Sláintecare more relevant in post-Covid-19 world than ever before
The Irish people will no longer accept the old ways, nor should they
All over Ireland in recent weeks, people like me who work in the health service have experienced a strange sensation: Overt, unabashed pride in the service we are delivering, echoed by warm public reaction and approving commentary.
Responding to a global pandemic is not the circumstances in which we would have wished this situation to arise, yet like so much in recent weeks it has been thrust upon us.
While we exist still in a maelstrom of so much death, suffering and pain it is nigh on impossible to fully reflect on what is afoot here, yet we owe it to one another and to the future, to try to understand what is going on under the bonnet.
Certain things which now seem self-evident, and maybe always were, have defined the response of the health service to the current challenge.
In our public hospitals, the speed with which you are treated now depends only on your need rather than your ability to pay
The first has been widespread, enthusiastic acceptance that the needs of the citizen in their time of illness are central to the operation of the service and that all available resources must be mobilised to service that end. The patient now moves relatively seamlessly through the system.
Rather than being considered a form of bijou temporary accommodation, trolleys are now used for the far higher purpose of ferrying patients to cohorted wards where they are now cared for by doctors and nurses proficient in the disease they have come in.
No longer do patients have to navigate the labyrinthine system of on-call teams, speciality teams, consultations and professional courtesy, or discourtesy that stands between them and timely diagnosis and treatment, which after all is what they came for.
Telemedicine and remote clinics that otherwise would have been discussed and piloted to death for years just happened overnight, everywhere. Inter and intra-hospital co-operation is mandated rather than an optional extra.
Meetings that should have been emails are now just emails. Paper in general, is considered, well, all a bit 2019. Important diagnostics are being done in the community using all the sinews of the service.
Work is no longer duplicated or triplicated in our emergency departments, where senior decision makers of all specialities are more proximate.
In our public hospitals, the speed with which you are treated now depends only on your need rather than your ability to pay. The private system, for its part, is now leveraged to enable the public system, rather than the inverse.
We have belatedly realised that healthcare workers are useful and good people, in demand the world over, who will stay here and serve us if we just treat them with a bit of humanity.
Those four letters G, D, P and R are no longer accepted as the antidote of choice to doing the right thing when you’re not sure if you really want to do it.
What awaits the health service on the far side of this crisis is not pretty. Chronic disease and early cancer is perfectly happy to work from home during the lockdown, safely hidden away from scans and scopes and the prying eyes of specialist teams. Astronomical waiting lists will become intergalactic ones.
Any success our health service has had in recent weeks has come from embedding Sláintecare’s core principles of community and patient-centredness
The poverty, unemployment, despair and all their attendant miseries of physical and mental health that we became so familiar with in the last recession will return.
Our already depleted corps of healthcare workers will be physically, mentally and emotionally exhausted to a degree to which some will never fully recover. The healthcare spending hawks of the commentariat so uncharacteristically quiet now are doubtless sharpening their quills.
Business as usual will not be an option.
Students of the project will no doubt recognise that any success our health service has had in recent weeks has come from embedding Sláintecare’s core principles of community and patient-centredness.
Citizens are getting the right care, in the right place, at the right time, delivered with empathy, equity and efficiency using the best technology.
The people have spoken and while parts of this compromise plan need finessing, there should be no going back
Sláintecare is more relevant in a post-Covid world than ever before. Calls to abandon it from those who are spooked by one or more provisions in the plan are well-intentioned but wrong-headed and opportunistic.
The Irish people will no longer accept the old ways, nor should they. Everyone should have a say, but no group or interest has the right to tell them what healthcare they can and can’t have.
In one of the most divisive elections in our history the one area of violent agreement came in the healthcare debate when all parties united in their commitment to Sláintecare. The people have spoken and while parts of this compromise plan need finessing, there should be no going back.
When I go home from work these days I no longer think of what I might do with the rest of my day, but I am just overcome by a lovely sense of relief that we have one more day behind us and we are still afloat.
And as the evenings lengthen we can allow ourselves to dream of how we might shape the legacy of these times once we prevail. And we will prevail. We must win the peace too.
Anthony O’Connor is a consultant gastroenterologist at Tallaght University Hospital and a member of the Sláintecare advisory council
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