Pressure mounts on health service

YET again we enter another year when the state of the Irish health service is close to the top of the news agenda.

Just before Christmas, it was reported that a Clare teenager had died of meningitis, having spent hours on a hospital trolley in Limerick.

The family of 16-year-old Shannon schoolgirl Aoife Johnston believe that she was administered antibiotic drugs too late to fight the infection.

The hospital has now begun an investigation into the death.

The Taoiseach, a former hospital doctor himself, seems to have taken a keen interest in Aoife’s death, and made several observations in the run-up to Christmas when asked to comment.

And he said he would immediately seek assurances from the HSE that the investigation would be done ‘as thoroughly and as quickly as possible’, adding: ‘I know that’s what the family expects, and that’s what they have a right to expect.’

Issues with University Hospital Limerick have been reported by medical professionals for some time now, and come as no surprise to anyone working in the sector in Ireland.

But the problems in Limerick, while the most acute of all of our major hospitals, are not unique in that the trolley situation is now in very dangerous territory in many counties.

One staff member in Limerick described the situation there as being like conditions in a ‘third world country’, but anyone who has had to visit an A&E in recent months will attest to witnessing similar situations in almost all emergency departments.

University Hospital Waterford appears to be an outlier, having reported no patients on trolleys awaiting admission since March of 2020.

The hospital’s general manager Grace Rothwell is likely to have a busy 2023, however. Not with trolleys, it seems, but with HSE bosses and patient advocates contacting her to see what they are doing right in Waterford, and how it can be replicated throughout the country.

Although Ms Rothwell admitted that a one-size strategy does not ‘fit all’, she did give some insights into how the hospital has managed to cope with high demand.

Firstly, it is about managing that demand, she explained. If they allowed everyone seeking admission straight in, they would not be able to cope. So they divert some of their winter funding to cover private nursing home beds.

That allows patients who would otherwise not be able to leave hospital, because they are a few days short of being discharged, into a safe space in a nursing home. That, in turn, frees up hospital beds on the wards.

They have also had to make some tough decisions, like cancelling day cases and delaying transfers of patients returning from procedures in other hospitals. 

It is not ideal, of course, but it does mean that patients attending A&E are not subject to long trolley waits, which could exacerbate their illnesses, leading to a vicious cycle of holding up beds for longer than many have been necessary otherwise.

And it is not a complete solution, because those delayed procedures and admissions will ultimately need to be addressed, so the system will never get proper ‘breathing space’ to readjust.

Waterford’s strategy, however, shows the great lengths to which our hospital staff are going to, in order to stop the system from grinding to a complete halt. This is a new year. We have a new Taoiseach at the helm, albeit for the second time. The government has chosen not to change the minister in charge of the health department. But something will have to change, and fast, if the system, currently teetering on the edge of a very vulnerable precipice, does not fall off the cliff altogether, in 2023.

And there are not more families like Aoife Johnston’s, looking for answers to heart-breaking questions.