. but he didn’t he justified leaving a 66 year old woman with muscle myopathy, parkinsons and mitochondrial disease on a chair all night unable to sit up and feeling utterly awful. He said he was HAPPY. but i know why – no doctor wants to challenge the system. not really. they accept as normal shambolic health care and if we patients complain – we are blamed. i am now terrified of st vincents A&E – i just don’t want to go there – but i have to. Why should sick, older, disabled patients be so terrified that they fear A&E will kill them?
@Margaret Kennedy: I’m so sorry you went through this. This government are letting everyone down. I hope you don’t need to go back there any time soon.
@Margaret Kennedy: The same old age people who constantly vote FFG do not see that it is theirs and other peoples voting that has the country the mess it is, we reward failed corrupt parties and then wonder why everything is so bad?, its basic common sense which so many just cannot grasp…..join the dots folks.
@Margaret Kennedy: that’s awful! The last time I was in A&E was midnight to midday, accompanying my sister who turned out to have double pneumonia (I was heavily pregnant) we sat on steel chairs for 12 hours, but seriously counted ourselves lucky when our poor elderly neighbour was brought in by ambulance having had a stroke and was still waiting to be treated 12 hours later. on a steel chair. overnight. i mean even a young fit person with no illness would feel horrendous sitting up with no sleep for that long, but it’s people who are old and very sick. it’s really shocking
Cut the committees cut HIQA cut management cut pen pushers, hire real old style management matrons, you have CNM 1 2 3 4 but nurses on the floor minimum. Accountability lacking, snowflakes
Maybe if the consultants dropped their salaries the system could afford more staff
@Me_a_monkey: That was done in 2013 and now we have 500 empty consultant posts and the lowest number of consultants per capita in the EU.
Your begrudgery politics has failed patients.
@Me_a_monkey: Maybe if they paid the consultants the money they are looking for (which is not above the industry norm) they might get more consultants applying for the posts that are vacant, we are down 1200 consultants as it is, due to the wage cut brought in by James O’Reilly back in 2012
@Marie Agnew: so it really is greed over helping patients then…
@Me_a_monkey: ah come off it. You must be a real sharp mind if your solution to overworking the crap out of our doctors is to also pay them a lot less.
@Me_a_monkey: what a heartless response to an article about suicide and mental health.
The anti doctor attitude in this country of begrudgers is astounding. Why would any highly qualified professional want to stick around to be part of this. The great unwashed continue to reap what they sow…
@Me_a_monkey: “so it really is greed over helping patients then…”
So how much do you propose a consultant earn considering..
1. It takes, on average, 10-15 years (AFTER 5-6 years of college) of continual studying, professional exams, training schemes, time spent doing research or fellowships abroad (generally unpaid) while moving to a different part of the country every year during this time which is completely incompatible with any semblance of a normal family life (not to mention the 60-80hr weeks and 24hr shifts weekly)
2. Consultants not only have clinical responsibilities but also responsibility for teaching medical students, supervising junior doctors, involvement in governance issues and carrying out research.
3. You have all the responsibility for patient care yet none of the resources to allow you to meet those responsibilities and operate in a system which is extremely litigious.
4. The marginal tax rate in 52%
Oh and don’t forget being ultimately responsible for making life and death decisions in real time with changing complex fact patterns and limited access to information (and being held to account, legally and professionally, for every decision made)
I’m really curious to know what you think the salary should be specifically, taking account of the above?
Health system is a mess, insurance sector is a mess,Broadband deal is a mess, children’s hospital costs are a mess and homelessness is rising why is this government this here and why is the cowardly FF still propping them up!!!!!!
As long as we have 3 billion for broadband that’s fine. Lives really don’t matter in this country. I also think the population is to blame also. Like I said before 10,000 marched for homeless, yet 100,000 marched over water charges. Unless you have a Hong-Kong style revolt nothing will change.
Get rid of all the paperwork attached to medical care. As far as I can see all government services is so now preoccupied with ar*e covering documentation that personal care services are diminished as a result. We are now lost in bureaucracy.
@Mac Eoin: Which is a direct response to the highly litigious society we live in.
Doctors are professionally, legally and ethically obligated to provide high standards of care to patients and rightly so. The problem is the system at present is so dysfunctional that it makes it downright IMPOSSIBLE to provide those high standards of care, yet the legal and professional obligation remains. This is made worse by the highly litigious environment in which doctors operate in in Ireland. This is extraordinarily stressful as you’re put in an impossible situation. There are so many cracks in the system from inadequate admin support, to extreme volumes of patients, excessive working hours and a byzantine system of patient records in which patients have volumes of illegible, tattered paper notes (that are often falling apart). There are so many ways for things to go wrong or mistakes to be made and as a doctor you will ultimately be held responsible for said mistakes despite the fact that the dysfunctional nature of the system makes them inevitable (of course the back-room bureaucrats are never answerable to anyone!). What’s more, its doctors who are on the front-line who are having to constantly apologize for system failures over which we have no control (wait times, difficulty getting scans, pts. on trolleys) and having deal with angry patients/family members (a not insignificant portion of whom just want someone to shout at – its certainly not pleasant spending large parts of your day being berated at for things outside your control). As long as these issues with our health system remain and the myriad of others (illegal and unhealthy working hours especially) then posts will remain vacant, doctors will continue to leave for greener pastures and a disproportionate number of those who remain will be forced into various shades of ill mental health by the dysfunctional system.
@Damon16: Spot on. Unfortunately this statement of fact is falling on deaf ears, or more specifically, ears that don’t want to hear. It would seem that no one cares…
If your job is getting to you that much, you leave. No ifs/buts. You leave. Better alive on the dole than dead behind a desk!
@GerryCummins: if you find your calling you’ll never leave. It’s your vocation. Improve conditions of the job.
@Dermot Foley: they are also just human, they have limitation. I’m just curious why the 2 Docs left their US jobs? Is it because they want to help or because they will make more money in Ireland?
@GerryCummins: You’re being a little short sighted in your response. What about the bigger picture when all our doctors break and leave. Will our wonderful suited imbeciles outsource our health system?
@Green Lentils: I was talking about individual health. I’m sure there are some who thrive on the stress!
@worldpeace: Maybe they have family here?
All this and the electorate will go out next time and vote for the same idiots again. And they got another pay rise this week to add insult to injury.
@wacker macker: There’s only one thing for it; run in the next election as a non-idiot candidate.
The HSE has to many chiefs, and no Indians. It is a total disgrace.
Another Fianna Gael cock up.
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