Hundreds on trollies reflects paltry funding of GP services

The best time to fix the health service was 20 years ago.The second best time is today.

Many of us driving to work have a Groundhog Day feeling as we hear about the number of people lying on trollies in hospital corridors.We are told there are many causes for the annual crisis, but none of the problems ever seem to get solved.

Does the solution lie with the patients? Obesity is a huge problem and children can now expect to have shorter lifespan than their parents.But fewer of us are smoking and we are constantly being told to eat less and exercise more.

The uptake of the anti-flu injection is poor among those who need it.There is a case to made for intensive management of the patients with chronic conditions who soak up an inordinate amount of the health budget by neglecting their medications and missing appointments.

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The primary care strategy has been grinding along for years without ever properly taking off due to paltry funding.Yet research shows primary care is shouldering a huge amount of the work in the health service, doing about 95 per cent of the work for 4 per cent of the budget, and it is starting to creak badly. GPs are getting old and tired and are carrying an unfair burden.

Work harder for less

If these GPs had not managed to work harder for less, the numbers on hospital trollies would be in the the thousands, not hundreds. But it is taking a toll on their health,their practices and their families.

Even with the addition of the under-6 GP visit card, most GPs manage to see most patients on the day a consultation is sought, unlike in the UK where it takes a week to see a GP, and a very small number of those patients end up in hospital.

If GPs were properly resourced to hire extra doctors, if doctors could be paid properly to work in rural and deprived areas, and if practice support could be enhanced to provide nurses and administration staff to maximise patient health and provide optimum care for chronic illness and the elderly, many of these patients would not trouble the hospital system at all.

International evidence has shown that a euro spent on primary care goes a lot further than it does in secondary care. So put the money into keeping people at home and keeping them well,with home helps, social workers and whatever it takes.

Wards lie empty

Small hospitals, in many cases, have been downgraded.Wards lie empty in county towns where once the majority of patients were admitted, treated and discharged.There was a move to centres of excellence,which may have been all very well if the centres of excellence had been ready for the move. It is now obvious they were not.Would it be so terrible to wind back the clock a little and open up the smaller hospitals again?

There is a major difficulty with the shortage of nurses.This is a worldwide problem .The solution would seem to be to pay them properly and give them decent conditions.There seems to be no debate about paying managers.

We have one of the most expensive healthcare systems in the world and it does not deliver for the price.

Not only would we seem to have an inordinate number of managers ,but we seem to be short of people who can manage.

I would hire a hotel manager for each hospital and see what they would come up with.

A lot of hospital equipment, like MRI scanners, lie idle from 5pm-9am, even though the patients are still on the premises . Imagine if you were in a hotel where the telly and the bar shut at 5pm.

Dr Pat Harrold is a GP in Nenagh