HSE refuse to pay E400,000 - E450,000 pa to nurse patient at home

Murt10

http://www.herald.ie/news/lockedin-david-crushed-as-bid-to-go-home-rejected-30145163.html


While I feel a small element of pity for your man, 1/2 a million euros a year to care for him at home is way way too much. I don't often agree with the HSE, but I can think of many far more worthy projects on which this money could be spent.

Think of the amount of tax deducted from your wages each week, divide that into E500,000. That gives some idea of the money involved and means that the total tax from an awful lot of peoples wages would go straight to caring for 1 person.

The people who are supporting him need to get a grip and live in the real world

Reggie.

Murt10 wrote: »

http://www.herald.ie/news/lockedin-david-crushed-as-bid-to-go-home-rejected-30145163.html


While I feel a small element of pity for your man, 1/2 a million euros a year to care for him at home is way way too much. I don't often agree with the HSE, but I can think of many far more worthy projects on which this money could be spent.

Think of the amount of tax deducted from your wages each week, divide that into E500,000. That gives some idea of the money involved and means that the total tax from an awful lot of peoples wages would go straight to caring for 1 person.

The people who are supporting him need to get a grip and live in the real world

Totally agree

GLaDOS

Murt10 wrote: »

While I feel a small element of pity for your man

A small amount of pity for someone completely paralysed :eek:

Agree with the decision though, hopefully some sort of arrangement can be made at a lower cost.

Knine

That amount of money would take a huge chunk out of disability/health services. This would greatly affect other patients.

When I ran out of incontinence wear for my daughter recently I was told to go buy some by the HSE. Yeah because you can buy nappies in Tesco for a 29kg child.

Tiddlypeeps

This confuses me

"David has begged the HSE to be allowed to be nursed at home."

Locked-in syndrome, or LIS for short, is a condition in which a patient is aware and awake but cannot move or communicate verbally due to complete paralysis of nearly all voluntary muscles in the body except for the eyes.

Do they have some sort of devices that allows people in this state to communicate?

Either way it sounds like a horrific affliction. People are entitled to access to medical treatment but to what level is fairly fuzzy. Realistically there has to be a cut off point where things are too expensive. The system just wouldn't be able to function if they spared no expense for every single patient. Half a million a year does sound a bit on the excessive side for something that is not life saving or totally necessary.

godtabh

Tiddlypeeps wrote: »

This confuses me





Do they have some sort of devices that allows people in this state to communicate?

Eye movement is used. Took him 2 weeks to right the letter to the HSE

Amirani

Tiddlypeeps wrote: »

This confuses me





Do they have some sort of devices that allows people in this state to communicate?

Either way it sounds like a horrific affliction. People are entitled to access to medical treatment but to what level is fairly fuzzy. Realistically there has to be a cut off point where things are too expensive. The system just wouldn't be able to function if they spared no expense for every single patient. Half a million a year does sound a bit on the excessive side for something that is not life saving or totally necessary.

This is done on a fairly scientific basis, generally by the National Centre for Pharmoeconomics. It's always difficult to make these sorts of decisions, but there has to be cut off points based on a number of factors.

mdebets

While E400,000 - E450,000 sounds much, you have to remember that his care at Beaumont is not free either and costs also a lot of money. He is also effectively blocking one bed in Beaumont, meaning other patients have to wait, making the waiting lists longer and might cost money, if patients need to be sent private or even abroad because of this.
You also have to see the cost for his family, who probably travels down from Dundalk on a regular basis.

Electric Sheep

I wish we could afford at home care for everyone that needs it/wants it. There are a lot of elderly people in nursing homes who could be in their own homes if 24 hour nursing care could be provided. In the real world, however, this is just not feasible.

Cee-Jay-Cee

mdebets wrote: »

You also have to see the cost for his family, who probably travels down from Dundalk on a regular basis.

True, however that is not really a good enough reason. They're actually lucky that they're a short spin up the M1 from his hospital. There are many families having to suffer long cross country treks to see loved ones in long term care in Dublin hospitals. It's not the States job to find their travels, the state already pays for their sons long term care.

barone

450k per anum is 1,232 euro per day, its scandalous that stuff cost that much to begin with

Donkey Oaty

godtabh wrote: »

Eye movement is used. Took him 2 weeks to write the letter to the HSE

Did it take them more than two weeks to respond? I bet it did.

Electric Sheep

barone wrote: »

450k per anum is 1,232 euro per day, its scandalous that stuff cost that much to begin with

Not really. That would be 3 shifts of nurses, probably need 2 per shift to be able to lift/turn the patient. Then the cost of equipment, doctors' visits, physiotherapy, etc. It all adds up.

ScumLord

mdebets wrote: »

He is also effectively blocking one bed in Beaumont, meaning other patients have to wait, making the waiting lists longer and might cost money, if patients need to be sent private or even abroad because of this.

This is what I was thinking too, how many lives are risked by keeping this guy in a hospital bed?

I have sympathy for the guy, it's one thing to be an old person stuck in a hospital bed because your body is slowly shutting down but I think it's different for a young man to have the fear they're going to live out the rest of their days in a hospital bed and possibly die early because of it.

I doubt he's a completely unique case, people like him could do with a purpose built facility rather than being left in with every other medical case.

the_syco

To clarify, we're talking about €400k to €450k for the rest of his life. He's 33 now, so how many millions will be spent on him? Also, what happens when his home care is cut? Shall his family bring him back into the hospital, or attempt to care for him themselves?

As for the bed he takes up; which would be cheaper over a time-frame of ten years? Paying for his home help, or building a new wing for long term cases like himself?

Tiddlypeeps

the_syco wrote: »

To clarify, we're talking about €400k to €450k for the rest of his life. He's 33 now, so how many millions will be spent on him? Also, what happens when his home care is cut? Shall his family bring him back into the hospital, or attempt to care for him themselves?

As for the bed he takes up; which would be cheaper over a time-frame of ten years? Paying for his home help, or building a new wing for long term cases like himself?

The article disagrees with you.

The estimated cost of this home care package is a minimum of €400,000 to €450,000 per annum.

weldoninhio

Tiddlypeeps wrote: »

The article disagrees with you.

Eh, the article fully agrees with him.

ScumLord

the_syco wrote: »

To clarify, we're talking about €400k to €450k for the rest of his life. He's 33 now, so how many millions will be spent on him?

If you're to put the welfare of Irish citizens above, or at least on a par with the financial costs surely you have to look at the amount of care that can't be given out because of this bed being used by one person who needs specific care and not all the care a hospital can supply. How many patients will be left on a waiting list because of the lack of a bed? It could lead to the death of other sick people.

FullblownRose

That gentlemans sister was on Pat Kenny's radio program. It costs less to allow him to go home and have his care there than to keep him incarcerated in hospital but the hse would then have to pay for caring for a new patient from the waiting list for his hosital bed. that is their responsibility though. He could go home and have some quality of life with his family, and the next on the waiting list could have hospital treatment instead of him. If the HSE was being run properly that is what would be happening.

Donkey Oaty

FullblownRose wrote: »

It costs less to allow him to go home and have his care there than to keep him incarcerated in hospital but the hse would then have to pay for caring for a new patient from the waiting list for his hosital bed.

Somebody please tell me that this form of accounting is not how the decision has been made.

Raging_Ninja

Tbh the costs are pretty much the same if he were to be in a hospital. I had to stay overnight for suspected appendicitis and the insurance was charged about €1400 - the bed alone was €800, the rest being other fees.

mdebets

the_syco wrote: »

To clarify, we're talking about €400k to €450k for the rest of his life. He's 33 now, so how many millions will be spent on him? Also, what happens when his home care is cut? Shall his family bring him back into the hospital, or attempt to care for him themselves?

Yes, but you have to pay a similar amount as well if you keep him in hospital for this time.

the_syco wrote: »

As for the bed he takes up; which would be cheaper over a time-frame of ten years? Paying for his home help, or building a new wing for long term cases like himself?

Agreed, it would be better to have him in a specialised nursing home for people like him, but does Ireland have one of these and if it doesn't, does it have, is the number of patients there to sustain it and how long would it take to built it?

ScumLord

Raging_Ninja wrote: »

Tbh the costs are pretty much the same if he were to be in a hospital. I had to stay overnight for suspected appendicitis and the insurance was charged about €1400 - the bed alone was €800, the rest being other fees.

I think once it comes to an insurance company paying the costs go up substantially.

sdanseo

ScumLord wrote: »

I think once it comes to an insurance company paying the costs go up substantially.

Which is why medical insurance is so absurdly expensive.

Gotta love the system!

FullblownRose

Donkey Oaty wrote: »

Somebody please tell me that this form of accounting is not how the decision has been made.

The radio show was boradcast about two weeks ago so i cant remember exact figures but the difference was marked, it may be on a odcast but i have not got tie to check just now and listen all the way through if it is.. also there is the matter of his human rights, surely he must be afforded some dignity?



There are nursing homes like that but theyre hardly a substitute for home care and for participation to whatever extent is possible in family life..Cheshire Home in Rathfreda co. Limerick is one example.

the_syco

ScumLord wrote: »

How many patients will be left on a waiting list because of the lack of a bed? It could lead to the death of other sick people.

I remember an equipped ward not being opened due to lack of funding. Think it was in Galway? I was querying cost as to see if it would cause ward closures due to funding issues. From below, however, I don't think would be the case, and thus home care may be better.

mdebets wrote: »

Yes, but you have to pay a similar amount as well if you keep him in hospital for this time.

This was pretty much what I was asking. Best to have him at home in that case.

mdebets wrote: »

Agreed, it would be better to have him in a specialised nursing home for people like him, but does Ireland have one of these and if it doesn't, does it have, is the number of patients there to sustain it and how long would it take to built it?

Had a quick look for paralysed people, and there seems to be quite a few who can't get a grant to change their homes to allow said people live there. Having a Paralysis Hospice where long term and short term patients could goto could in theory be set up in a retrofitted old folks home. There have been several such state owned homes closed in the last few years, and imo one of these may suit the needs?

sillyoulfool

ScumLord wrote: »

If you're to put the welfare of Irish citizens above, or at least on a par with the financial costs surely you have to look at the amount of care that can't be given out because of this bed being used by one person who needs specific care and not all the care a hospital can supply. How many patients will be left on a waiting list because of the lack of a bed? It could lead to the death of other sick people.

Spending €500,000 needlessly on homecare when there is a bed in the hospital is just as likely to lead to a death.
Totally agree with the HSE on this one.

mdebets

sillyoulfool wrote: »

Spending €500,000 needlessly on homecare when there is a bed in the hospital is just as likely to lead to a death.
Totally agree with the HSE on this one.

But the bed he occupies is not a spare bed, which would be empty if he was gone. The bed could be used by other patients if he weren't there.
You don't have enough hospital beds in Ireland (hence the sometimes month long waiting list). Going by Beaumont average stay of 10.5 days per patient, there could be up to 30 people taken off the waiting list if he would be cared fore somewhere else (nursing home or at home)

seamus

mdebets wrote: »

But the bed he occupies is not a spare bed, which would be empty if he was gone. The bed could be used by other patients if he weren't there.
You don't have enough hospital beds in Ireland (hence the sometimes month long waiting list). Going by Beaumont average stay of 10.5 days per patient, there could be up to 30 people taken off the waiting list if he would be cared fore somewhere else (nursing home or at home)

That's not how it works. There is no shortage of beds in the Irish health system, only a shortage of money. Shortage of beds is a symptom of money problems.

Taking this man out of a public hospital doesn't free up a bed in the same way that outsourcing your IT to India doesn't free up a job. If you move him home, then the money spent caring for him in hospital is spent on caring for him at home. You haven't freed up a bed, you've only transferred it from one place to another.

In fact, the additional cost means that you will have taken more beds out of the system. If we say for the sake of simplicity that the cost of caring for him in a hospital is 200k pa, and the cost at home is 400k pa, then by transferring him home you don't gain a bed, in fact you lose a bed because now he is consuming two beds from the public system.

The most reasonable solution would appear to be for the family to relocate closer to the hospital, perhaps build a new home with a properly kitted out room for him. Then the HSE will be amenable to him overnighting more frequently in the family home, for special occasions, etc.

Either that or transfer him to a nursing home with the specialist care he needs. Hard when he's so young, but it's better than spending the rest of his life in a hospital.

oldyouth

There is no answer to this one. Costs are too high but we are dealing with a tragic personal story and the hardship endured by his loved ones. I agree with all sides to this but that is no solution at all

withless

"where's de compassion?"

diomed

My mother is in a nursing home 50 kilometers from where I live. She would like to be at home. I would like that too. She can walk one or two steps if supported. More than that and she would fall.

Why is she 50 km from me? The cost is about €4k a month. Here it would be €8k to €10k a month.

If she was at home she would need staff 24 hours a day, 7 days a week. It would take a minimum of three staff.

It is easy for people to spend other people's money. The country can not spend needlessly.