Madam, – The decision of Health Service Executive management to remove a medical post from the Donegal Hospice (by the simple expediency of not recruiting a doctor for next year) will result in its closure to admissions from December 21st, 2010.
This destructive “cutback” concludes a HSE management agenda of hospice staff reduction and disinvestment commenced years before the present financial recession. Hospice inpatient nursing staff level is now at an appalling 50 per cent of its original, secretarial service reduced to one day a week, we have no receptionist at the hospice door or to answer telephones, and reduction in catering staff has resulted in substitution of “cook-chill” food for individually prepared patient meals. Further proposed reductions (against clinical advice) include: removal of hospice night time care assistant, the retraction of the hospice medical service and the rostering of the remaining Hospice doctors to cover other HSE units.
The authors of these Dickensian strictures claim they will achieve savings, but international evidence overwhelmingly states the opposite. In their last year of life people use up over one quarter of their personal lifetime health service budget.
Evidence shows that a functioning palliative care service reduces hospital inpatient stay by 25 per cent and emergency department attendance by over 40 per cent. Most terminally ill patients want to live out their days at home. It is suffering that drives emergency admissions into hospital.
Hospice ameliorates the situation with a short admission for an intense multidisciplinary programme of symptom management and establishment of comfort. It works. Presenting symptoms are quickly controlled; plans are formed to get the patient home.
Hospice community services are organised to provide follow up on discharge. The hospice 24-hour advice phone line supports our patients and their carers at home and forestalls further hospital admissions.
The Donegal Hospice charity funds approximately 20 per cent of the hospice upkeep. Some months ago it displayed a keen interest in financing a questionable HSE management scheme to build a hospice extension (without extra staff). It is disappointing that this charity does not direct its manifest financial reserves towards the rescue of hospice from understaffing – or even raise objection to these pecuniary reductions in care for the dying.
If publicly tolerated, HSE management will progress nationwide with disinvesting our tax euros in specialist palliative care, under the umbrella of recession. The dying cannot tighten their belts until the recession fades and the good times return.
Is their last experience of life to be that society has abandoned them to suffering – for a pittance of savings?
– Yours, etc,