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UCHG A&E

Shakti

Friend spent 14 hours in A&E last night,
When are Conneely, Crowe et al. going to get up off their arses and do something about this? It's like an episode of MASH in there, stress levels are through the roof, people are suffering and mistakes are being made.

The sheer ignorance of Conneely sighting concerns about Hospital Smokers while its a warzone in A&E.

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Sniipe

Shakti wrote: »

There is only ONE public MRI machine for the entire west of Ireland even though a recent study found that we have the highest rate of pancreatic cancer in the country.

Shakti wrote: »

They are private,

Your previous statement is still wrong. However, I am curious; can the public hospitals not use those MRI's when there is a queue?

2rkehij30qtza5

Sniipe wrote: »

Shakti wrote: »

There is only ONE public MRI machine for the entire west of Ireland even though a recent study found that we have the highest rate of pancreatic cancer in the country.

Shakti wrote: »

They are private,

Your previous statement is still wrong. However, I am curious; can the public hospitals not use those MRI's when there is a queue?

No they can't unfortunately. It's criminal really the way ppl without health insurance or the money to pay for private treatment are treated.

Shakti

Sniipe wrote: »

Your previous statement is still wrong. However, I am curious; can the public hospitals not use those MRI's when there is a queue?

Wrong? how so?

Mrs OBumble

Jad Inexpensive Numerology wrote: »

No they can't unfortunately. It's criminal really the way ppl without health insurance or the money to pay for private treatment are treated.

Are you seriously saying that the private sector will not accept publically-funded patients into those machines, paid for by, say the NTPF?

I'm afraid my BS detector is a-twitching.

biko

Everyone please calm down a bit or Kitty will get angry

Sniipe

Shakti wrote: »

Wrong? how so?

My bad - I missed the word public. Sorry.

JustMary wrote: »

Are you seriously saying that the private sector will not accept publically-funded patients into those machines, paid for by, say the NTPF?

I'm afraid my BS detector is a-twitching.

I thought the same as this.

Anyway ; there are 2 public MRI machines in Galway. 1 in merlin park and one in the regional hospital.

The ones in the clinic and the bons are private but public patients can use them if they are in the waiting list for the NTPF. However this is a 6 month contract from the government and currently the bons are not contracted... perhaps this is true also for the clinic currently. I guess the government look at how many are in the queue and then decide to take out a contract with a private hospital to assist with the waiting list.

2rkehij30qtza5

JustMary wrote: »

Jad Inexpensive Numerology wrote: »

No they can't unfortunately. It's criminal really the way ppl without health insurance or the money to pay for private treatment are treated.

Are you seriously saying that the private sector will not accept publically-funded patients into those machines, paid for by, say the NTPF?

I'm afraid my BS detector is a-twitching.

Justmary, I'm sure if someone, whoever that may be, is willing to pay the €500 to get it done, then yes, the private hospitals will take the money. But as standard practice, no it is not done where a public patient gets one in a private hosp paid for by the HSE. I know this because I was recently in hospital and the woman I was sharing a room with had this issue. She was public, long wait for MRI publicly. She asked to get one privately and was told no (by her consultant) as that is not done. Now I am sure there are exceptions to every rule but as a rule, NO they are not done privately and I've better things to be doing than feeding your 'bs detector' tbh.

Shakti

Sniipe wrote: »

My bad - I missed the word public. Sorry.

Thanks and thats quite alright,

I thought the same as this.

Anyway ; there are 2 public MRI machines in Galway. 1 in merlin park and one in the regional hospital.

The ones in the clinic and the bons are private but public patients can use them if they are in the waiting list for the NTPF. However this is a 6 month contract from the government and currently the bons are not contracted... perhaps this is true also for the clinic currently. I guess the government look at how many are in the queue and then decide to take out a contract with a private hospital to assist with the waiting list.

As far as I know the MRI machine in Merlin Park is part of a "private medical imaging centre located on public land within the grounds of Merlin Park Hospital" in 2010 it came to light that it was owned in part by Dr David O’Keeffe the Clinical Director (boss) of UCHG at the time*.

*http://www.galwaynews.ie/16761-galways-public-hospital-boss-owns-private-mri-facility

_Whimsical_

JustMary wrote: »

Are you seriously saying that the private sector will not accept publically-funded patients into those machines, paid for by, say the NTPF?

I'm afraid my BS detector is a-twitching.

Why the level of agression?

The NTPF only kicks in after you have been waiting a certain length of time,most often thats too long if you have a serious illness that requires diagnosis. These days the NTPF aims to tackle backlogs in particular areas rather than routinely accept all patients waiting over a certain period who are referred. Even in the boom time people on public lists have died waiting for routine diagnostic procedures they could have done in a matter of days if they were private patients. One famous case was Susie Long just 5 years ago.

Wompa1

Back in 2000 there was no MRI machines in the west. My dad had a suspected stroke so they wanted to airlift him to Dublin for an MRI. I remember my dads friend who worked in the US for a while saying that the Chicago Bears NFL team had something like 6 MRI machines in their stadium.

I really don't know where the money from the Celtic Tiger went. The road and railway were subsidized by the EU. The healthcare system sucks....I'm guessing it's lining the pockets of all the politicians..

KittyeeTrix

biko wrote: »

Everyone please calm down a bit or Kitty will get angry

Rawrrrrr.....:p

I don't pretend to know anything about how the hospitals are run but I can empathise with the discontent of public patients faced with a trip to A and E.
My own Mum spent 70 hours on a trolley once whilst suffering a stroke. I wrote a letter to the Advertiser about it at the time where I praised the staff in the face of such limited resource.

Mrs OBumble

_Whimsical_ wrote: »

Why the level of agression?

The NTPF only kicks in after you have been waiting a certain length of time,most often thats too long if you have a serious illness that requires diagnosis. These days the NTPF aims to tackle backlogs in particular areas rather than routinely accept all patients waiting over a certain period who are referred. Even in the boom time people on public lists have died waiting for routine diagnostic procedures they could have done in a matter of days if they were private patients. One famous case was Susie Long just 5 years ago.

I'm sorry if you perceived my post as aggressive: it wasn't intended to be, and I cannot see it myself (even after waiting overnight before replying).

It is mad that we're having this discussion about MRI access based on someone meeting someone whose consultant refused to refer her for a privately-funded scan, for reasons unknown to us.

My mother spent years waiting for a knee replacement because her GP believed that the public system should provide it for her. In the meantime she got more and more crippled, so that the rest of her body was screwed by the time she got the surgery. But the GP's ideological baises were satisfied.

We interweb-randoms have no way of knowing if a similar dynamic was at work here or not.

But on a broader note, no country's health system will ever provide all the care that its citizens could benefit from: that's just the nature of health-care, there is always more that can be done. Each country has to decide how to spend its resources - and while I don't doubt that celtic tiger money lined the pockets of politicians, it's the general public who elected those same politicians and continues to allow corrupt behaviour from them to go unchecked.

bagels

Rob A. Bank wrote: »

I really don't know where to start with this ridiculous post...

I could respond by stating "I really don't know where to start with this ridiculous post..." but i don't resort to personal insults nor denigrating other posters contributions to a discussion.

Rob A. Bank wrote: »

How do you know ? Figures please...

I'm not in possession of actual statistics, however i rarely hear of the A&E being praised. I am aware though of very many complaints regarding the service provided at A&E. I and my family have attended A&E on many occasions and our good experiences are far outnumbered by the the bad.

Rob A. Bank wrote: »

But the beds are all full and do not exist on the ward, that's why people end up on trollies.

Thats why i pointed out the problem and the need for it to be resolved.

Rob A. Bank wrote: »

X-rays are very dangerous to humans and there has to be a risk/benefit analysis done for the potential information gained from the procedure... And that is a doctor's job. Your idea would cause a rise in cancer rates in Galway.

If a GP with decades of experience decides that his patient requires an x-ray, then it is unreasonable for the patient to have to wait many hours in A&E for a trainee doctor to eventually send the patient for x-ray or, worse still, refuse to do so. The referral letter from the GP should be treated as an instruction to the hospital and not as a begging letter. Common sense should prevail, not the protection of petty fiefdoms. If a bone of my body was protruding through the flesh, i'd prefer to have a speedy x-ray rather than wait indefinitely in A&E with the wound exposed to infection. As for cancer, once again i refer you to common sense.

Rob A. Bank wrote: »

Not everyone going to A/E needs a blood test, and different types of blood tests need different types of anticoagulants in the tubes. The nurse is to take all possible blood tests from everyone attending A/E ??? Your idea would cause greatly increased costs and a rise in anaemia in Galway.

From the letter of referral it must be obvious to the triage nurse that certain patients definitely require bloods to be taken. As the triage nurse isn't run off his/her feet then he/she should take the bloods and set in motion the diagnostic procedure. If the A&E doctor requires further tests then it shouldn't be a problem. As for greatly increased costs, do your CBA in respect of the patients work output, compare the results and then provide proof of which has the more detrimental effect on our GDP/GNP. Your reference to anaemia is purely speculative and entirely without foundation.

Rob A. Bank wrote: »

Can you produce any objective evidence to support this accusation ?
I thought not !

I think what you meant to state was 'empirical' evidence, rather than objective. I don't have empirical evidence, only my own observations and those of family, friends & acquaintances. I'm satisfied as to the authenticity of those. Anyway, the hospital authorities are hardly going to compile records of queue-jumping in A&E, are they?
Your haste in answering your question for yourself, ref "I thought not !" was the equivalent of an interruption. Why ask me a question if you're don't want me to answer and instead you answer yourself?

Rob A. Bank wrote: »

If that is not an attack on the professional competence of the triage nurses, what is ?

It wasn't an attack on the personal competency of anybody, it was merely an utterance of my experience and that of many others who attend A&E. However, triage nurses aren't gods/angels/etc to be bowed down to, they're workers being paid a good wage for what they do or don't do, regardless of whether they do it well or otherwise.

Rob A. Bank wrote: »

I asked for any objective evidence to support this accusation, and I am still waiting......

I refer you to my more than adequate answer above.

Rob A. Bank wrote: »

Perhaps Health Minister Dr James Reilly should have a look at Galway A/E too.:(

He did. Just a few months ago he visited A&E unannounced and spoke with staff and patients there. How come you didn't know that? Afterwards he made public his dis-satisfaction that the unit was not operating as it should. Who operates the unit, patients?
No, the A&E staff under the conditions imposed upon them by hospital management, their unions and the staff themselves. I reckon theres room for compromise by all parties. Meanwhile patients suffer.

_Whimsical_

Excellent post Bagels. Fully agree!

Shakti

bagels wrote: »

I reckon theres room for compromise by all parties. Meanwhile patients suffer.

without a doubt,

Rob A. Bank

bagels wrote: »

I could respond by stating "I really don't know where to start with this ridiculous post..." but i don't resort to personal insults nor denigrating other posters contributions to a discussion..

Now hang on a minute !!!! I never ‘personally’ insulted you or anyone else on these boards. I simply commented to the content of your post, as did others who referred to “armchair hospital management experts“.

I'm not in possession of actual statistics, however i rarely hear of the A&E being praised. I am aware though of very many complaints regarding the service provided at A&E. I and my family have attended A&E on many occasions and our good experiences are far outnumbered by the the bad..

So without actual statistics, your statement: “No matter how good UCHG A&E is purported to be, the complaints greatly outnumber the compliments.” is pure conjecture and guesswork.

Thats why i pointed out the problem and the need for it to be resolved..

You originally said “If the staff there were able to admit patients to the wards in a timely fashion, then perhaps waiting times might be halved.“ The A&E nurses are not conjurers or miracle workers and cannot admit people into non-existent beds on the wards. The problem will only be resolved when there are enough beds to meet the public’s need, funded by the politicians… until then the trolley issues will remain.

If a GP with decades of experience decides that his patient requires an x-ray, then it is unreasonable for the patient to have to wait many hours in A&E for a trainee doctor to eventually send the patient for x-ray or, worse still, refuse to do so.

What are you on about ? If a GP needs an x-ray... the patient is referred straight to the Radiology Department, not A&E !!!

The referral letter from the GP should be treated as an instruction to the hospital and not as a begging letter. Common sense should prevail, not the protection of petty fiefdoms. If a bone of my body was protruding through the flesh, i'd prefer to have a speedy x-ray rather than wait indefinitely in A&E with the wound exposed to infection.

So are you going to pay for a hospital many times the size of UCHG when there is no screening of admissions at the door ? Anyway, that is a hospital management issue and has absolutely nothing to do with the people who work in A&E. The rest of your comments about ‘petty fiefdoms‘ bones protruding through flesh and infection sound hysterical, purely speculative and entirely without foundation, simply because open fractures would be triaged straight away into the assessment area, if possible.

As for cancer, once again i refer you to common sense.

And I refer you to the Radiological Protection Institute of Ireland … who are “Ireland’s expert voice on ionising radiation.” Their role is to ensure that Irish people and the environment are adequately protected from the harmful effects of ionising radiation. I would suggest they know a little more about the subject than you do. They clearly say “All medical exposures to radiation must be clinically justified and should only be carried out if recommended by a GP or medical consultant.” Yet in your original post you suggested that “the triage nurse send patients for x-ray without the patient having to be seen by a doctor first ” !!!

exposureSourcesPieChart.aspx

On average, a person in Ireland receives 540 μSv per year from medical procedures (over 13% of the total exposure) and radiation dosage and damage is cumulative, thereby increasing the incidence of cancer. So basic common sense would dictate that all unnecessary radiation exposure should be avoided. Your notions would blast the Irish population with God only knows how many extra microsieverts.

From the letter of referral it must be obvious to the triage nurse that certain patients definitely require bloods to be taken.

Not everyone who attends A&E has a letter and very little is ‘obvious’ in medicine. If everything was ’obvious’… doctors and nurses could qualify with a 2 week correspondence course !

Your reference to anaemia is purely speculative and entirely without foundation.

I suggest you Google ‘iatrogenic anaemia’ before you suggest that everyone coming to A&E should be bled without any clinical justification.

I don't have empirical evidence, only my own observations and those of family, friends & acquaintances.

Random observations are no basis on which to decide hospital or A&E management issues.

It wasn't an attack on the personal competency of anybody, it was merely an utterance of my experience and that of many others who attend A&E. However, triage nurses aren't gods/angels/etc to be bowed down to, they're workers being paid a good wage for what they do or don't do, regardless of whether they do it well or otherwise.

Really ? May I remind you of your previous ‘utterance‘: “Drunkards, junkies and travellers far too often are jumped ahead in the queue, not out of medical necessity, but merely because they'll make a nuisance of themselves. So much for triage.”

Smells like an attack on the commitment and competence of the A&E nurses to me, particularly the scornful “So much for triage” bit at the end. And BTW I don’t think the nurses in A&E are paid half enough, considering the abuse they have to take from ill informed people (and “armchair hospital management experts“) for things that are totally beyond their control.

He did. Just a few months ago he visited A&E unannounced and spoke with staff and patients there. How come you didn't know that? Afterwards he made public his dis-satisfaction that the unit was not operating as it should. Who operates the unit, patients?
No, the A&E staff under the conditions imposed upon them by hospital management, their unions and the staff themselves. I reckon theres room for compromise by all parties. Meanwhile patients suffer.

I didn’t know that Dr James Reilly visited UCHG A&E, quite simply because I was not a patient there when he dropped in.

Yet our dear minister for health allowed Letterkenny to open a brand new Emergency Department and medical admissions unit… Meanwhile Galway patients suffer in an inadequate building which is not fit for purpose.

There is a very simple way to resolve the A&E situation… Make a law that those responsible for funding public hospitals must attend them. In other words, that all government Ministers/TD’s and their families (as far as first cousins) are banned from private hospitals and must use public hospitals and A&E facilities. They would get an earful about the problems at all meals, weddings and family gatherings… and the problems would be sorted in no-time flat.

And if the TDs moan about that law, include second cousins too.

bagels

_Whimsical_ wrote: »

Excellent post Bagels. Fully agree!

Thank you for your kind words.
Unfortunately any and all suggestions are prone to be shouted down by the misguided defenders of the current fiasco in A&E.
Some can't even accept that A&E gives rise to a multitude of well-founded complaints and very, very few compliments.
One even suggested that the Minister should visit UCHG A&E, ignorant of the fact that the Minister had done so only a few months ago.
I suspect only vested interests could defend the running of UCHG and, in particular, the A&E therein.
I'll leave them to it.

ted2767

Yet our dear minister for health allowed Letterkenny to open a brand new Emergency Department and medical admissions unit… Meanwhile Galway patients suffer in an inadequate building which is not fit for purpose.

Have you got some issues with the people of Donegal getting access to emergency departments?

Just cause the administrators and/or medical staff in uchg are particularly inept is no reason to deny services to the rest of the country.

Rob A. Bank

ted2767 wrote: »

Have you got some issues with the people of Donegal getting access to emergency departments?

Not at all...

But anyone who has been in the Galway A&E would realise that we need a new Emergency Department and medical admissions unit too.

ted2767

Rob A. Bank wrote: »

ted2767 wrote: »

Have you got some issues with the people of Donegal getting access to emergency departments?

Not at all...

But anyone who has been in the Galway A&E would realise that we need a new Emergency Department and medical admissions unit too.

Luckily I've never been to uchg A&E but I've heard that it is fairly dreadful.
I'm not entirely sure a new building is whats needed.
Personally I'd prefer the adminstrators/staffing to be sorted out first before any new buildings are undertaken.

Shakti

ted2767 wrote: »

Luckily I've never been to uchg A&E but I've heard that it is fairly dreadful.
I'm not entirely sure a new building is whats needed.
Personally I'd prefer the adminstrators/staffing to be sorted out first before any new buildings are undertaken.

The current A&E is simply not fit for purpose either for patients or staff,

hondasam

ted2767 wrote: »

Luckily I've never been to uchg A&E but I've heard that it is fairly dreadful.

Rob A. Bank wrote: »

But anyone who has been in the Galway A&E would realise that we need a new Emergency Department and medical admissions unit too.

Shakti wrote: »

The current A&E is simply not fit for purpose either for patients or staff,

I'm not sure it's all that bad tbh. I have been there numerous times and had some good and bad experiences.
I'm not sure a bigger building is the solution.

Rob A. Bank

ted2767 wrote: »

Luckily I've never been to uchg A&E but I've heard that it is fairly dreadful...

Personally I'd prefer the adminstrators/staffing to be sorted out first before any new buildings are undertaken.

Why ?

ted2767

Rob A. Bank wrote: »

ted2767 wrote: »

Luckily I've never been to uchg A&E but I've heard that it is fairly dreadful...

Personally I'd prefer the adminstrators/staffing to be sorted out first before any new buildings are undertaken.

Why ?

Because it's people that make anything work not their surroundings and that goes for any walk of life or business.

A new shiny building means nothing will really change except the scenery it'll just be the same over crowded A&E with the
same inept administrators in a new setting.

Thats why!

Shakti

ted2767 wrote: »

Because it's people that make anything work not their surroundings and that goes for any walk of life or business.

A new shiny building means nothing will really change except the scenery it'll just be the same over crowded A&E with the
same inept administrators in a new setting.

Thats why!

With respect Ted you should really take a look at the cramped conditions in Galway UH A&E, I believe a modern working space which amongst the numerous would include the required appropriate square footage would go a long way to helping the staff work better and more efficiently, fact is they have been working in an ever shrinking space for well over a decade.

Rob A. Bank

ted2767 wrote: »

Because it's people that make anything work not their surroundings and that goes for any walk of life or business.

A new shiny building means nothing will really change except the scenery it'll just be the same over crowded A&E with the
same inept administrators in a new setting.

Thats why!

You have never been there !

Yet you have prescribed a remedy which involves delaying a new building !!!

The unit is too small for the number of people attending and is therefore not fit for purpose.

ted2767

Rob A. Bank wrote: »

ted2767 wrote: »

Because it's people that make anything work not their surroundings and that goes for any walk of life or business.

A new shiny building means nothing will really change except the scenery it'll just be the same over crowded A&E with the
same inept administrators in a new setting.

Thats why!

You have never been there !

Yet you have prescribed a remedy which involves delaying a new building !!!

The unit is too small for the number of people attending and is therefore not fit for purpose.

And yet new A&E departments in places like Tallaght and university hospital Cork are just as crowded and the delays almost as bad as in Galway.
Why?
Because of the system thats why
Were the medical system better organised many less people would present at A&E as their primary health care provider i.e. doctors, community nurses etc. would see them instead and those that did present at A&E would be seen faster hence less overcrowding.
All this would cost a lot less than a new hospital or new departments.
As I said just building a new department without changing work practices is a waste of money.
Solve beauracry in the HSE and you will go a long way to solving the problem but I know thats easier said than done.

Rob A. Bank

ted2767 wrote: »

As I said just building a new department without changing work practices is a waste of money.

Solve beauracry in the HSE and you will go a long way to solving the problem but I know thats easier said than done.

Really ? What do you know about UCHG Emergency Dept. work practices ? Being someone who has never darkened the door of UCHG A&E !

It's the fourth busiest emergency department in the country, seeing over 60,000 patients a year, with only 2 resuscitation bays, 9 treatment bays in the major’s area and 3 in the ambulatory care area plus 2 paediatric bays.

Moving acute orthopaedic patients from Merlin Park and the closing of Roscommon A&E have further added to the workload, without any increase in the unit’s size. 12,500 patients/year used to be seen in Roscommon A&E before it’s closure.

It's simply too small for the job it's supposed to be doing.

ted2767

Rob A. Bank wrote: »

ted2767 wrote: »

As I said just building a new department without changing work practices is a waste of money.

Solve beauracry in the HSE and you will go a long way to solving the problem but I know thats easier said than done.

Really ? What do you know about UCHG Emergency Dept. work practices ? Being someone who has never darkened the door of UCHG A&E !

It's the fourth busiest emergency department in the country, seeing over 60,000 patients a year, with only 2 resuscitation bays, 9 treatment bays in the major’s area and 3 in the ambulatory care area plus 2 paediatric bays.

Moving acute orthopaedic patients from Merlin Park and the closing of Roscommon A&E have further added to the workload, without any increase in the unit’s size. 12,500 patients/year used to be seen in Roscommon A&E before it’s closure.

It's simply too small for the job it's supposed to be doing.

Because I've worked in A&E departments in Ireland I believe that I know a thing or two about how they work.

Also I said I was lucky never to have had occassion to go to the unit in UCHG not that I never darkened its doors, but don't let that stop you as you seem to have ignored most of what I've said.

So therefore I believe that I'm a lot more qualified to comment on it than you.

Rob A. Bank

ted2767 wrote: »

And yet new A&E departments in places like Tallaght and university hospital Cork are just as crowded and the delays almost as bad as in Galway.
Why?
Because of the system thats why

I agree with you there, the system is at fault.

And as long as the two tier Private/Public health care system exists in Ireland, the chaos in public A&Es will continue and get worse, simply because lots of people cannot afford health insurance any longer, putting further strain on the public system.

In general you get the quality of health care system you pay for… UNLESS you try to copy the crazy, incredibly wasteful, inefficient market based system in the USA, which is exactly what we have done. Mainly thanks to that bag of lard ex-health minister and her doctrinaire Friedman-esque right wing views.

A gold plated health system for the rich and an under-resourced ‘safety net’ public health care system for everyone else.

‘Crazy’ because it consumes 16% of the USA’s GDP (almost twice as expensive as the average for the developed world) and gives them a health service which ranks 37th out of 191 national health care systems in the world, according to the World Health Organization and others. And the situation looks even worse if you look at the US per capita spending on health care.

IMHO the health care system should be looked at as a public service, like the fire brigade or the police, rather than another money-generating opportunity for the greedy 1% (the ‘golden circle’ of politician‘s benefactors and friends). The so called "free market" approach to health care means profit will always come first before society’s health needs.

I wonder how people would feel if the fire brigade also ran a two tier system ?… You get the most expensive fire engine for your burning house if you are rich, the ‘safety net’ fire engine (with delays) if you cant pay.

As long as the two tier system exists and politicians, and their families, don‘t have to use the public A&E in Galway themselves, things will continue to deteriorate.