Just under half the Irish population currently have private health insurance. Traditionally seen as advantageous in avoiding long waiting lists for elective procedures such as hip replacements and cataract removal, a new trend has now emerged. As our public health system continues to crumble, more insured people with acute flare-ups of multiple chronic diseases are voting with their feet and opting for treatment in a private hospital.
For many years now, our public hospitals have struggled to offer a bed to patients who have been medically assessed as needing admission. But now the malaise has deepened – previously one could make an argument that once admitted to an acute hospital, the care you received would be of an acceptable standard.
This is no longer the case.
For readers living in the southwest of the country, the situation is especially worrying. University Hospital Limerick (UHL) and University Hospital Kerry (UHK) are the subject of recent damning inspection reports from the Health Information and Quality Authority (Hiqa) that underline just how dangerous our public hospitals have become.
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Unprecedented warning signs about UHL have been flashing for some time. Last June, Hiqa issued a damning assessment of patient care at the hospital’s emergency department (ED) – in a searing report following an inspection visit, the State’s health watchdog found that the “overcrowded and understaffed” department posed a significant risk to the provision of safe, patient-centred care.
A Hiqa inspection of UHK last September found the hospital to be substantially compliant with just two national standards out of a total of 14 that were assessed during the visit. Hiqa found “gross overcrowding” of the ED along with significant patient flow issues. The ED had a significant shortage of medical and nursing staff. Most worrying of all, the report found “there were significant deficits in governance and management arrangements which impacted on the hospital’s ability to effectively and promptly manage any increase in service demand”.
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Such is the level of concern among staff at UHL, some 70 doctors working there penned a letter listing patient safety problems on the wards of the hospital. It said patients have to wait more than 10 hours for a bed in the medical assessment unit without medical attention while other “lost” patients are sometimes left unseen by doctors for a number of days.
As I wrote in January, unfortunately, this scenario resonates with experiences reported from other public hospitals around the country. There are multiple stories of patients not being seen by doctors for a number of days following admission to wards. It seems the very basics of good care and governance are now missing from more than just our hospital EDs. According to a recent analysis of Health Service Executive (HSE) data by the Irish Patients’ Association, almost 1,300 patients died over the winter as a result of delays in hospital admission from emergency departments.
Delays to inpatient admission in excess of five hours are associated with an increased risk of death. This indisputable metric shows that people are dying in Irish public hospitals because of delays spent in EDs.
It is a huge indictment of the uncaring culture of the HSE that there has been no significant response to the dangerous environment that exists in UHK and UHL, and to similar situations in other public hospitals. The late Irish health reformer, Dr Aidan Halligan, showed how to deal with wilfully dangerous hospitals in the UK, by setting up “flying squads” to intervene rapidly where NHS managers were failing their duty of care. We need a system of “flying squad” intervention teams to be deployed to any hospital labelled by a Hiqa inspection as unsafe.
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To be clear, I do not advocate we simply accept our public hospital system with its current shortcomings. No stone should be left unturned by the Irish State in bringing it up to the standard that all people in Ireland deserve.
However, as our public hospital system withers on the vine, I have one piece of advice. For those who can – and with apologies to people who simply cannot afford private health insurance – you must do all in your power to continue to pay the not inconsiderable cost of “going private”.
Why?
Because our public hospitals are increasingly unfit for purpose and represent a growing danger to you and your family. If you have a choice, choose private healthcare.