Saturday, 5 July 2008

It's access to health care, stupid.

Posted by: Dr. Thunder

Hi all. Sorry about the lengthy absence. I've been sent up to a hospital in "rural Australia" to cover staff shortages for a few weeks, so I've not had regular internet access. I shall blog about my outback experience when I'm back to civilisation next week, and have a functioning laptop at my disposal.

But Ain't No Angel's post below inspired me to haul my ass out of bed between 24 hour shifts and put finger to keyboard this morning.

It seems he's been poached away from the coalface by the private sector, like so many good nurses before him. Good luck to him. Given the right opportunity, I'd jump ship too. I wish him all the best. Sadly, the hospital system has lost yet another bright young mind to disillusionment and poor management.

But does it really need to be like this. We have nurses tempted away from the coalface, not by unimaginable sums of money, not by improved status, not by glamour and not by less work. I don't know the details of Ain't No Angel's contract, but it seems he was won over by......."normality".

What I mean is that... what the private sector could offer him, that the public sector can't, is the chance to have a normal life, and human working conditions. In the new job he's well respected, he's properly and promptly trained for the tasks he's expected to perform, and he is allowed make decisions. He also, presumably, has opportunities for promotion, too. OK he gets a pay increase. He also gets a company car, but it's an "on the road" kinda job, by the sounds of things.

My point is that a company car and an extra few quid wouldn't be enough to pry our nurses away from doing the job they were trained for if they had the other things that Ain't No Angel talks about....autonomy, respect, proper training, career progression, reasonable working hours and freedom from bureaucracy.

I have said it time and time again...whatever savings the HSE think they're making in the short time by shafting patients and staff in Irish hospitals is costing them in the long term.

How many agency staff will be employed to cover Ain't No Angel's work? how much will that cost? How much did we spend to train Ain't no Angel? Now the private sector will reap the benefits of our investment. How many nursing students will miss out on his mentoring skills, and how many patients will be worse off for not benefiting from his care?

But then again, this government has never cared about the long term. They can't see past the next election.

Which brings me onto.....well, healthcare in Ireland actually! More specifically access to healthcare in ireland.

This week I have gotten 2 text messages from friends in Ireland asking for medical advice about their ailments. This, I must say, has been a quiet week for the Dr. Thunder health advice line.

Why would an adult risk their health by taking advice via text message from a paediatrician who's in a different hemisphere?

Well, let's look at what you need to do to get a non emergency medical problem dealt with in Ireland.

Step 1: Go to your GP. Take time off work. possibly loose money for it. Then you pay 60 euros for the privilege.

Step 2: Try conservative management first, then come back for a review. Another 60 euro.

Step 3: After an indeterminate amount of GP reviews, you might be referred to a specialist. Waiting list in Ireland are up to 2 years.

Step 4: Specialist sees you, and tries first line treatment. Can't bring you back to evaluate treatment for another 6 months due to lack of appointments.

And so on.
3 years later, you're well on the road to getting an appointment to start the process of recovery!

In fairness, I'd take my chances with a "I have a lump on my head, wot is it plz?" text message, too.

Free access to GP services is what I believe needs to happen. Then, and only then, will those on low incomes be able to take control of their health. Sure, it'll cost a hell of a lot of money. But if people could afford to go to their GP to get their cholesterol checked, to have their blood pressure measured, to talk about giving up the fags, then we could potentially claw back a significant amount of the money, while at the same time improving the nation's health.

But when you have the choice between paying 60 euro to have your BMI measured, or buy the tin of baby formula that your nipper needs, I know which most people would choose.

But what do we expect of a government that has so little regard for public health that it refuses to allow public health consultants to use the title "consultant", and pays them less than half of what their clinical colleagues earn?

Pay peanuts.......and everyone will emigrate to Australia :D

Dr. Thunder.


  1. It seems this is the "year of health care". In USA, Canada, UK, now you mention Australia and Ireland...
    I think there is one rule - we can have not much for everybody or much for somebody. The society can't afford pay top hi-tech treatment to everybody. Recently, fther of Canadian health care, Claude Castonguay, announced that our system is slowly falling down. We in life insurance brokers Toronto are selling health insurance as well and I believe Castonguay is right - private insurance should be allowed everywhere, at least as an option.
    Best wishes!

  2. Lying in my bed reading this excellent post on a laptop.

    Feel too sick to eat x 24 hours yet not sick enough to want to get medical help (despite worrying symptoms) because of the expense involved.

    Don't worry, I've no intention of picking your brains. I'll look for help tomorrow if time doesn't turn out to be the best healer.

    This post is spot-on!

  3. Ever heard of going to your local Pharmacist?
    It won't cost 60 euro for a consultation.