Is our health service already undergoing a collapse?

Indestructable

I've a feeling our health system has already, at least partially, collapsed.

I was in a pharmacy today and the woman ahead of me was getting antigen tests for her parents. She was almost certain both of them had chest infections. She couldn't get hold of a GP, her own wasn't answering the phone for the past 2 days and none other in the area would see them. The advice was to bring them to the A and E.

On the radio today some higher up in the HSE was saying avoid A and E if at all possible.

There are many other stories like this, what are you experiences?

It's borderline impossible to get frontline medical attention now. A collapse won't happen all at once, it's a gradual process that seems to be ongoing now. Starting with GP care.

igCorcaigh

https://www.rte.ie/news/2021/1118/1261626-virus-covid-politics/

The Chief Executive of the HSE has said that the latest surge in Covid-19 cases is having the highest level of impact on health services since the pandemic began

Higher than the peak of illness in January when 200 were in ICU and 2,000 in hospital with Covid?

SupplyandDemandZone

No. A lot of scaremongering going on though.

Most things don t need to see the doctor. What was stopping her dropping a note through the letterbox or ringing the bell?. Most ridiculous thing i saw was a letter from my kids school saying there was a covid case and advising concerned parents to ring their GP first!, despite all the advice being online and hse helpline also. Didnt advise to ring gp if kid got sick

Indestructable

The difference this year and going into January is that we shouldn't have a lockdown. All the usual pressures on the HSE will be there in addition to Covid.

Flu, alcohol related issues, accidents all the regular stuff the inefficient HSE can just about cope with, in addition to Covid, is a recipe for disaster.

Backlogs and missing scans/tests from the past 2 years will surely begin to catch up shortly too.

Indestructable

https://www.boards.ie/discussion/comment/118187739#Comment_118187739

I've read a lot of your posts on the Covid threads and for the most part I agree with what you say.

However, I don't think it's scaremongering to say the HSE is under massive pressure, its being realistic.

This is not solely related to Covid, but it is the straw that broke it.

Strumms

A lot of GP surgeries are oversubscribed with patients....

this is because of a GP shortage...

Approximately 2500 GPs

Approximately 4,995000 people living here

About 1 GP to every 2000 people about.... not one practice, one GP,

You’ll wait one week from picking up the phone at my GP’s surgery to obtaining an appointment.

There are 6 full time GPs at the surgery.

my Dad hasn’t been well recently, few months ago before vaccinations he called his GP surgery which is different to mine, despite the urgent nature of symptoms relating to an ongoing condition, he was not even put through to his GP or called back by him... the PA relayed what he told her.. she said the doctor said his options were...

A) obtain an appointment for 6 days later when he could see him

B) he’d type a letter for him, email it to me, I’d print it off, give it to Dad and he could go to a&e where he could show said letter...

he choose option B but waited, then 24 hours later, he called a taxi to bring him to a&e with the letter as symptoms worsened...

he came home hours later not having seen anybody in the hospital...

cant see his GP, can’t get seen to in hospital... man has a heart issue, arthritis and a gastrointestinal problem that this was related to...man is mid ‘80’s

Solution : there should be a cap on the number of patients on a doctor’s patient list... 450 or whatever...

you have no GP ? You have to go a swiftcare clinic, ddoc etc...

a gp is only of any use if you can get to see him.... an accident and emergency is only of use if you can get seen to..

if you bought a ticket for the All Ireland final only to be told on arrival at Croke Park that they’d sold too many tickets and better luck next year... you’d be pissed.... so when you pay xxxx tax yet can’t get to see a gp or a doctor in A&E... ehhhhh no....

needs to be sorted, and whatever party sorts it will be in power for decades... but thanks to the wokies it probably never will be.... it will get wayyyy worse before it gets better.

NSAman

Of course the Irish health system has collapsed. It’s not fit for purpose and is a total basket case.

covid or not, the system does not work. What we are seeing now is the stress being put onto frontline staff, there simply are too many managers doing “paperwork” and not enough people looking after patients.

frankly, it needs dismantling and re-invention.

tara73

https://www.thetimes.co.uk/article/national-childrens-hospital-delayed-to-2024-as-cost-rises-5t6tl2r70 (sorry, link is a pay link, but just for proof of the number 2 billion)

but there's 2 billion !! to build a new childrens hospital. Nothing against building a new childrens hospital, the opposite, but the costs !! This is madness. Some guys are getting really, really rich here while 80 years old can't get an appointment with a GP or will be treated at A&E. I had this story with the 80ish dad of a friend. Waited in A&E for 20 hours and was eventually sent home without seeing a doctor and it wasn't something minor he had. absolute disgrace.

kirk.

They just need a cash injection of 20bn

Oh wait what am I sayin

lawrencesummers

900k people on waiting lists for treatment.

People getting appointment letters for 5 years time.

€20-30 million of court settlements to affected patients every week.

Has it collapsed?

Im surprised you have to ask that question

.42.

I’m just surprised that our health service has lacked efficiency for decades and No minister or party has ever been able to fix it.

also nobody has ever explained what the issue is.

we are a rich little Island country that pumps billions into their health service only to make it worse then the year before.

Cluedo Monopoly

Is anyone in the least bit surprised? There was an ICU consultant (Vincents) on the radio earlier in the week saying ICU capacity has been too low for a long time and multiple reports saying the same thing. He said it should have been increased significantly to account for the new Covid workload.

The INMO have been begging for improvements every winter for decades but nobody was listening. You reap what you sow.

This INMO press release is from November 2019.

2019 breaks record for most patients on trolleys – and it’s not even December (inmo.ie)

2019 has seen the highest number of patients on trolleys in any year since records began – despite it still being November.

“Winter has only just begun and the record is already broken. These statistics are the hallmark of a wildly bureaucratic health service, which is failing staff and patients alike.

“We take no pleasure in having to record these figures for a decade and a half. We know the problem, but we also know the solutions: extra beds in hospitals, safe staffing levels, and more step-down and community care outside of the hospital.

“No other developed country faces anything close to this trolley problem. It can be solved, but a strong political agenda to drive change is needed.

“The INMO has written to the health and safety authorities this week to try force a change from the employers. Hospitals should be a place of safety and care – not danger.”

banie01

If not collapsed, it is most certainly facing serious issues. Even prior to Covid, ICU was under resourced and the primary care system far too fragmented to be effective.

The move towards Slainté care and universal GP coverage has been far to slow. As has the amalgamation of GP's offering minor surgery.

I have a great GP practice, everyone there really does a great job but, far too much of what they can do is currently limited and it was such prior to the pandemic.

A move towards a better integrated healthcare system with a greater focus on actual primary care. GP, community nursing, physio, Advanced Nurse Practioners and other support services including minor surgery. Run those services on broader time base say 16hrs a day in a shift cycle and it would allow for a far greater utilisation of services than the current 8-5 model of GP/primary care service delivery.

As for the current state of play, we knew pre any pandemic that we were short @ 150 ICU beds. Some have been added but it is an understandably slow process. Even if 150 ICU beds were immediately funded, bringing the actual staff online to run them 24/7 requires multi-year grad and specialist recruitment.

I don't know what the fixes are. It's easy to say money yet, there are multiple bottlenecks in staff, deployment, resourcing and unions all with their own area foremost. Rather than developing an encompassing strategy to deliver world class frontline and patient services.

Given our health budget, that should be the ultimate aim.

Figuring out just how to deliver that? Is a process that really does require engagement and candour from all parties.

listermint

https://www.boards.ie/discussion/comment/118199853#Comment_118199853

What in the jaysus has wokies got to do with the health service. What the jaysus is a wokie.

Is your da working? Or is he on state pension. If it was up to the libertarian nonsense that's across these boards your sick da would and should be out working old or not.

Wokies. Lol 😊

Burty330

Paul Reid should be drawing the dole, the peanut headed waste of space. Amazing how such failure goes completely unchallenged in this country

Amazing how the same population who disregard their health in favour of obesity - and all the dire consequences that come with it (diabetes, cardiovascular disease, hypertension, strokes, heart attacks etc.) - are often the same people who now complain about not having enough GPs / healthcare provision in the country.

Perhaps if people looked after themselves more, rather than relying on the government to catch up with the number of GPs needed, that would help.

That, and people wasting GPs time with issues that go away themselves anyway; and old people clogging up GPs surgeries because they've often got nothing better to do with their time. And people wasting GPs time in Winter going to the doctor to get prescribed antibiotics for the common cold, a viral infection. There's a few practical solutions to ponder in the meantime.

Ireland has one of the highest levels of obesity in Europe, with 60% of adults and over one in five children and young people living with overweight and obesity.

Grab All Association

Lot of fake dubious doctors in the system too. Many Irish doctors have retired to be replaced with “doctors” lacking basic medical knowledge and who think elbows are ankles.

seenitall

My GP is really good and prompt as well, I can’t say I have any complaints whatsoever about the service we receive, especially when I read some horror stories on here. (My heart goes out to the old and vulnerable people who are shabbily treated because of the lack of staff and resources, and their carers alike.)

I think perhaps not living in the overcrowded beehive AKA Dublin may have something to do with it?

Brucie Bonus

We had a broken system for a long time.

It's traditional to have people lying on trolleys in corridors and sitting in chairs.

Covid just adds to the mix.

My concern is that after covid its all let go back to 'normal'.

Nobody thus far has had the will or the balls to sort it out.

Slaintecare is nicely designed inaction.

Mary Harney wanted the health portfolio so she could milk the system for her husband's and others private companies.

Most just want to kick the can down the road.

Brucie Bonus

https://www.boards.ie/discussion/comment/118200938#Comment_118200938

He had zero health experience before being made top man.

RandomViewer

https://www.boards.ie/discussion/comment/118200264#Comment_118200264

If you add the legal bills to those awards the figures for negligence cases must be close to half a billion a year,

lawrencesummers

https://www.boards.ie/discussion/comment/118202203#Comment_118202203

And thats the ones that go to court.

many others are settled out of court.

shesty

I am at the other end of the scale to the poster with the elderly father.

I have 3 kids, and getting an appiontment is impossible.Been in and out myself lately with an issue or two...have to wait 3 days for a phone appointment.3 weeks for a nurse appointment!Kids, you just get told, DDoc or Temple St.DDoc have 8-10 hours waits for appointments.Temple St....well that is 8 hours as a standard wait.To get an ear looked at, or a chest listened to.Because usually that's what it is.

I don't know if this is a collapse, it has been getting progressively worse the last few years.Nobody seems interested in improving it, or has the appetite to take on vested interest groups.Covid has resulted in a small number of good changes, but a wider situation where everything is placed second to covid, and it is miserable.My entire stress this winter lies in not being able to get timely access to a GP.Kids can go from ok to bad, and from bad to worse over a very short period of time (and also from bad to ok quickly!!)You don't have time to hang around if their temp won't go down below 40 with calpol or neurofen, or they get bad croup out of nowhere, and can't breathe.When you layer 3 or 3 days messing around with PCR tests over that, it is incredibly hard at the moment.And nobody seems willing to acknowledge or sort it.

https://www.boards.ie/discussion/comment/118202169#Comment_118202169

I’m sure that you have sources for your claims? Care to share them? Or even care to share your solutions. Thanks in advance.

km991148

This question could have been asked in 2019 and the answer either be the same.. yes

Repo101

The government blames the HSE, The HSE blames a lack of funding and the Unions, middle managers blame the HSE, staff blame middle management. The problem is multifaceted and each group has some responsibility. One sector of the HSE that is a disgrace is the assessment of need, where staff seem to be constantly on maternity leaving children waiting months to get assessed. Staff should not be allowed to take maternity leave all at once leaving no cover in a particular area for 9 months. It's a joke of a system and all the staff abuse it.

What public sector body actually works well except for Revenue? No personal responsibility creates these problems.

Brucie Bonus

https://www.boards.ie/discussion/comment/118205513#Comment_118205513

You want me to fix the health service? At least you recognise its broken.

Chris_5339762

https://www.boards.ie/discussion/comment/118205813#Comment_118205813

Thats just trolling its such a crazy suggestion.

But to add to the problems, once COVID is "over" there will likely be an exodus of fed-up staff from health services worldwide. And it'll be harder to get people into health as the pay/conditions/environment are terrible for all but the top consulants and management.

https://www.boards.ie/discussion/comment/118205883#Comment_118205883

So…..no links, nor suggestions.

Brucie Bonus

https://www.boards.ie/discussion/comment/118206088#Comment_118206088

I'm not a health expert no.

When your car breaks down and the mechanic comes, does he ask you to suggest a fix? If you can't is he justified in leaving your car by the side of the road?

https://www.boards.ie/discussion/comment/118206425#Comment_118206425

I’m simply curious as to what ideas you might have. Don’t need be a health expert, more a financial or business one.

Brucie Bonus

https://www.boards.ie/discussion/comment/118206962#Comment_118206962

Nothing, no. I see people lying sick on trolleys in corridors every year at this time. I say to myself, that's a problem. I then conclude government should address it. Thats what we pay them for after all.

Economics101

The real scandal is not that health is underfunded. Ireland is well up in the league of public expenditure per head and as a % of National Income. Add in to the mix (a) a relatively young population and (b) a sizeable chunk of private funding via health insurance (> 40% of households), and the picture is even more scandalous.

There may be some genuine measurement issues (i.e. do all countries classify social care as "health" of under some other heading?). My own purely personal hunch is that management is hopeless, and restrictive practices are rife.

One example of what's going on: a local TD has been sending flyers about a new primary care health centre: opening hours Monday-Friday 0900 to 1700. I have heard it said that one aim of the new centres was to treat minor injuries and thus relieve pressure on Emergency Departments: imagine doing that when you close at 5pm!

buried

Only thing that will fix that service, or any service in this country for that matter is to get serious with the racket that is and has always been going on. Set up a tribunal or trial of enquiry as to where, what and who were ultimately responsible for the hundreds of Billions of our money that was funneled into a service and was ultimately p!ssed down the drain. Have 12 members of the citizenry to adjudicate on the findings of the trial. Set it up as enquiry that could lead to criminal charges for those found to be responsible, if charged then they and their descendants can pay for the trial/tribunal costs. Implement a few goes of something like that, you'd definitely see everything running very very smoothly.

Brucie Bonus

https://www.boards.ie/discussion/comment/118207143#Comment_118207143

We have people in place carrying out checks and balances. The problem is there are obviously holes and nobody wants to address them. Its not my job or kick the can down the road. You can be sure somebody is making out nice.

If you recall something simple like storing e-voting machines. Every political chancer and his friend had one out the back earning them storage fees. These are the kind of petty little gangster we have watching over health.

buried

https://www.boards.ie/discussion/comment/118207180#Comment_118207180

There is no accountability to those checks and balances. The findings are only published after the deeds have been done in a burlesque style narrative to make everybody sigh "oh dear that's terrible". We need to demand actual accountability. The same accountability the likes of the Department of Revenue ascribe to the ordinary citizenry who ultimately have to pay for everything.

Brucie Bonus

https://www.boards.ie/discussion/comment/118207211#Comment_118207211

I agree. Look at the NCH. Blank cheque until the media got wind.

Wasn't it 14 million sent to a music promoter based in the middle east for not fit for purpose ventilators.

enricoh

I read 300 millions worth of PPE was purchased last year and has been written off as unusable. It didn't mention anyone getting the bullet over it!

https://www.irishtimes.com/news/ireland/irish-news/allegations-of-abject-failure-on-ppe-purchase-rejected-1.4682245

Every year for the last 5-10 years there was a budget over run in health but more than expected corporation tax was taken in n it was well covered. With new changes in corporation tax we may no longer get more than expected but I'll bet we'll still get budget overruns in health!

BrianD3

Another week, another case of ruined lives and an 8 figure settlement.

https://www.irishexaminer.com/news/courtandcrime/arid-40753377.html

Based on my experiences in public hospitals it is not at all surprising that things like this happen. Less serious variations happen all the time - hospitals are a shambles, patients with pre existing conditions are admitted to A&E, nobody has a clue what's going on and arrogant HCWs don't listen to relatives when they explain.

85603

Having done the a+e long wait I did wonder at the time why it couldnt be arranged for the waiting 'patient-to-be' to leave and come back closer to the time when the doctor could see them. (Without risk of losing slot)

Thats something that could actually be fixed.

Im sure there are barriers, and reasons (most probably including legal reasons), why it works this way.

But if I was going to attack the whole mess then 'people hanging around in a+e for 10-20 hrs' would be the low hanging fruit to go for first. I know theres a better way.

As it stands you check in and thats it, no more information for you, see you in 2-20 hours maybe, but dont leave because reasons, next.

Its after the first 9 hours that you wonder did they even put you in the queue.

Multipass

https://www.boards.ie/discussion/comment/118231176#Comment_118231176

These huge settlements are a problem - that money is needed elsewhere. By all means the victims of malpractice should get all of their medical needs and housing adaptations etc covered, but I don’t see why that shouldn’t be on the basis of receipts, instead of these enormous lump sums. No one person, in any condition, is going to need 25 million. It’s obscene when you have people waiting years for treatment.

Wanderer78

https://www.boards.ie/discussion/comment/118231910#Comment_118231910

sounds like an easy fix, but id imagine these type of ideas have already been floated, the reality is, theres no real way of accurately predicting how long it would take to deal with every case, as every case would be uniquely unique, yes many cases would be very similar to past experiences but.....

theres also already existing pre a&e systems in place, yes they have their limitations, but theres a reason why these systems send people to a&e, sending these patience away in an emergency situation would be potentially very dangerous and extremely risky, as their condition could dramatically deteriorate unexpectedly, and services simply wouldnt be able to react to this, i.e. ambulance services may not be able to get to these individuals in time

it may seem like low hanging fruit, but......

85603

https://www.boards.ie/discussion/comment/118232058#Comment_118232058

Then something other than a plastic and stainless steel seat, and a seemingly endless wait.

One thing that makes waiting intolerable to humans is uncertainty. Thats why we do bus time displays and pedestrian crossings with timers.

A 30 min wait with certainty is a whole lot better than not knowing during a 10 min wait.

An estimated consultation time within a 2 hour window/variable is surely achieveable.

I almost fecked off home several times while using the current system as it is. The temptation is strong.

Give people a curtained cubicle, a trolley to lie/sleep on, an estimated time.

And now the a+e crisis is a lot less crisisey.

Multipass

https://www.boards.ie/discussion/comment/118232171#Comment_118232171

I went to A&E at midnight, after a mini stroke, and was told minimum of 8 hours wait. I sat on the hard chair for 2, and then decided I’d rather take my chances in my bed. I asked could I just go and come back at 6 or 7am and was told no. It’s inhumane and stupid to have people sit all night on a chair. I went to my gp next day, who sent to me to a different part of the same hospital - I forget what the name of the unit was, but it was like a secret A&E - they gave me toast and everything

riclad

Even if covid is over there, ll be 200k plus people who need treatment for long covid our medical service was not designed for a pandemic there's also a problem with highly trained medical staff getting covid they take 2 weeks off and there's no one to replace them when does covid end no one knows there's millions of people in Africa who cannot even get vaxxed out economy can't survive if we don't allow travellers to come here

It's obvious our health services are very limited already

https://www.boards.ie/discussion/comment/118232589#Comment_118232589

Shhhhsh. Don't ruin it for the other people with serious illness

mandrake04

I used to work in Pathology Diagnostics years ago, I worked over in the UK for a few years before coming back and working in Ireland for a few different companies. Some of the stuff I was working on was ex-NHS and was absolutely flogged, its was called 'refurbished' but really it should have been in the skip or on the donation boat to 3rd world counties. They did buy new equipment but this was often sweetened with a selection of old stuff as I was told the money wasn't there.

BattleCorp1

https://www.boards.ie/discussion/comment/118232023#Comment_118232023

It actually does cost that amount of money to look after someone with a severe brain injury. Remember, they have to be cared for for the rest of their lives.