Nuala O’Loan
The View
There can be no doubt that Ireland’s health care services are struggling, as are many of those who work for them. Here are a few facts:
The Irish Independent reported this week that 500,000 public patients are waiting to see a specialist. “Some 138,584 of these patients spent the whole of 2017 on the waiting list. Half of these patients have been waiting for an outpatient appointment since the middle of 2016. The number of patients needing surgery also rose last month to 81,468 – up from 80,595 the previous month.”
There are staff shortages right across and inadequate resources to run the system.
On September 11 this year the Irish Nurses and Midwives Organisation (the INMO) announced that hospital overcrowding was the worst ever recorded in August, with 7,911 patients having to wait in corridors on trolleys or chairs for a bed to become free. 969 of those patients waited at University Hospital Limerick.
The INMO also pointed out that it was no coincidence that Limerick had 70 unfilled nursing vacancies. That was during the summer. It does not bode well for the winter which is nearly upon us. In their press release the INMO said that they were asking the HSE to present plans for dealing with the winter crisis, including which hospital services they plan to curtail to meet extra demand.
Vacant posts
On August 1 it was reported that the Irish Medical Organisation (IMO) believes that there are nearly 500 vacant consultant posts in the public health sector. The IMO has also said that 700 of the 2,600 GPs on the HSE’s medical card scheme — between 25 and 35% of all GPs in most counties — are expected to retire by 2023. In Kilkenny, Mayo, and Leitrim it is between 40 and 50%.
The IMO has indicated that cuts to consultants’ pay and GP services are causing a recruitment crisis that will impact on patient care. Peadar Gilligan, president of the IMO, said “the recruitment and retention problem in Ireland is now at crisis point”.
Add to this the range of problems created by the tragic and terrible cervical smear failings which have already led to so many deaths, and the need to compensate so many cancer victims who lost precious treatment time through the failure to diagnose, and who must now seek compensation from a new tribunal to be set up.
Minister for Health Simon Harris was reported in the Irish Times on October 17 as saying that “the cost of establishing and operating the proposed new tribunal for dealing with the cases of women affected by the cervical screening controversy will be ‘significant’”. These women are entitled to compensation, though it can never compensate them or their families for what they have lost.
At this time, when medical practitioners are so clearly struggling to provide a service, the Government and all the main political parties are forcing through the Dáil legislation to introduce the abortion services for which the people of Ireland voted in May this year.
Having had no consultation with GPs on the ground, abortion is to be introduced as a GP led service on January 1, 2019. Over 600 doctors called on the Irish College of General Practitioners (ICGP) to call an urgent EGM to discuss this. The ICGP has responded that it cannot call the meeting until December 2, after the Abortion Bill has passed. They will not assist their members.
The Minister was able to meet the ICGP and the National Women’s Council in October. He has not met the hundreds of GPs challenging what is happening.
There has been no planning, no attempt to resolve issues around access to necessary equipment, no strategy, no consideration of the implications for GP’s professional insurance, no training under way and above all no flexibility, so as properly to protect doctors, nurses and midwives who have a conscientious objection to providing abortion and to referring patients to other practitioners.
No medical practitioner should be forced to participate in what the Abortion Bill describes “a medical procedure which is intended to end the life of a foetus”. A foetus is a baby in the womb. Referring means sending a patient to someone else to end the life of the baby.
There is absolutely no protection for pharmacists.
This is not a minor issue. As healthcare practitioners contemplate their future, they may conclude they have no future in the Irish healthcare system. Ireland cannot afford to lose any of them, such is the level of current shortages and pressure on services.
When any system is under pressure cracks develop in the structures. When people are under constant pressure, and forced to do that which they believe to be wrong (referring to another practitioner a patient who wants an abortion), there is a risk that that pressure creates further stress, which will inevitably have an adverse effect, firstly on the medical practitioner and then, ultimately on the patient who may need that practitioner’s services for any one of hundreds of reasons other than abortion.
Politicians can give effect to the referendum without placing an intolerable burden on so many GPs, nurses, midwives and pharmacists. If they want abortion why not invite abortion practitioners such as Marie Stopes to come into Ireland and do what they need?
At least that would allow medical practitioners who wish to do so to continue to practice without fear of losing their jobs because, in conscience, they cannot be involved in any way in abortion.