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Don Moloney

'I’ve never seen morale so broken': What one change do healthcare workers want to improve the system?

We asked health workers and others familiar with the sector what they want to see happen to improve healthcare in Ireland.

IRELAND’S HEALTHCARE SYSTEM is frequently hit with criticism and suggestions for how it can be improved. 

Change is currently underway in the form of Sláintecare – the programme aimed at eliminating Ireland’s two-tier health system. 

But progress on the overhaul has been slow. In the meantime, patients and staff continue with the system in place.

We asked a number of healthcare workers and others familiar with the sector: What one thing would you like to see happen to improve healthcare in Ireland? 

Here’s what they said.  

Dr Catherine Motherway – head of the Intensive Care Unit at University Hospital Limerick 

“I would like policymakers to listen to frontline staff and if they commission reports, to act upon them.

“If they commission a report from a group of experts, they should act upon them and publish them and if they can’t act upon them, say why not.”

Tony Gregg – paramedic and branch secretary for the National Ambulance Service Representative Organisation

“The one thing from a paramedic point of view to improve services would be a more fluid system of admission through the Emergency Department.

“Ambulances are held up unnecessarily at A&Es due to the crowded situation that exists at the moment. We need to get into A&Es to drop people in quicker and do the job we need to do quicker.”

Tadhg Daly – CEO of Nursing Homes Ireland 

“I think the big thing really is development of primary care services. For me, care in the community is huge. Access to therapies like OT [occupational therapy], physio and public health nursing for people in the community and nursing homes is critical.

“We’re working with the HSE on mobile medical X-rays. If you take an older person in a nursing home – 89, 90 years of age – it makes no sense for that person to be sitting in an ambulance or transport going into a hospital for an X-ray. So bring the service out to people.

“I think there’s a role there for nursing homes in that. Nursing homes have the physical infrastructure for example.

If you’re in West Cork or North Donegal and you’ve a nursing home there based in Gortahork or Castletownbere, why would you be building a primary care centre beside it?

“Why not actually bolt on services to the nursing home and get people to come into the nursing home for their monthly check-up or their wound care or whatever. Utilisation of existing resources and the whole of primary care services is critical.”

Dr John Cannon – non-consultant hospital doctor and chair of Irish Medical Organisation’s NCHD committee 

“The government needs to start listening to the staff of the health service, particularly its young doctors. We want to stay in Ireland, we’re giving them every opportunity to change things, we’re telling them what will stop us from emigrating.

But the government seems unwilling to listen to young doctors, who are the GPs and consultants of tomorrow.

“It’s a great shame, because most of us want to stay in Ireland, but the government through neglect, equivocation and disinterest is slamming the door on us and perpetuating the recruitment and retention crisis for another twenty years.

“Essentially the government is calling the bluff of young doctors. They’re gambling that we will tolerate the untenable and austere conditions because we have a vocation and calling to be doctors.

“They’re gambling we will work unsafe hours because we won’t leave the hospital until every patient has been seen and their needs attended to. They’re gambling that a tired doctor won’t make a serious or life-threatening mistake because of exhaustion.

“They’re gambling we won’t emigrate because of our love of Ireland and our family ties.
And where has that strategy got them?

I’ve never seen morale so broken. This generation of doctors is ready to pack its bags unless the government decides to stop equivocating and act. But no one is listening.

Dr Illona Duffy – Monaghan GP  

“Improved access for everybody to general practice in Ireland. We now know that there’s so many people out there with no GP.

“The HSE has always wanted to ignore this as a problem until it came to Covid when they needed to [address it].

“They asked the IMO [Irish Medical Organisation] and the ICGP [Irish College of General Practitioners] to ask members to take on these patients in a temporary capacity.

“This allowed them to get social welfare services so they wouldn’t go into work with Covid and so that they could get tests done. It proved so important, but it also proved that the HSE knows that there are loads of people with no GP.”

Lourdes Sanchez – family carer for her son Conor

“At the moment for us, the main issue is to get respite. I’ve been fighting for that since August [2021] because we used to get six nights of respite per month. Then when Covid started, that was suspended completely. It hasn’t been reinstated. 

The premise of respite is seen as nice to have and it’s not that at all. Respite is not a nice to have, respite is a necessity for families.

“In my case, my husband has MS [multiple sclerosis] and he cannot look after our son. I can barely look after him. And even though we have home support, it’s exhausting because we have Connor 24/7.

“For us, that little bit of respite gives us the opportunity to recharge and to have something to look forward to. 

“We never go out as a family, we never go on holidays, we never have some time away so it’s not a ‘nice to have’, it’s a necessity. They fail to recognise that respite is a necessity. 

“There are many [issues], it’s not the only one. But right now it’s my main objective to get that respite reinstated.” 

Dr Mohsin Kamal – paediatric doctor  

“The one thing I want to change in the Irish health system is fair chances of medical training on merit for everyone, irrespective of their ethnicity.

“I want Ireland to give equal opportunities to everyone and if someone has already gained experience in the system, then the system needs to utilise that experience to provide the highest level of care.

“If Ireland starts giving BST [Basic Specialist Training] exemption on the basis of experience and membership exams to overseas doctors, then within five years our health system will have enough doctors to run the system efficiently.” 

Ciarán Freeman – third year nursing student in NUIG and chairperson of the Irish Nurses and Midwives student section  

“With one year left until I qualify, I want to see Ireland try its best to keep [nurses] here when we graduate. One change we want to see is the government to take leadership in following up on promises to improve our conditions.

Currently, and for the last number of years, Irish nurses and midwives have been working in incredibly challenging conditions, and as their students we’ve been by their side throughout it all.

“Irish third level students pay the highest fees in the EU, and yet no nursing student in Ireland currently receives adequate allowances to even cover their transport to placements. When this is how we are valued as students by the HSE, we know it will be no better when we qualify. 

“The future of the HSE depends on significant improvements in our conditions. Most of us want to stay – so don’t keep forcing us to leave.”

Dr Damien Lowry, chartered member of the Psychological Society of Ireland

“Improve the staff-facing supports that currently exist in the format of occupational health, particularly in terms of resourcing this domain with psychological personnel.

“Recent research [currently under peer review], led by psychologists at the Mater Hospital, on healthcare workers across five, prominent, Dublin-based, adult hospitals (Mater, James’s, Beaumont, Tallaght and Vincent’s) revealed markedly elevated levels of psychological distress amongst survey respondents.

“It’s also well known that healthcare workers have experienced higher levels of mental health distress long before the Covid pandemic. 

Our staff is our greatest resource and patient care is likely to be enhanced by a healthy workforce.

Eimear Kyle – third year in TCD undergraduate medicine and spokesperson for the Association of Medical Students Ireland

“The overarching feeling of many Irish medical graduates knowing no alternative but to emigrate in search of better pay and working conditions is undeniable.

“It could be derived from the relative inaccessibility to medical education to begin with.

“Many students believe that expensive preparation courses for the HPAT and GAMSAT [admission tests] are required not just to succeed, but to merely level out the playing field to begin with.

“The specialist Graduate Entry Medicine loan from Bank of Ireland is being discontinued this July.

This will likely further the culture of financial inequality within medical education, with a decrease in levels of diversity within Irish medicine and the closing of doors for people who are greatly suited and would contribute to the field.

“The overwhelming message here is that only well-off families have the ability to support their children through a medical degree.

“The issue of repaying such a large debt needs to be addressed. No doubt, such debts result in emigration to countries that boast higher pay scales. It is this attitude and culture that will only exacerbate the current shortage of medical doctors in this country.”

This work is co-funded by Journal Media and a grant programme from the European Parliament. Any opinions or conclusions expressed in this work are the author’s own. The European Parliament has no involvement in nor responsibility for the editorial content published by the project. For more information, see here

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    Mute Shane McGettrick
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    Sep 9th 2013, 3:19 PM

    I’d there any bigger motivator for the people to abolish an institution that should be retained and reformed than watching these self interested clowns strut around the midlands, with only their own enrichment in mind?

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    Mute Dermot Ryan
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    Sep 9th 2013, 4:09 PM

    How exactly did these Senators vote when they were given a chance to save the Seanad ?
    Article 27 is at your disposal at all times Dail Eireann; your failure to use it tells its own story.
    WHIP !

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    Mute SeanieRyan
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    Sep 9th 2013, 4:15 PM

    A life time of political service to the state is hardly an act of self interest. Mary o’Rourke, like all in her family put the people of Ireland first when it would have been easier to go in to a business or the civil service etc. Seriously it is not as if she has a yacht.

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    Mute Shane McGettrick
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    Sep 9th 2013, 4:38 PM

    Ah Seanie, pull the other one. Either you’re being disingenuous or you’re just delusion.

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    Mute Shane McGettrick
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    Sep 9th 2013, 4:43 PM

    @Dermot Sitting party senators were between a rock and a hard place. Vote in favour, lose their place in the chamber, retain the useful party backing, vote against and lose the whip knowing that you’ll never get a Seanad nomination again. The party boys covered their arse of course, you can’t beat real politik after all.

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    Mute Dermot Ryan
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    Sep 9th 2013, 4:54 PM

    “vote against and lose the whip knowing that you’ll never get a Seanad nomination again.” …that assessment suggests self-interest to me shane ;I understand realpolitiik , but realpolitik in austerity should be about the nation first , the person and party last !
    I understand I have quoted back only a section of your point but that to me is one of the core problems with Ireland ……
    If they defeated the vote when they had the chance then this waste of money of a campaign would not be even happening ;and it just a whim of a former merchant banker called Faughan who never stood for election ; a guy who, when a president visited his local National school, decided that a great present for said president would be a painting of the castle he lived in; that incident smacked of ego-mania and the whole thing points to a Taoiseach who isn’t in control and who wouldn’t have a clue what he should be doing even if he was !

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    Mute Shane McGettrick
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    Sep 9th 2013, 5:05 PM

    @Dermot I’m not defending any of these clowns, in fact the Seanad as it stands is wide open to manipulation by the party whip, in what other case would a chamber vote up abolish itself? I believe the chamber should be retained and reformed, that some current senators (interestingly not political appointees) stabs head and shoulders above sitting TDs.
    A functioning upper house should serve as a check against the Dail rather than a rubber stamping exercise, how it operates in its current form.

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    Mute Dermot Ryan
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    Sep 9th 2013, 5:15 PM

    With you on that shane ; reform !
    What is getting me is that we are being asked to abolish something that will be replaced with what ?
    It’s like being asked to buy a pig in a poke and being asked to pay up front and given the poke and told come back sometime for a pig that should be in it in the first place !
    very suspicious !

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    Mute Shane McGettrick
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    Sep 9th 2013, 6:33 PM

    As far as I know the current proposal is the establishment of a myriad of committees (obviously appointed and controlled by the government of the time) which would oversee relevant legislation. That’s right, attempting to abolish a house that is “antidemocratic” and replacing it with whomever the government sees fit to.

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    Mute Malachy Quinn
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    Sep 9th 2013, 9:20 PM

    Seanie your beloved FF is not the FF of my grandfather or my mothers generation- both of whom if still alive would be saddened by how they morphed into the Irish mafia. Mary O Rourke, Pat Carey & the Andrews family were all decent people but unfortunately they were few & far between. Even the late Brian Lenihan’s
    Son could even bring himself to support them!
    FF are the Party of the big business instead of the small farmer as it was!

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    Mute gumbridge
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    Sep 9th 2013, 3:18 PM

    To be honest, I’m only gonna vote to keep it cos Edna wants rid of it.

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    Mute Reg
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    Sep 9th 2013, 3:26 PM

    It’s no wonder so many eejits get elected in this country. By all means vote no if you want to keep the Seanad, not because of who’s proposing the referendum. Pathetic.

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    Mute Rob Hunt
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    Sep 9th 2013, 4:00 PM

    Gumbridge, posts like that make me think there should be an IQ test to register as a voter…

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    Mute Ryan Ash
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    Sep 9th 2013, 4:06 PM

    @ gumbridge:

    As I have pointed out several times already, the effects of this referendum will most likely be felt for much longer than Enda Kenny will be Taoiseach for.

    Why not try thinking in the long term rather than the short term?

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    Mute John Kelly
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    Sep 9th 2013, 4:26 PM

    @Gumbridge – If this level of reasoning and thought that goes in to deciding who or what to vote for is prevalent throughout the country (which I fear it is), then what’s the point even hoping for things to improve? I mean seriously. We really are our own worst enemy, and quite frankly the piss-poor politicians we have accurately reflect the piss-poor electorate.

    We’re a very immature nation. Any chance we’ll grow up sometime soon?

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    Mute Nigel O Keeffe
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    Sep 9th 2013, 7:20 PM

    @gumbridge
    spot on..Anyone need a reason to vote to abolish it..ivor callely..fidelma healy..

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    Mute Pádraig McCarrick
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    Sep 10th 2013, 9:08 AM

    Classic Irish begrudgery there.

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    Mute Paul Mc
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    Sep 9th 2013, 3:52 PM

    Clowns every one of them

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    Mute Reg
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    Sep 9th 2013, 10:06 PM
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    Mute Salvage Guy
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    Sep 9th 2013, 6:50 PM

    I Really wish Mary O’ Rourke would go away.

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    Mute Rose
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    Sep 9th 2013, 10:49 PM

    Retire Mary

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    Mute Denise Friary
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    Sep 9th 2013, 3:52 PM

    The freeloading senators are in a panic because the gravy train is crashing…Let’s give the money to the needy not the greedy.

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    Mute Whelan
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    Sep 9th 2013, 3:58 PM

    The money won’t be going to the needy. It will be going into committees, aka yes men, that Enda will select himself. Better to reform it then get extra FG zealots in the political atmosphere.

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    Mute SeanieRyan
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    Sep 9th 2013, 4:12 PM

    The needy are often there because they expect others to lift them out of the hole that they fell in to or that life tripped them in to. The attitude is what they need help with, teach them to be a self starter.

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    Mute Little Jim
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    Sep 9th 2013, 3:51 PM

    Two pigs and a wannabe propping up the trough.
    That’s too funny.

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    Mute Richard Keogh
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    Sep 9th 2013, 5:27 PM

    In fairness to Mary O’Rourke she chaired a Committee into Seanad reform in 2004 and has been an advocate for it for years. That successive governments have refused to implement it shows their fear of a strong second chamber. She is no longer a member of either house so has nothing to gain personally from campaigning unlike Bruton et al on the government side.

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    Mute Connaughtabu
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    Sep 9th 2013, 4:43 PM

    I agree that the Seanad isn’t perfect and requires a major overhaul, but feel it should be retained in a new form.

    Here are some suggestions:
    i) The position of senator is should not seen as a career it should be seen as a public service
    ii) A senator should only be allowed to sit for 2 terms each of 4 years
    ii) It should attract no salary and no pension. Senators instead should receive expenses for attending sitting of the Seanad
    iii) Senators should be elected as individuals not as members of political parties, which would remove the scourge of Irish politics, the party whip. When the “3 line whip” is applied on every issue in the Oireachtas, no politician is ever allowed to express her/his opinion which makes a mokery of democracy in Ireland
    iv) No senator may stand for the Dail, to do so she/he must firstly resign from the Seanad

    :-))

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    Mute Aine Griffin
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    Sep 9th 2013, 4:55 PM

    How much are the referendum documents costing? how much are the stupid posters costing? How much are the radio ads costing?

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    Mute the lost lenore
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    Sep 9th 2013, 4:06 PM

    Democracy Matters? Another campaigning or lobby group? We must have one per head of population by now.

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    Mute Denis Moynihan
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    Sep 9th 2013, 4:12 PM

    As opposed to sit back and do nothing but complain.

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    Mute Reg
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    Sep 9th 2013, 4:28 PM

    It’s ironic that a campaign group to save the Seanad is called Democracy Matters. The Seanad is not a very democratic institution!

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    Mute Kerry Blake
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    Sep 9th 2013, 5:14 PM

    Could be and should be Reg. That is what most of us want.

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    Mute Dermot Ryan
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    Sep 9th 2013, 5:16 PM

    Saw the lectrurer involved in democracy matters on V.B. ; What I saw impressed me I must say !

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    Mute the lost lenore
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    Sep 9th 2013, 5:41 PM

    No Reg. almost all these lobby groups are funded and ran by people pushing an agenda of some sort. It’s rarely democratic and usually seeks to create as much noise around whatever agenda it is they’re pushing that politicians give them whatever they’re looking for.

    And of course everyone involved usually gets a nice few quid for their involvement in whatever worthy cause is on the menu today. These are not grassroots movements and shouldn’t be confused with them.

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    Mute linda o neill
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    Sep 9th 2013, 4:06 PM

    They should scrap the Dail while there at it..and sell the house that the president lives in because that has to be the biggest waste of All

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    Mute SeanieRyan
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    Sep 9th 2013, 4:11 PM

    Mary is an absolute legend and great to see her still making an impact.

    I’d like to think that John’s work with Democracy matters campaign will see him eventually leaving the dead ducks of the Labour party and joining FF given the party hopping at the moment. FG have 2 TD’s at the moment in a traditionally hostile const. that will not last. John can take one of them between his personal vote and the renewal of the FF vote and org.

    His choice is does he want his political career to end or continue.

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    Mute John Kelly
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    Sep 9th 2013, 4:35 PM

    LOL

    Here’s the latest FF sock puppet! Fresh from the Fianna Fail Academy of BS with a certificate in delusion. Is your mate Oliver on holidays at the moment?

    Tell us more about this “renewal of the FF vote and org” – I’m intrigued.

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    Mute Reg
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    Sep 9th 2013, 4:39 PM

    Maybe it’s Chris Andrews’ new nom de plume, in a new attempt to further discredit Fianna Fail ;-)

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    Mute Rommel Burke
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    Sep 9th 2013, 4:46 PM

    Your last sentence sums FF’s attitude to politics perfectly. Career trough feeders without a hint of conviction. I wouldn’t limit it to FF either to be fair.

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    Mute SeanieRyan
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    Sep 9th 2013, 4:47 PM

    29% in the polls and on the path back to power. If other parties want to be in power then they have to act for the people, organize in communities and be constructive. FF is up 12% on the election disaster because it listened to people, apologized for the mistakes it made, pointed out the difficulties that hammered Ireland and got on with presenting a credible opposition platform. That is what renewal is about.

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    Mute Rob Hunt
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    Sep 9th 2013, 5:19 PM

    SeanieRyan: your shower is on the up and up because people have memories like goldfish and it’s easy to blame the people loading budget after budget onto them in the heat of the moment. There are still plenty of us who watched your party drag this country into the pit on a landslide of greed and incompetence. If you had ANY integrity you’d distance yourself from FF, but I’d hazard a guess that your folks did very well out of the celtic tiger era and as such you’ll always have fond memories of their cronies.

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    Mute the lost lenore
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    Sep 9th 2013, 5:45 PM

    All that proves, Seanie, is that we have a healthily sized of complete and utter idiots with the collective memory of a goldfish. If the Irish put FF back into power they will deserve everything they get as a consequence.

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    Mute the lost lenore
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    Sep 9th 2013, 5:46 PM

    *healthily sized minority

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    Mute Martin Grehan
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    Sep 9th 2013, 7:11 PM

    “Back on the path to power”, says it all really.

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    Mute Malachy Quinn
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    Sep 9th 2013, 9:24 PM

    Seanie SF is the only Party in the state to increase it % in the polls since the last election by 100%- now that’s a Party on the move!

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    Mute Malachy Quinn
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    Sep 9th 2013, 9:29 PM

    Seanie your % increase has plateau at the late 20s- it will not go any further because it is a middle class vote which is shared by FG & to a lesser extent Labour.

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    Mute Bill
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    Sep 9th 2013, 5:00 PM

    Democracy Matters !! rather odd name for a group posing as defenders of an institution in which only about five percent of the population are permitted to vote all others are excluded .

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    Mute Shane Mullally
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    Sep 9th 2013, 4:05 PM

    Whilst we are on the gravy train subject-I would like a breakdown of the money collected by our national lottery draws as well-maybe the journal.ie could have a peep under an freedom of information request?. ..

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    Mute Denito
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    Sep 9th 2013, 4:40 PM

    “Turkeys in opposition to Christmas shocker!”

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    Mute Sandra Webster
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    Sep 9th 2013, 7:29 PM

    To be honest… I don’t know what way to vote so would really appreciate some advice on the matter.

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    Mute Sheik Yahbouti
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    Sep 10th 2013, 2:12 AM

    And in other news bears were observed defecating in the woods. Self preservation above party loyalty, eh chaps?

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    Mute Brianog2
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    Sep 9th 2013, 11:24 PM

    I had enough of Mary and her Eircom shares that she also spouted about and robbed us

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