Our screwed up health service claims another victim

billy the squid

If you remember the controversy surrounding the situation that one Billy Burke found himself in earlier this year when a hospital in the UK refused to carry out a lung transplant for him, and then being prevented from having the operation by some stupid contract the health service had with the first hospital

Well the problems of the government are now over. Billy Burke is dead, I was just wondering but is it just me or have there be more screw ups in the health service resulting in death in this governments term of office than in any other since we had health cuts back in the eighties.

The government should spend less time listening to their over paid civil servants and more to their conciences.

Oh linkage below

http://www.rte.ie/news/2004/1123/burkeb.html

bonkey

billy the squid wrote:

I was just wondering but is it just me or have there be more screw ups in the health service resulting in death in this governments term of office than in any other since we had health cuts back in the eighties.

I'd say its a mix of "just you" and "increased media attention".

I don't there are more screwups (opinion)....just that we hear about more of them.

jc

Villain

Tragic Story, which shows what a Life is worth these days.

chill

billy the squid wrote:

If you remember the controversy surrounding the situation that one Billy Burke found himself in earlier this year when a hospital in the UK refused to carry out a lung transplant for him, and then being prevented from having the operation by some stupid contract the health service had with the first hospital

Well the problems of the government are now over. Billy Burke is dead, I was just wondering but is it just me or have there be more screw ups in the health service resulting in death in this governments term of office than in any other since we had health cuts back in the eighties.

The government should spend less time listening to their over paid civil servants and more to their conciences.

I don't agree. No system is perfect and I don't see any more mistakes than ever before.
We spend WAY too much on our health service and waste enormous amounts on bloated and incompetent management drawn from civil servant type training instead of private business. We get the service we deserve because we vote in our politicians and support the rediculous spiralling in spending instead of reform and efficiency.

ishmael whale

Death is a sorrowful event, and young death particularly so. However, the issues in this case do not seem to particularly relate to lack of resourcing or organisation in the health services. From what I can gather from this story the problem is simply a shortage of donors. There are twenty five people in need of an urgent transplant, but only two sets of donor lungs since September. Presumably there’s also a question of compatability between the donated organs and the recipient.

Two into twenty-five doesn’t go, whether the unit is located here or in the UK or whether we have an exclusive arrangement with one hospital or not. There’s plenty of real issues in the health services to occupy us. Its an area filled with people in truly tragic circumstances, but we have to let the head rule the heart.

http://www.examiner.ie/pport/web/ireland/Full_Story/did-sgMo1NviCPR-2sg7IQHSmeYhNE.asp

24/11/04
Donor shortage blamed for delay in Ireland’s first lung transplant
The cardiothoracic surgery team at Dublin’s Mater Hospital have been on call since September in the event of a suitable donor being found. There are 25 people in Ireland who desperately need a lung transplant. …………
Surgeon Freddie Wood, who heads the transplant team, said the delay in carrying out the first lung transplant was because they had not been offered a suitable donor.

“There have only been two lung donors since September,” he said.

There are three main causes for lung transplantation: cystic fibrosis, smoking-related emphysema and pulmonary fibrosis. The Cystic Fibrosis Association says Ireland has the highest incidence of cystic fibrosis in the world.

There is no cure for cystic fibrosis so patients rely heavily on the health system to manage its often severely debilitating symptoms. Many patients need two hours of physiotherapy each day.

pickarooney

What's the story with people dying without donor cards? Do they ask the next of kin or just assume the victim was not a donor? It'd be nice to see organ donation made opt-out, as in it's assumed you're a donor unless you have a card saying you don't want your organs re-used.

seamus

ishmael whale wrote:

However, the issues in this case do not seem to particularly relate to lack of resourcing or organisation in the health services.

Actually, they do seem to pinpoint some issue of bloated administration and red tape in this case. Basically, the health board pays an English hospital to carry out its lung transplants, and thus it receives all Irish lung donations. Billy didn't qualify as fit for a lung transplant by this hospital. However, he did qualify for a different hospital in the UK, but the health board would not allow any donor lungs to be released to the other hospital because of its arrangement with the first hospital.
Regardless of the shortage of donor parts, essentially they had denied Billy the chance for this transplant.

There was actually a thread on it somewhere.../me rummages in Google's big box..
Ah, here we are:
http://www.boards.ie/vbulletin/showthread.php?postid=1554685

ishmael whale

seamus wrote:

Actually, they do seem to pinpoint some issue of bloated administration and red tape in this case. ..... the health board would not allow any donor lungs to be released to the other hospital because of its arrangement with the first hospital.

At the risk of getting drawn into the minutiae of one case, I don't understand your point.

As I understand it from the story above, there were only two sets of donor lungs in Ireland since September, which don’t seem to have been suitable for any of the twenty five Irish people urgently in need of a transplant. Presumably, and hopefully, they have found suitable recipients for these organs abroad. The argument over the exclusive contract is a storm in a teacup. It has had no material impact on the facts of the case.

Now I can understand that people in the middle of a crisis will try every avenue to find a way out. That is to be understood, and not to be commented on. However, there’s no benefit to allowing someone’s personal tragedy to create a fake issue where none exists. If you want to take a lesson from this case it’s the shortage of donor organs. If the situation was that the UK NHS was papering the walls with Irish donated lungs while Irish people gasped for breath that’s one thing. But if the reality is the number of people in urgent need of a transplant (most of whom haven’t made front page news) far exceed the number of suitable donor organs, then that’s the issue we need to address.

seamus

As I understand it from the story above, there were only two sets of donor lungs in Ireland since September, which don’t seem to have been suitable for any of the twenty five Irish people urgently in need of a transplant. Presumably, and hopefully, they have found suitable recipients for these organs abroad. The argument over the exclusive contract is a storm in a teacup. It has had no material impact on the facts of the case.

Actually, whether the lungs were available *is* the minutae of the case. This has been going on longer then September.

I'm more looking at the higher implications of the case. Basically, because of the arrangement the government has with Newcastle, they were effectively denying Billy the right to an operation that may save his life. OK, in theory he could have gone to another country, but as an Irish citizen he had the right to treatment for his illness from the country. Poor Billy was stuck in a bureaucratic loophole, but what's to avoid it happening to someone else?

Since when did the Irish health service's priorities switch from treating Irish citizens? It wasn't that tough a call - If a pair of lungs become available, and if they are deemed suitable for Billy, and it was his "turn" on the waiting list (i.e. he was a higher priority than anyone else they may be suitable for), then pay Manchester to take the lungs and make the transplant.

That's my grievance on this one - what was the problem with making the above, correct call?

ishmael whale

If the Mater unit was in operation they would presumably be making the same kind of clinical judgments as those being made in Freeman’s. So if the clinical opinion in the Mater was there’s no point/its unsafe to do a transplant in this case then the person would be in the same objective situation – without access to Irish donated lungs and doing their best to find somewhere else to take them.

The only concrete difference in this case is a clinical decision being taken in the Mater as against the same decision being taken by an outsourced unit in Freeman’s. So, unless someone is trying to pretend there is a subtext of wholesome Irish lungs were being harvested and given to Brits while the flower of Eireann dies, the arrangement has no essential impact on the lives of the twenty five Irish people urgently in need of a transplant. What would help them is if more Irish people carried a donor card.

seamus

ishmael whale wrote:

If the Mater unit was in operation they would presumably be making the same kind of clinical judgments as those being made in Freeman’s. So if the clinical opinion in the Mater was there’s no point/its unsafe to do a transplant in this case then the person would be in the same objective situation – without access to Irish donated lungs and doing their best to find somewhere else to take them.

But what if another Irish hospital also did lung transplants, and deemed said person eligible for treatment? My point being, that if a person finds themself in the same situation, but manages to find a comparable treatment that could save their life, then why shouldn't we pay for it?

ishmael whale

I don’t think payment was ever the issue here. It was simply that the clinical judgement of the people we had working for us – in this case a UK hospital that we have outsourced the service to – was that a transplant should not be proceeded with.

If we had one Irish centre – which is what will shortly be the position – the situation will be exactly the same, in that someone will have to make a clinical judgement that will sometimes be negative. If there were two Irish centres – which at present is a purely hypothetical question – then there would indeed be scope for two conflicting clinical judgements. But, one can assume, someone would still have to decide how the scarce amount of organs should be distributed between the Mater and your hypothetical centre.

Which brings us right back to where I started. The real issue here is the shortage of donor organs, not the mechanics of how the small number available are allocated. Any system trying to manage this scarce resource will involve people being turned away.