Viewers of the first episode of RTÉ's impressive fly-on-the-wall documentary about the health service, Keeping Ireland Alive, last week saw consultant neurosurgeon David O'Brien remove a tumour from the spine of a patient, with a little help from backing music by Led Zeppelin.
The programme provided a unique insight into the work performed at the neurosurgical unit of Beaumont Hospital, which handles some of the most complex and life-threatening cases in the Irish health service, referred from hospitals across the entire country.
It is tempting to describe the work of the surgeons here as miraculous, when in fact they are just doing their job. What is miraculous is that they manage to do it so well, given the obstacles that are put in their way.
A chronic lack of ward beds and intensive care beds, together with the closure of operating theatres, means Beaumont’s neurosurgery limps along at less than half the resourcing you would find in an equivalent unit in the UK.
For years now, the hospital has been operating a series of rolling theatre closures, mostly because of staff shortages. From one day to the next, with little notice, a surgeon can see their list cancelled, with all the inconvenience and worry that entails for patients and their families. Entire medical teams, hired at considerable, have to be stood down because of failures of resourcing and organisation.
Extra staff have been hired, and that might seem like a good thing. In fact, it has proven the opposite; more surgeons combined with more theatre closures means each consultant has less access to theatre and is consequently more frustrated. This frustration is evident in the internal memo by Dr Mohsen Javadpour, clinical director of the centre, who says the level of theatre and bed access is not sufficient to provide a safe service.
Such is the scale of the problem that last Friday, nine patients with malignant brain tumours could not be transferred for treatment in Beaumont because there were no beds for them. Other patients requiring urgent care were left to languish at home for the same reason.
Perhaps the only upside of this situation is that doctors, deprived of the chance of operating on patients because the lights are out in the operating theatre, have more time to reply to the never-ending stream of representations from politicians.
Every day the Dáil sits, the Minister for Health fields dozens of questions from TDs wanting to know when constituents will get an operation or an appointment. The Minister has no influence here – nor should he – and the questions are passed on to the HSE, which employs scores of people specially to deal with this unrelenting stream of self -serving representations.
There is something seriously wrong with a health system where senior staff cannot perform the job for which they were hired yet have to field so many clientelist requests from politicians. As Dr Javadpour points out, patients are dealt with according to strict clinical priority.
One day, perhaps, we will provide our valued health staff with the resources they need to just get on with the job.
