All Content Copyright emyvale.net
These are articles I wrote some time ago but is still worth reading: Monaghan General Hospital 004 This past week showed us just how serious the position is regarding getting hospital treatment and getting it in time and in the proper environment. Of course all finger pointing is directed at the current Minister for Health, Stephen Donnelly and he is expected to rectify the situation over night and save the lives of those who will pass away before they get proper treatment. I pity the poor Minister and indeed some of those who have gone before. This entire scenario began back in the 1960’s when certain people in power decided that all patients should be taken to one hospital and so close the others and redirect the money saved to some pet project. They soon got support from powerful Medical personnel who saw the benefit to them and year by year this idea gained strength but was not really workable until the 1990’s when the decision makers were not challenged and by 2005 they had the power to go ahead with hospital downgrading after a few years of nibbling at the services in the smaller hospitals thereby making the hospital ‘unsafe’ and a place where doctors and consultants were afraid to work because of the possibility of litigation and blame. At the same time they removed beds and equipment, failed to fill vacant doctor and nursing posts putting extra pressure on those who remained. This also reduced the possibility of advancement and development, which made the job unattractive and uninviting. Minister after Minister did as they were told, tried to make an impossible systems work, and divert monies from one necessity to another and so for years they moved the chairs around the deck and achieved nothing. The Health Boards were rolled into one and the number of managers and office staff grew as did the cost of running the HSE itself leaving less for hospitals and medical staff below Consultant level. Now we may have reached the pinnacle of the damage to patients and their lives but so far there seems to be just another effort to move the chairs around on the deck - take the money from one area where the public are not actually complaining and redirect it to where the public are crying out and the TV, radios and Newspapers are following the poor patient and very soon that same money will be needed elsewhere. From 2002 until 2009 the Community Alliance was fed up telling the Governments of the day that removing the services from Monaghan, and similar hospitals in Ireland, would cause major problems for patients and medical staff and that many patients would die a needless death as a result. We now hear a top consultant telling them the same thing. They did not listen to us but what we foretold has come to pass and it has all landed on Stephen Donnelly’s shoulders. He is not to blame nor has he the power or ability to change things for the long term betterment of patients. The head of the HSE has taken on a system in chaos - if he can dictate a solution to Government and reverse the damage of previous Governments he will be worth every euro he is paid and part of that solution is the return of services to Monaghan and similar hospitals as well as making the vocation of nursing an attractive job enticing nurses to want to work in our hospitals. Monaghan General Hospital 003 This was its name and I still refer to it as such. I do wonder why so many of our hospitals are ‘University’ hospitals – like Kerry University Hospital, Roscommon University Hospital etc etc while Bantry became Bantry General Hospital, Mallow became Mallow General and Wexford became Wexford General. Cavan, Monaghan, Dundalk, Navan etc are just hospitals. At one stage, just prior to the removal of services from Monaghan, it was treated as a top class University as NCHDs all praised the quality of the teaching and learning available in Monaghan in comparison to all the other teaching hospitals in the country. Anyhow – what’s in a name? It is great to read in the Northern Standard re. the renovations and additional spaces in Monaghan and the work outside is also terrific. All of that we applaud as it should ensure the future use of the hospital. However is does not meet the needs of patients in emergencies and does little to make our lives more secure. Everyone agrees that early attention and treatment always leads to better outcomes and that the ‘Golden Hour’ is still the yardstick. During the recent ‘Demonstration to save services in Navan’ it was stated and endorsed by people who know that taking a patient from Navan to Drogheda decreases the chance of survival and at very least increases the need for more intensive treatment for a longer period of time with poorer outcomes. Living in Emyvale I shudder when I hear, on nearly a daily basis, a bluelight/siren ambulance coming from Letterkenny and taking a very ill patient to a Dublin hospital. I think of the poor patient inside and the poor medical personnel trying to keep him/her alive and comfortable during the long journey till they get to the Hospital. I have also witnessed a bluelight/siren ambulance coming through Monaghan town and turning right at the traffic-lights for Cavan and I can imagine how the patient inside must feel as the ambulance rounds the corner at speed and how the medical presence must try to do whatever is necessary without being bashed from side to side of the ambulance. None of this is in the best interest of the patient. Indeed the road from Monaghan to Cavan is frightening for anyone travelling that road even in the best of health. Hospital Upgrade. I was delighted to hear and then read about the increase in hours for Monaghan Minor Injuries Unit. At least it is some movement on the part of Government and HSE. However there is still a need for a further increase in opening hours AND its ability to treat more than they are allowed or capable of at the moment, plus remove the charge to be paid by those without a referral. Illness and accidents don’t just happen between 8am and 8pm Monday to Friday and the people of Monaghan are entitled to a 24 hour proper service instead of being the only MIU in the country with such small opening hours and ability to treat even though the numbers attending the MIU are greater than most of those open 24/7. It has taken 18 years for us to get these extra hours – will it take another 18 years to get it open on Saturday and Sunday? The Government and Department of Health need to sit down and sort out the mess of the Health Services in this country. What happened in the last two decades has made a complete hash of our health services and the change from local Health Boards to HSE has been a disaster. When these decisions were being made it is obvious that the authorities did not listen to the knowledgeable people, who tried to tell them the best way to proceed and plan for the future. It appears that the cities of Dublin, Cork, Limerick, Galway and Waterford etc had stronger voices than rural Ireland. In any emergency, be it heart attack, accident, or sudden illness speedy access to hospital care has always been a necessity for recovery. Access was pushed into second place. Advanced Paramedics, who would be first to the scene, were expected to do, at the side of the road, what Consultants would do in a hospital situation – impossible. The Helicopter was the answer – patient injured, someone calls an ambulance (5minutes), it arrives 20 minutes or an hour later (25 minutes +), examine patient and decide immediate hospitalisation needed and calls helicopter (35 minutes +), Helicopter arrives and finds a landing spot 500 metres away from patient (55 minutes +), Ambulance takes patient to landing area and transfers to Helicopter (65 minutes +), Helicopter gets ready for lift-off (75 minutes +). So the patient is still at the scene after 75 minutes + and the ‘Golden Hour’ is well past and the Golden Hour is still the important time limit. ‘Dead on Arrival’ or ‘death by geography’ outcomes have been numerous and continue but are seldom made public. Access to healthcare in Ireland depends on place of residence as well as personal wealth and this begins with primary care. Little research has been carried out on rural isolation, social deprivation and remoteness and less research has been carried out on the outcomes as a result of fewer GPs. Rural Ireland in particular is suffering as a result of lack of doctors during the day and especially during the night hours yet there seems to be little effort to change things. Added to that is the health policy of centralisation, which also adds to the disadvantages suffered by the populations of rural Ireland. Centralisation really began back in 1968 when certain consultant groups based in the big cities recommended that all acute surgery be centralised to 16 major hospitals in the cities mentioned earlier but the geographical and social inequalities in health outcomes, service provision and access has never been mapped and/or remains hidden from the population and death rates by county are never available. The Government gave Consultants the power to arrange the provision of services to suit their own interests. A Comhairle na nOspidéal was set up in 1970 with consultants making the majority of the staff, which gave them the power to control the provision of services in public hospitals. General and County hospitals like Monaghan were starved of resources and consultants. The training of doctors became more important than patients and decisions were made with the training uppermost in the decision making. Specialisation was now the main priority. Doctors would select what specialisation they wanted and their training in that area followed. On that note let me recall the position in Monaghan at that time. We had surgical and medical services with consultants and anaesthetists. We had consultants who covered the Children’s Ward and we had a Cardiac Consultant. We had three anaesthetists and the hospital ran smoothly even though resources were scarce and funding light. However it was regarded as a training hospital and every six months junior doctors in training moved to a new location. Monaghan General Hospital was at the top of the list where the trainees wanted to come. Monaghan had a great reputation for its training and the Consultants were noted for their terrific training programmes. Junior Doctors were given training in a variety of patient needs and problems. Indeed many of them requested to do a second 6 month term in Monaghan. When we add to that the inspection and assessment carried out by the Royal College on Cardiac services in Monaghan during the year 2007 which found that it was excellent and the quality of treatment in Monaghan matched and in some cases outperformed some of the top Cardiac units in Ireland. Yet all of that was taken from us. We are all now at risk due to centralisation and unequal distribution of resources. We are also expected to pay the price of having to travel to a centralised unit, to pay the price for relatives to travel to that unit to visit a loved one, to accept the danger of travelling difficult roads to and from some of these units, to take days off work to travel the long distances to and from these units when we want to visit loved ones, and to accept that the Golden Hour will not apply to us if we need urgent assistance and care. We also must accept that we are not promised proper care as there are not enough nurses or doctors in most hospitals, that we have to lie on a trolley for hours before we can get a bed, and then have to wait months, or even years, to get called for tests to establish our condition, hoping that it will not be a late diagnosis. Surely we have intelligent people in the Department of Health and in the HSE and in Government to solve these problems and provide the people in this country with proper health care. Or is there a move to force people to pay Health Insurance and get the Private sector to look after our needs and so reduce their workload. Your comments please to peadarmc63@gmail.com Monaghan General Hospital 001 Monaghan General Hospital is hitting the news again and it is good to see as Governments have really put the lives of people in Monaghan in jeopardy and indeed, if the truth be known, possibly brought an early death to some patients in Monaghan. Since they removed acute services from our hospital the long journey to Cavan or Drogheda in an emergency has been too far and it was too long before the patient received adequate treatment. We were made many promises at that time, promises that were never delivered and some that were delivered were withdrawn soon afterwards. Monaghan General Hospital became a political football and vested interests were able to sway decisions. At that same time other hospitals were under threat too but the amazing things is that none of them suffered the same level to reduction in services that Monaghan did. This and that could not be allowed continue in Monaghan as it was ‘UNSAFE’ yet other hospitals were allowed to maintain them.
All Content Copyright emyvale.net
These are articles I wrote some time ago but is still worth reading: Monaghan General Hospital 004 This past week showed us just how serious the position is regarding getting hospital treatment and getting it in time and in the proper environment. Of course all finger pointing is directed at the current Minister for Health, Stephen Donnelly and he is expected to rectify the situation over night and save the lives of those who will pass away before they get proper treatment. I pity the poor Minister and indeed some of those who have gone before. This entire scenario began back in the 1960’s when certain people in power decided that all patients should be taken to one hospital and so close the others and redirect the money saved to some pet project. They soon got support from powerful Medical personnel who saw the benefit to them and year by year this idea gained strength but was not really workable until the 1990’s when the decision makers were not challenged and by 2005 they had the power to go ahead with hospital downgrading after a few years of nibbling at the services in the smaller hospitals thereby making the hospital ‘unsafe’ and a place where doctors and consultants were afraid to work because of the possibility of litigation and blame. At the same time they removed beds and equipment, failed to fill vacant doctor and nursing posts putting extra pressure on those who remained. This also reduced the possibility of advancement and development, which made the job unattractive and uninviting. Minister after Minister did as they were told, tried to make an impossible systems work, and divert monies from one necessity to another and so for years they moved the chairs around the deck and achieved nothing. The Health Boards were rolled into one and the number of managers and office staff grew as did the cost of running the HSE itself leaving less for hospitals and medical staff below Consultant level. Now we may have reached the pinnacle of the damage to patients and their lives but so far there seems to be just another effort to move the chairs around on the deck - take the money from one area where the public are not actually complaining and redirect it to where the public are crying out and the TV, radios and Newspapers are following the poor patient and very soon that same money will be needed elsewhere. From 2002 until 2009 the Community Alliance was fed up telling the Governments of the day that removing the services from Monaghan, and similar hospitals in Ireland, would cause major problems for patients and medical staff and that many patients would die a needless death as a result. We now hear a top consultant telling them the same thing. They did not listen to us but what we foretold has come to pass and it has all landed on Stephen Donnelly’s shoulders. He is not to blame nor has he the power or ability to change things for the long term betterment of patients. The head of the HSE has taken on a system in chaos - if he can dictate a solution to Government and reverse the damage of previous Governments he will be worth every euro he is paid and part of that solution is the return of services to Monaghan and similar hospitals as well as making the vocation of nursing an attractive job enticing nurses to want to work in our hospitals. Monaghan General Hospital 003 This was its name and I still refer to it as such. I do wonder why so many of our hospitals are ‘University’ hospitals – like Kerry University Hospital, Roscommon University Hospital etc etc while Bantry became Bantry General Hospital, Mallow became Mallow General and Wexford became Wexford General. Cavan, Monaghan, Dundalk, Navan etc are just hospitals. At one stage, just prior to the removal of services from Monaghan, it was treated as a top class University as NCHDs all praised the quality of the teaching and learning available in Monaghan in comparison to all the other teaching hospitals in the country. Anyhow – what’s in a name? It is great to read in the Northern Standard re. the renovations and additional spaces in Monaghan and the work outside is also terrific. All of that we applaud as it should ensure the future use of the hospital. However is does not meet the needs of patients in emergencies and does little to make our lives more secure. Everyone agrees that early attention and treatment always leads to better outcomes and that the ‘Golden Hour’ is still the yardstick. During the recent ‘Demonstration to save services in Navan’ it was stated and endorsed by people who know that taking a patient from Navan to Drogheda decreases the chance of survival and at very least increases the need for more intensive treatment for a longer period of time with poorer outcomes. Living in Emyvale I shudder when I hear, on nearly a daily basis, a bluelight/siren ambulance coming from Letterkenny and taking a very ill patient to a Dublin hospital. I think of the poor patient inside and the poor medical personnel trying to keep him/her alive and comfortable during the long journey till they get to the Hospital. I have also witnessed a bluelight/siren ambulance coming through Monaghan town and turning right at the traffic-lights for Cavan and I can imagine how the patient inside must feel as the ambulance rounds the corner at speed and how the medical presence must try to do whatever is necessary without being bashed from side to side of the ambulance. None of this is in the best interest of the patient. Indeed the road from Monaghan to Cavan is frightening for anyone travelling that road even in the best of health. Hospital Upgrade. I was delighted to hear and then read about the increase in hours for Monaghan Minor Injuries Unit. At least it is some movement on the part of Government and HSE. However there is still a need for a further increase in opening hours AND its ability to treat more than they are allowed or capable of at the moment, plus remove the charge to be paid by those without a referral. Illness and accidents don’t just happen between 8am and 8pm Monday to Friday and the people of Monaghan are entitled to a 24 hour proper service instead of being the only MIU in the country with such small opening hours and ability to treat even though the numbers attending the MIU are greater than most of those open 24/7. It has taken 18 years for us to get these extra hours – will it take another 18 years to get it open on Saturday and Sunday? The Government and Department of Health need to sit down and sort out the mess of the Health Services in this country. What happened in the last two decades has made a complete hash of our health services and the change from local Health Boards to HSE has been a disaster. When these decisions were being made it is obvious that the authorities did not listen to the knowledgeable people, who tried to tell them the best way to proceed and plan for the future. It appears that the cities of Dublin, Cork, Limerick, Galway and Waterford etc had stronger voices than rural Ireland. In any emergency, be it heart attack, accident, or sudden illness speedy access to hospital care has always been a necessity for recovery. Access was pushed into second place. Advanced Paramedics, who would be first to the scene, were expected to do, at the side of the road, what Consultants would do in a hospital situation – impossible. The Helicopter was the answer – patient injured, someone calls an ambulance (5minutes), it arrives 20 minutes or an hour later (25 minutes +), examine patient and decide immediate hospitalisation needed and calls helicopter (35 minutes +), Helicopter arrives and finds a landing spot 500 metres away from patient (55 minutes +), Ambulance takes patient to landing area and transfers to Helicopter (65 minutes +), Helicopter gets ready for lift-off (75 minutes +). So the patient is still at the scene after 75 minutes + and the ‘Golden Hour’ is well past and the Golden Hour is still the important time limit. ‘Dead on Arrival’ or ‘death by geography’ outcomes have been numerous and continue but are seldom made public. Access to healthcare in Ireland depends on place of residence as well as personal wealth and this begins with primary care. Little research has been carried out on rural isolation, social deprivation and remoteness and less research has been carried out on the outcomes as a result of fewer GPs. Rural Ireland in particular is suffering as a result of lack of doctors during the day and especially during the night hours yet there seems to be little effort to change things. Added to that is the health policy of centralisation, which also adds to the disadvantages suffered by the populations of rural Ireland. Centralisation really began back in 1968 when certain consultant groups based in the big cities recommended that all acute surgery be centralised to 16 major hospitals in the cities mentioned earlier but the geographical and social inequalities in health outcomes, service provision and access has never been mapped and/or remains hidden from the population and death rates by county are never available. The Government gave Consultants the power to arrange the provision of services to suit their own interests. A Comhairle na nOspidéal was set up in 1970 with consultants making the majority of the staff, which gave them the power to control the provision of services in public hospitals. General and County hospitals like Monaghan were starved of resources and consultants. The training of doctors became more important than patients and decisions were made with the training uppermost in the decision making. Specialisation was now the main priority. Doctors would select what specialisation they wanted and their training in that area followed. On that note let me recall the position in Monaghan at that time. We had surgical and medical services with consultants and anaesthetists. We had consultants who covered the