What if our hospitals were run like hotels . . .

SECOND OPINION:There's plenty of room for improvement on the wards

A PATIENT OF mine who has cystic fibrosis recently had a heart-lung transplant in an English hospital. I am glad to say that it all went well, and a lovely young life was saved. I got an impressive discharge letter from the hospital. One sentence in particular jumped out at me. Before and after her time in hospital, the patient had stayed in a hospital flat. Now there is a good idea.

The Irish nation has an endearing habit of copying UK policy about 15 years later. Often the British have decided the idea was a terrible one in the first place and are doing their best to undo the damage (closing small hospitals and running motorways into cities are examples) by the time we get around to making the same mistake – but they have a winner in this one.

Every patient who has cystic fibrosis, which makes them prone to catching infections, needs appropriate care and attention. The proposed special unit in St Vincent’s Hospital should have been built years ago. And while it should still go ahead, there is a case for putting many patients, and not just those with CF, in off-site accommodation when they are recuperating or in for procedures.

What do they need between treatments? A bed, a chair, a loo, a hand basin, a shower and a telly. What they don’t need is to be on a ward with 10 or 20 ill people coughing and spluttering, scattering germs about.

Thanks to Nama and all that goes with it, the nation now owns thousands of hotel rooms that could be put to use in the health service. Any amount of pre-op, post-op patients and those with uncomplicated conditions could be put up in these rooms at a tenth of the cost of a hospital bed. It could all be in place by Christmas. Mind you, the HSE has never been cursed by a sense of urgency.

The hospital service has a lot to learn from the hotel industry. If an experienced hotel manager could be assigned to every hospital in the country we would see a difference in no time. Take outpatients, for example. Everybody is given an appointment for 9am. So there is a huge queue in the car park at peak traffic time. You might have come from Donegal and have had to stay overnight to make it for 9am, and you haven’t a hope of being seen until at least noon – but that, apparently, is your problem and you must book in anyway.

You join the huge queue at a tiny desk. When you are eventually seen, a nice big hospital chart appears, exactly like the ones used when Dev ran the show. All the information in this chart is duplicated onto a computer screen in front of you – God knows why – and you stand there as it is typed up.

You are asked your name, date of birth, and for a host of information clearly visible to you in the GP’s letter at the front of your chart. You then sit until you are directed to the phlebotomy queue or the ultrasound queue or a queue for Lady Gaga’s new album for all you know. You may have a blood sample taken and be told to pop back in a week or two for a result, which means the whole rigmarole will be repeated. Or you have to have an X-ray, which could have been done any time in the six months since your last visit. All in all, for the couple of minutes spent with the consultant, an awful lot of time, money and resources have been wasted.

Not all these features occur in every hospital, but the experience is usually chaotic, dispiriting and stressful. It is old-fashioned and unnecessary. The whole consultation could probably have been done by video link.

Imagine if you had to do all this in a hotel every time you ordered a drink or went to the pool. Imagine if every time you went to hospital the process was smooth and easy: “Eleven o’clock appointment? Certainly sir. Sign here. Click click. Here’s your card with all your electronic details. Come this way please.” All you would have to worry about would be whatever ails you, which is quite enough for anyone.

Things have moved on. The old method of banging everyone up in a bed, if they’re lucky, or on a trolley if they’re not, does not work. People now ring the hospital to see if they have a bed. They book in, go for a walk or out for a pint while the bed sits empty, like a symbol of ineptitude. It will only be needed as a place for an able-bodied person to hang about until they return from their procedure at about 4pm tomorrow. They’ll be gone home by 6pm. It is a system, of sorts, with plenty of room for improvement.

Pat Harrold is a practising GP