The answer to the Hospital Trolleys Crisis: Lemsip!!!

Snickers Man

The 6:1 news on RTE yesterday (Monday 6th Jan 2020) led with the by now regular news item from Fergal Bowers, RTE's medical correspondent, that there were "record numbers (760) of patients on trolleys in our acute hospitals."

Usual over-wrought description of chaos: Ambulances backed up for hours waiting to unload patients into gridlocked A&E departments; non emergency surgery procedures cancelled; the usual litany of interviewees: spokesperson from the INMO, soundbite from De Minister, outraged patients/passersby outside hospitals tut tutting and saying how the "whole world's in a state of chassis".

And just in case you didn't get enough of Fun-time Fergie, there he was back in the RTE news office offering some insightful analysis of where it's all going wrong. Verbatim transcript:

Interviewer: "What is causing the problem to be at such a record levels this year?"

Fergal Bowers: "Well this is traditionally one of the busiest weeks of the year for the country's acute hospitals. It's the post Christmas/New Year surge which is predictable. People have been socialising, gathering in large gatherings and that aids the spread of influenza and colds. People may have put off attending a doctor over the festive season and are now turning up at hospitals. While the flu has peaked it it is going to continue to affect the hospital system over the coming weeks.
.......
We have an aging and growing population. The capacity of the system is not sufficient to cope with this surge that we are seeing."

Are you f***ing kidding me? People go to the A&E departments of acute hospitals because they have a few sniffles??? What the hell is wrong with saving themselves a lot of trouble (and the health service a lot of scarce resource) and just going down to the local pharmacy for some rudimentary over the counter medicine? Like a Lemsip??

Can staff at A&E not be empowered to tell people who are clearly ill but not dangerously so to go home, tuck up warm and have a hot whiskey with a nice squeeze of lemon inside? By being indulgently nice to someone who shows up with a shiver and a temperature we are being necessarily nasty to genuinely acute patients who may have suffered a car accident or a fall or an illness that necessitates hospital treatment.

Think of it this way: if your elderly mother HAD to go to hospital for an important procedure or because she had been diagnosed as seriously ill and had to wait for up to seven hours in the ambulance at the loading bay because some indulgent jerk ahead of her only needed a cough bottle, what would you think?

I know. Some of you are going to say I'm "Victim blaming" but I am only going by what RTE's esteemed Health Correspondent offered as his "analysis" of the problem. Colds and flu....in ACUTE hospitals??

GTF outta here. Literally.

Quantum Erasure

You're not wrong...

RobertKK

A number of people have died from the flu, for some people it is very serious and deadly.

amor3

A big difference between a cold and flu..

100% agree with you op though, couple of paracetamol and fluids till it passes is the only thing for cold

iamwhoiam

People have died from flu . Some are very ill and needing medical assistance .

Spanish Eyes

Jayzis you'd have to be really at the end of the road to go to A+E with a virus. OK, I know some are very vulnerable to pneumonia or whatever. Did they not get the jab?

Going to A+E is the last resort so I won't judge. But for me, a hot whisky and a Lemsip is the way to go. And get the fekkin JAB!

angel eyes 2012

The difficulty is even if they discharged 50 patients presenting with a cold, without a thorough check by an A&E Doctor, the condition of just one could invariably deteriorate overnight and that patient could succumb to their illness. Straight away, you could have the lawyers knocking on the door with a medical negligence case and who would blame the family for considering such a route.

Such patients were possibly discharged 20 maybe 30 years ago from A&E and told to go to their GP, but now boxes have to be ticked and strict regulations have to be complied with.

ILoveYourVibes

Obviously people are just dying to spend the night in the hospital.

Everyone knows granny is the easiest person to get to go the doctor.

Especially over Christmas i mean WHO DOESNT want to spend Christmas and new year in hospital?

iamwhoiam

I would be almost sure that people with a “ sniffle “ are not in A and E . Its no joke to wait 30 hours in A and E .

Tails142

Lol you haven't got a clue

These are generally people with other health problems that need medical intervention like oxygen, intravenous fluids, anti biotic through IV, do you think people that end up in ICU with the flu would be sorted with a lemsip? Maybe the HSE could issue out salt lamps next year to at risk groups too, might help with the lemsip to keep the numbers down

Rubberchikken

Of course it's stupid to go to a & e with a cold but you also have the drunks and druggies with no more sense than a cushion taking up space too. Plus the usual hanger-ons who seem to need to accompany de family member everywhere. Isn't there any bloody thing on the telly at home to keep them entertained?

And, our health services wouldn't be so crap and hemorrhaging money if someone had the balls to get rid of most of the useless management hanging around.

Spanish Eyes

Last place anyone would want to be is A+E. Honestly.

Charge everyone for going there. Sorry it has really come to this.

iamwhoiam

Spanish Eyes wrote: »

Last place anyone would want to be is A+E. Honestly.

Charge everyone for going there. Sorry it has really come to this.

Its a €100 to attend A and E without a GP referral

Lemsip rocks in fairness..

ytpe2r5bxkn0c1

iamwhoiam wrote: »

Its a €100 to attend A and E without a GP referral

Not with Medical Cards. 44% of people have one.

mrmorgan

I was in Tallaght recently and a woman was waiting there for 15 hours with a chest infection..... a bloody chest infection and she was going mad that she wasn't being seen!!

I actually told her, people like her are the reason that the waiting times are so long (well they kind of are)

her excuse was she couldnt get an app with her GP and needed meds to which I replied "is he the only GP in Dublin"...

the world is full of idiots I am afraid.

angel eyes 2012

Graysen Green Barbecue wrote: »

Not with Medical Cards. 44% of people have one.

Similarly, you can claim the €100 back if you are admitted.

iamwhoiam

Graysen Green Barbecue wrote: »

Not with Medical Cards. 44% of people have one.

Yeh well they don’t pay a GP either so I can’t see them cluttering up A and E for a “ sniffle “

iamwhoiam

mrmorgan wrote: »

I was in Tallaght recently and a woman was waiting there for 15 hours with a chest infection..... a bloody chest infection and she was going mad that she wasn't being seen!!

I actually told her, people like her are the reason that the waiting times are so long (well they kind of are)

her excuse was she couldnt get an app with her GP and needed meds to which I replied "is he the only GP in Dublin"...

the world is full of idiots I am afraid.

Most GPs in Dublin are not taking new patients on their books . Nor would they see a randomer with no appointment .

iamwhoiam

People are very quick to blame the patient instead of blaming the HSE for the dreadful management of A and E’s
There should be walk in clinics around the citys easing the burden on A and E

SEPT 23 1989

iamwhoiam wrote: »

Most GPs in Dublin are not taking new patients on their books . Nor would they see a randomer with no appointment .

There is a doctor ten minutes from Tallaght who will see patients within an hours notice

But you pay 60 quid for it

ldy4mxonucwsq6

Tails142 wrote: »

Maybe the HSE could issue out salt lamps next year to at risk groups too, might help with the lemsip to keep the numbers down

The HSE already gives flu vaccines free of charge to at risk groups.

Fair enough if someone needs medical intervention but others head off regularly to the GP or A&E for the slightest little thing.

If everything wasn't free for some patients then you'd see a drastic improvement in the currently overwhelmed health service.

If there was a charge people might only attend the GP or hospital when it's actually necessary, which makes for better treatment for those who really need medical assistance.

Although I'd never put money before health, I certainly don't run to the doctor for every little thing because I have to pay.

There are people in GP surgeries and hospitals week in and out with very little wrong with them. That takes time and resources away from those who need it most.

They need to get the balance right, charges or a limited number of free visits would be a step in the right direction.

angel eyes 2012

iamwhoiam wrote: »

Most GPs in Dublin are not taking new patients on their books . Nor would they see a randomer with no appointment .

There are a number of after hours GP services available in the Dublin area and you don't have to be a patient of a particular GP to attend.

Chiparus

iamwhoiam wrote: »

People are very quick to blame the patient instead of blaming the HSE for the dreadful management of A and E’s
There should be walk in clinics around the citys easing the burden on A and E

Ambulatory patients are not those on trolleys, you could open a load of walk in clinics and it would not make any difference to the trolley count.

These are sick patients who need inpatient care.

Chiparus

mrmorgan wrote: »

I was in Tallaght recently and a woman was waiting there for 15 hours with a chest infection..... a bloody chest infection and she was going mad that she wasn't being seen!!

I actually told her, people like her are the reason that the waiting times are so long (well they kind of are)

her excuse was she couldnt get an app with her GP and needed meds to which I replied "is he the only GP in Dublin"...

the world is full of idiots I am afraid.

Eh No, waiting times are so long because there is nowhere to see ambulatory patients generally.

iamwhoiam

angel eyes 2012 wrote: »

There are a number of after hours GP services available in the Dublin area and you don't have to be a patient of a particular GP to attend.

Tallaght TLc was packed to the rafters all Christmas week I believe

I was really talking about more about the need for HSE run walk in clinics that could ease the burden of A and E .
A and E should remain for Accidents and Emergency and clinics to see more minor illnesses

iamwhoiam

Chiparus wrote: »

Ambulatory patients are not those on trolleys, you could open a load of walk in clinics and it would not make any difference to the trolley count.

These are sick patients who need inpatient care.

I agree with you . But taking the ambulatory patients out of A and E would ease the burden on the staff at very least

SEPT 23 1989

What about a separate a&e for the drunks,smack heads ,pill poppers travellers and headbangers

Asitis2019

Snickers Man wrote: »

The 6:1 news on RTE yesterday (Monday 6th Jan 2020) led with the by now regular news item from Fergal Bowers, RTE's medical correspondent, that there were "record numbers (760) of patients on trolleys in our acute hospitals."

Usual over-wrought description of chaos: Ambulances backed up for hours waiting to unload patients into gridlocked A&E departments; non emergency surgery procedures cancelled; the usual litany of interviewees: spokesperson from the INMO, soundbite from De Minister, outraged patients/passersby outside hospitals tut tutting and saying how the "whole world's in a state of chassis".

And just in case you didn't get enough of Fun-time Fergie, there he was back in the RTE news office offering some insightful analysis of where it's all going wrong. Verbatim transcript:

Interviewer: "What is causing the problem to be at such a record levels this year?"

Fergal Bowers: "Well this is traditionally one of the busiest weeks of the year for the country's acute hospitals. It's the post Christmas/New Year surge which is predictable. People have been socialising, gathering in large gatherings and that aids the spread of influenza and colds. People may have put off attending a doctor over the festive season and are now turning up at hospitals. While the flu has peaked it it is going to continue to affect the hospital system over the coming weeks.
.......
We have an aging and growing population. The capacity of the system is not sufficient to cope with this surge that we are seeing."

Are you f***ing kidding me? People go to the A&E departments of acute hospitals because they have a few sniffles??? What the hell is wrong with saving themselves a lot of trouble (and the health service a lot of scarce resource) and just going down to the local pharmacy for some rudimentary over the counter medicine? Like a Lemsip??

Can staff at A&E not be empowered to tell people who are clearly ill but not dangerously so to go home, tuck up warm and have a hot whiskey with a nice squeeze of lemon inside? By being indulgently nice to someone who shows up with a shiver and a temperature we are being necessarily nasty to genuinely acute patients who may have suffered a car accident or a fall or an illness that necessitates hospital treatment.

Think of it this way: if your elderly mother HAD to go to hospital for an important procedure or because she had been diagnosed as seriously ill and had to wait for up to seven hours in the ambulance at the loading bay because some indulgent jerk ahead of her only needed a cough bottle, what would you think?

I know. Some of you are going to say I'm "Victim blaming" but I am only going by what RTE's esteemed Health Correspondent offered as his "analysis" of the problem. Colds and flu....in ACUTE hospitals??

GTF outta here. Literally.

I think this is a hugely disingenuous post, and shows a very naïve understanding of a complex problem. I will desist from commenting on the political motivation for your post.

First of all, thanks to your friends in FG, and previously FF, bed capacity has been significantly cut over the past decade or so. The crisis that is unfolding is not an A&E crisis - it is a bed supply crisis that becomes severe at peak periods of demand. The problem is not with the demands placed on the A&E department, but the fact that once a decision is made to admit a patient - on the basis that they are no clinically safe to be at home - there is insufficient bed capacity (and associated staffing) to expediently admit the patient.

Second, the argument that people turning up with the flu to an A&E departments is the problem is nonsensical. Certain groups with the flu need top be admitted - in that they need IV antibiotics and oxygen. These include the very old and very young, those with weak immune systems, and those who have respiratory conditions such as COPD, asthma, etc. People turning up to A&E outside these categories will likely never see a doctor because they are triaged. Very few people who truly have the flu, and don't need to be in the hospital, are going to sit on a hard plastic chair (if they are lucky) in an overcrowded room for 24hrs.

Third, you haven't mentioned the drunks, druggies, homeless and wanderers. I guarantee you if you attend a city ED right now, you will see these people hanging around. They need to come through due process - and some of them have complex medical needs; most others are looking for somewhere warm.

Fourth, we also have to ask ourselves why people are turning up to the A&E with flu like symptoms. It is because primary care also lacks capacity - GPs, public health nurses are the unsung heroes - but they are pressed to capacity as well. A predictable consequence of FG's election grabbing attempt to sway family voters by offering free GP care but without properly resourcing the same. Most people with flu don't need to even attend their GP - BUT, in other countries GPs can administer anti-virals that limit flu. The people who have to wait three weeks to see a GP end up attending A&E with more severe illnesses, including pneumonia. They need to be admitted.

So unless you can see that this is a supply issue, you really are being blind to the root causes of this problem. The root problem is government policy - not only on beds, but in their refusal to meet with consultants. It is also a fallacious believe that investments in primary care this year will immediately manifest in less attendances and admissions to A&E - the effect is cumulative, and will require bigger, sustained investments, negotiations with consultants, and smarter ways of working to resolve. It also requires behavioral changes on the demand side - I agree with you that the A&E department should be a place of last not first resort. We also need to do more about hygiene.

Structurally, we need to think about dedicated public centers for elective surgery. A smart start would be to acquire and nationalise some of the smaller private clinics, and test the model. Especially for orthopaedic, cardiac, and renal surgery - these could be become centers of excellence.

In summary, this is not an A&E crisis - it is a healthcare crisis that is manifesting itself in the lobby of the healthcare system.

mrmorgan

Chiparus wrote: »

Eh No, waiting times are so long because there is nowhere to see ambulatory patients generally.

Eh, maybe.,

didnt mean it was the total problem... but it doesnt help

youandme13

angel eyes 2012 wrote: »

There are a number of after hours GP services available in the Dublin area and you don't have to be a patient of a particular GP to attend.

Yes you do. When you ring TLC they ask what GP you're with and same with Lukedoc etc..

amor3

SEPT 23 1989 wrote: »

There is a doctor ten minutes from Tallaght who will see patients within an hours notice

But you pay 60 quid for it

I've to pay 60 euro anytime me or my kids needs the doctor so could you pass this doctors name on as I'm tallaght based.. my surgery is always at least booked up by 2 weeks ahead.

LeBash

I went to 4 pharmacies in 1 day trying to get the flu jab in November and 3 refused saying they didnt have anyone trained to do it, last one was honest and said come back this evening, we are out the door with prescriptions.

I got the impression it wasnt worth the while for them but maybe I'm wrong.

Assuming the flu shot is working that year, if you turn up to A&E with flu, you should be told, go home and suck it up Princess or its 5k a day to stay.

Get the bleedin jab if your high risk and dont block up A&E for genuine emergencies.

ILoveYourVibes

SEPT 23 1989 wrote: »

What about a separate a&e for the drunks,smack heads ,pill poppers travellers and headbangers

This is Ireland we are ALL at least one of the following. drunks smack heads pill poppers travellers and headbangers.

I am irish and i own that ****.

ILoveYourVibes

ILoveYourVibes wrote: »

Obviously people are just dying to spend the night in the hospital.

Everyone knows granny is the easiest person to get to go the doctor.

Especially over Christmas i mean WHO DOESNT want to spend Christmas and new year in hospital?

Also i am sure hospital doctors are obviously stupid enough to admit people into hospital who don't need to be there. I mean they LOVE over working themselves.

Montage of Feck

I would much rather die at home in my own bed, then in a overcrowded hospital corridor.

Are you allowed quote yourself?

corner of hells

ILoveYourVibes wrote: »

Also i am sure hospital doctors are obviously stupid enough to admit people into hospital who don't need to be there. I mean they LOVE over working themselves.

Do you know you're replying to yourself?

Was probably bound to happen at some stage she's so prolific..

Mr_Muffin

amor3 wrote: »

I've to pay 60 euro anytime me or my kids needs the doctor so could you pass this doctors name on as I'm tallaght based.. my surgery is always at least booked up by 2 weeks ahead.

So if you're sick, it takes 2 weeks for you to see your doctor? What if it's something serious?

ILoveYourVibes

corner of hells wrote: »

Do you know you're replying to yourself?

Im the only one I wanna talk to.

Do you think i can't read the poster!???? LIKE WHY WOULD YOU EVEN ASK THAT???

Sardonicat

Mr_Muffin wrote: »

So if you're sick, it takes 2 weeks for you to see your doctor? What if it's something serious?

---

> A&E

Montage of Feck

The government are doing their best to utterly destroy public health care, just wait until they implement more free healthcare for the under 8's.

corner of hells

ILoveYourVibes wrote: »

Im the only one I wanna talk to.

Do you think i can't read the poster!???? LIKE WHY WOULD YOU EVEN ASK THAT???

Stop shouting at yourself.

amor3

Mr_Muffin wrote: »

So if you're sick, it takes 2 weeks for you to see your doctor? What if it's something serious?

If it's really serious a&e, but if it's something I think me or kids need a prescription for you can walk in during opening hours and wait for a gap between patients, a right pain in the arse, you could be there for 4 hours or more, its shocking!

ILoveYourVibes

corner of hells wrote: »

Stop shouting at yourself.

I am a street preacher on crack ...a mad ranting street person..only online ..its really best NOT to engage with me and leave me to my own devices. I am enlightening myself and that is all that matters.

Snow Garden

An A&E consultant on the Tonight Show said repeatedly that the trolley crisis is primarily down to bed capacity. She said they have been asking for more beds for years. She said she was disgusted that the government tries to blame flu every year. She said a suitably equipped hospital should be able to handle flu cases.

mrmorgan

Snow Garden wrote: »

An A&E consultant on the Tonight Show said repeatedly that the trolley crisis is primarily down to bed capacity. She said they have been asking for more beds for years. She said she was disgusted that the government tries to blame flu every year. She said a suitably equipped hospital should be able to handle flu cases.

well, what I have been told by many doctors and nurses is that there are empty wards in hospitals it's just they don't have the staff to manage it all!!

Snow Garden

mrmorgan wrote: »

well, what I have been told by many doctors and nurses is that there are empty wards in hospitals it's just they don't have the staff to manage it all!!

She specifically said the A&E departments had insufficient bed capacity. The trolleys are in the A&Es.

mrmorgan

Snow Garden wrote: »

She specifically said the A&E departments had insufficient bed capacity. The trolleys are in the A&Es.

well thats fair enough I suppose then

ldy4mxonucwsq6

Mr_Muffin wrote: »

So if you're sick, it takes 2 weeks for you to see your doctor? What if it's something serious?

Practically every practice has slots for walk in emergencies who are seen without an appointment, there's also option to take a cancellation which happens regularly.