The current hospital / A&E crisis

"We as a nation are the big problems with the hospitals"

Yeah sure we are. It's not like there are kids waiting 2 years + to get treatment for scoliosis. It's all our fault though. FFS, you would swear attacking the health system is a personal attack on some of it's ardent defenders.

Wait till it happens your own kids then I'm sure you will be lashing out. I'm alright jack morons.

Not at this moment in time. You are wrong. That would be a patients' perspective at a normal busy time and if you don't mind me saying, would be fairly limited.

II have worked through this for the last 40 years and thankfully no longer have to. But this is much worse than any other year currently.

I know normally that what you say may be applicable.

But now the heat is on there will be extra scrutiny on who is coming in, whether they can be postponed safely with a referral for procedures at a later date or to be done on the NTPF in a private facility. There will be consultant led teams clearing bed blockers( as you refer to above) on the wards, discharging and sending to step down care anybody that can be.

You won't get people in for elective procedures or day cases. All will be cancelled Thise beds will be used as A&E overflow.

Thats how this situation works whenever there is a crisis. The problem is the double whammy of high Covid cases and Flu cases also requiring admission for oxygen and IV antibiotics and monitoring.

ICU is not overwhelmed.. yet.

Problem is not only lack of beds in acute hospitals but lack of step down hospitals (all those down graded and closed by successive governments) and lack of community nurses and community care (again poor policy decisions and no commitment by government to Sláintecare which could have alleviated this pressure on hospital led care)

The lack of nursing and medical staff due to attrition after Covid along with high costs of housing in cities, and emigration is another issue.

Not much point making more beds if there are no staff to run them.

We in nursing have been calling these issues out for many years and successive governments have tinkered around the edges but not taken the Healthcare system in hand and progressed a complete and ongoing reform . Slaintecare for all its failingswould have been a big improvement and was agreed as the way to go but is dying for lack of attention by one taoiseach after another.

You watch Leo pass the buck and Donnelly " overseeing" emergency measures that are already ongoing, vis a vis UHL. They will try to take the credit for what is already being done but as usual none of the blame, and once this crisis is over it'll be shoved behind the door until the next crisis, with nothing of any note or import done in the meantime.

Bit cynical I know, but all the positivity and hope gets knocked out of you when you have faced this year after year, all your working life.

Ireland needs a hugely expanded privatized primary care service.

At least with that the middle class can actually get to see a doctor for them and their kids. You pay money and you get a service. Its not cheap but at least it works.

The current situation is a huge disaster. Even if you are paying for prviate insurance, willing to pay the high GP fees you still can't see a GP within any reasonable time frame. Its causing so much pain and worry to patients as well as stressing the hospitals to hell.

Fail. Fail.Fail.

Start again with vastly expanded private clinic chains. Get private investment in to open more clinics and hire more doctors. They dont need to be surgeons just reasonably competent and AVAILABLE to see you. TIMELY treatment is a very important health metric. Clinics can then compete to offer better services.

GP system is absolute ****, a relic from the dinosaur age that charges high fees but can't keep up with the demands on it (increased population, aging population ) nor are they willing to work weekends and evenings much either.

All our family work in healthcare, it’s the price of doing business.

I only recently learned about them. There is no mention of such things at the GP and pharmacy and the only place I learned about their existence was the A&E.

They or you should have kicked up more of fuss, you pay your PRIS and are entitled to the treatment under the public systems, a medical card has nothing to do with it.

Interesting

Lovely, so much of the country is nowhere near one!

That would explain why I haven't heard of them.

Exactly, they should be everywhere. We have one in our town. Amongst the family, we've had to use it 4 or 5 times (cuts that required stitches, a broken foot, broken rib) and it was great. Never spent more than 90 minutes in there, and that was including x-rays. They're only open during the day, though, and there's limits to what they'll treat. But still, they would take a huge load of A&Es if used properly and were more common.

The Triage teams in E.D.s should be empowered to turn away cases that can be perfectly well dealt with at minor injury clinics or private centres or primary care centres.

I know thats not how the system is supposed to work, but minor breaks, sprains and bruising simply cannot be at the E.D. in this period. The very old and very young and those with serious respiratory illness must be prioritised.

Obviously complex orthopaedic injuries should still come to the E.D., but not little Johnny's broken wrist or collar bone.

The prevailing 'compo culture' is partly to blame. Up to the 1990's or so, GP's would treat a large range of ailments and injuries but now they refer almost everything on to cover their backsides in case they may have missed something bigger. It's years since I've heard of a GP doing suturing, when once it was commonplace.