HEART BEAT Maurice NeliganToday I was stung by a jellyfish. I discovered that I was no St Francis, and that for me praying for or with Brother Jellyfish was a step too far.
Currently, we have an incursion of jellyfish. They are not the common or moon jellies, with the four purple rings who I can tolerate on a live-and- let-live basis. These boys/girls, as I believe they are unisexual, are the more menacing looking compass jellies. They give an unpleasant although hardly life-threatening sting and I would rather not meet them socially. This poses a problem for the myopic swimmer and today I lucked out and retreated to coffee and the paper.
I don't expect good medical news and I was not disappointed. My tranquil mood dissipated completely. There were multiple reasons why. But first, I have to address an error, rather an omission, in something I wrote last week about the lowly position occupied by Ireland in the latest European table of health statistics.
A member of the public wrote and chidingly pointed out that we were not at the bottom in everything. In fact, he alleged that we were near the top in the numbers of administrators and in the amounts they are paid. He also pointed out that we lead the world in "expert" reports, committees, sub-committees, spin doctors and outside non-medical consultants. It is only in the less-important area of patient care that we perform so abysmally. I stand corrected.
So what perturbed me? Firstly the latest figures for acquired hospital infection. They were all there - MRSA, VRE, Clostridium difficile, etc. This has been a serious concern for hospitals and infection control teams for years.
Many proposals to alleviate the problem have been advocated - dealing with hospital overcrowding and appointing additional infection control staff. These recommendations were accepted including the creation of 52 such posts. The posts were not filled, the avowed reason being the cap on further appointments in the public sector. The Minister for Trolleys added her piece. The doctors and nurses should wash their hands!
Far from alleviating the problems of overcrowding she actually recommended that an extra bed be placed in each ward to help with the trolley problems in A&E departments.
Until the latest figures were published, little appeared to happen. Now in the face of waves of negative publicity, there is movement. Funding has been found for these essential posts.
This is a serious problem and demands serious commitment. It will require resources and trained personnel to deal with it. Even then it is a near certainty that it will be with us for the foreseeable future. In the light of these latest figures, why was the approval for such posts not given earlier? Nobody will be responsible for the delay, as usual.
Pat O'Byrne, chief executive of the National Treatment Purchase Fund, writes to correct any misleading notions I may have disseminated about the fund. I used the word unaccountable, and Mr O'Byrne baldly states this is untrue.
All right Mr O'Byrne, to what hospitals and in what numbers have these patients been referred? For what procedures have they been referred? How much have these institutions charged for the various procedures? Have some had their procedure in the very hospital from which their names had been taken from the waiting list? If so, why? Where are such figures readily available to the public? Do you publish them? Please don't hide behind "commercial sensitivity", just tell us the figures.
It gets worse. In response to my allegation that waiting lists are being hidden, Mr O'Byrne says that through the Patient Treatment Register "we now have for the first time a fully transparent, open and accountable management collation of waiting lists in Ireland".
As I find difficulty in finding this wonderful tool, could you please let us all know simple things, eg how many patients await initial rheumatology consultations in Ireland? How many patients await neurology consultations, orthodontic treatment, psychiatric assessment, neurosurgical procedures, hip and knee replacements etc, etc? The list is endless.
Finally the crowning gem: "The NTPF is a resource for patients throughout the country many of whom waited unreasonably long periods for surgery." Whose fault was that Mr O'Byrne? Why were the facilities not there? Why are these facilities not being provided right now?
Perhaps a clue to all of this lies in another snippet in The Irish Times of the same day, July 6th. This refers to difficulties being experienced by the Galway Clinic. It states that James Sheehan, its founder and one of the founders of the Blackrock Clinic, ascribes these difficulties to inadequate cover from the VHI and to insufficient referrals from your NTPF.
The VHI is more than capable of answering this criticism but Mr Sheehan's second point bears examination. Is it a function of the NTPF to prop up private hospitals which otherwise might not survive? This is important, in view of the number of such developments being planned. Anybody but a complete fool must know that these are not viable on present insurance cover alone. Adding to the hiding of the waiting lists, are we seeing the privatisation of the health service by stealth?
Lastly Mr O'Byrne, I hope you enjoyed Mary Raftery's excellent column in the same edition. She's not fooled either.
Maurice Neligan is a cardiac surgeon.