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Groundhog day for our failing health system


Reilly copy

 

Here’s a news item – “a new hospital waiting list initiative has been launched aimed at clearing long waiters. At present, five hospitals account for over 60% of those on inpatient hospital waiting lists for more than a year. Latest  figures show that just over 18,500 patients are waiting over three months for hospital treatment, while just over 8,600 are waiting over six months.”

Here’s another new item – “a new hospital waiting list initiative has been launched aimed at clearing long waiters. At present, five hospitals account for 70% of people waiting more than a year for treatment. Latest figures show that just under 24,000 are waiting more than three months for treatment, while just over 11,300 are waiting longer than six months for treatment. The numbers waiting over six months have nearly doubled over the past four months.”

The first news item is from January 2010, during the tenure of that much berated former Health Minister, Mary Harney. The second news item is from this week, during the tenure of the current Health Minister James Reilly, who we are told (frequently) is tackling the waiting list problem.

Well, if frequently launching waiting list initiatives and issuing upbeat statements constitutes tackling the problem, one can suppose that Minister Reilly is tackling the problem.

Unfortunately, statistics tend to be brutally frank, and the latest waiting list figures would beg the question as to whether anything has really changed since Mary Harney departed Hawkins House in early 2011.

Admittedly, the numbers on waiting lists increased substantially during Ms Harney’s tenure after January 2010, and by the time James Reilly came to office in March 2011, three month plus waiters stood at 26,000. After a short period of decline,the numbers are now almost reaching those not so dazzling heights yet again.

The Minister has just announced he has launched yet another initiative aimed at clearing the long waiters from the five hospitals responsible for the longest lists

Ministerial initiatives to tackle waiting list backlogs have been part and parcel of the health planning landscape since before Mary Harney’s time as Minister.

Unfortunately, to date they have been no more than more than sticking plaster solutions that so far have failed to tackle the resourcing and organisational problems that have bedevilled proper access to public hospital care for decades, and which have worsened as a result of the economic collapse of recent years.

To be fair to James Reilly, his establishment of a Special Delivery Unit to cut waiting lists and improve access to hospital care has had some success. During 2012, the SDU’s intervention did lead to some improvements in treatment waiting lists, particularly for long waiters.

By the end of 2012, the total number of three month plus waiters had reduced to 18,773, and among these, only 143 patients were waiting over nine months for treatment. The latter figure is now 3,715. The average waiting time for treatment is now three months, compared to 2.5 months last December.

History is repeating itself. Before they started to get out of control, in late 2009, Mary Harney, through the National Treatment Purchase Fund, had got waiting lists down to roughly the levels James Reilly achieved by late last year, before they inevitably rose again.

This waiting list roller coaster of recent years has a common theme running through it- diminishing healthcare resources and in particular, inadequate hospital and community resources to deal with pressure points in the system.

Can any Minister really keep a permanent lid on waiting lists in a health system that has had more than one fifth of its funding removed since 2008, and with more cuts to come in 2014 and in 2015?

Yes, James Reilly can argue that he  has had some success with waiting lists and he will deal with the latest ‘slippage’ through a €18 million funding injection (which will probably get swallowed up pretty quickly).

download

 

But to date it appears that his actions have essentially been ‘fire brigade’ exercises that have yet to deal with systemic flaws in the system.

He says the recent waiting list rise was due to a longer ‘clinical winter’ and a higher than normal level of elderly emergency admissions. But if the system is being changed for the better, as we are told, shouldn’t it be able to cope with these surges?

If waiting lists are really being tackled, shouldn’t we be seeing a more or less permanent decline in numbers, and not have to be frequently going back to the waiting list drawing board simply because very ill emergency patients are turning up in hospitals and needing beds?

It is alarming to note that the Minister admitted this week that the recent pressure on beds caused by higher than usual admissions through EDs had to be be dealt with through reducing the number of planned procedures, thereby increasing waiting list numbers, which then have to be dealt with by yet another special initiative.

And the Minister certainly likes his initiatives.

James Reilly’s SDU has launched many of these with varying degrees of success. We have had the patchily successful treatment waiting list initiative referred to above.

We have had an ED trolley wait initiative, which has has reduced trolley numbers, although the figure are still quite high.

Also, figures from the Irish Nurses and Midwives Organisation indicate that recently, the old trolley problem has simply turned into an overcrowded ward problem.

We have had two initiatives under James Reilly to reduce waiting times for colonoscopy and gastroscopy tests. Numbers waiting for these tests, often used to check for cancer, are on the rise again.

We have had a more recent initiative from the SDU to reduce outpatient waiting lists. With nearly 7,000 waiting over four years for a first outpatient appointment and 380,000 in total on these lists at the latest count, this particular initiative clearly has a long way to go.

And then we have the ‘hidden’ waiting lists that don’t normally get officially reported.

A recent Irish College of General Practitioners survey of 300 GPs showed that their private patients only had to wait an average of four days when they were referred to a private hospital for for an ultrasound test, whereas their public patients had to wait on average 14 weeks for this test at a public hospital.

The average wait for an MRI scan for a GP‘s public patient was 22 weeks – nearly six months. Private patients could get these scans done within seven days, the survey showed.

If the GP college didn’t tell us this then we would never have heard about these shocking waiting lists. Up to date figures on average waiting times for GP referrals for hospital diagnostic tests are not published by the HSE or the Department of Health.

Another hidden waiting list is where even if patients get into the hospital system, they still have to wait. Diabetes patients in some hospitals sometimes have to wait two to three years for an outpatient check up, where they are already in the hospital system and have already seen a consultant for the first time.

Again, these statistics are not revealed publicly by the HSE or Department of Health.

James Reilly cannot be faulted for making an effort to improve public patient access to our health system.

Yet, through all the swings and roundabouts of fluctuating waiting list and trolley numbers, and the often reported hardship suffered by sick patients through poor access and poor facilities, and Ministerial promises that things are getting better, the underlying message seems to be that our health system still doesn’t work, despite all the ‘spin’.

The bottom line seems to be that despite some pockets of efficiency and indeed excellence in the service, our broke statelet simply does not have the resources at the moment to provide a uniform standard of quality care.

The hidden truth is that all that can be hoped for is to keep the current system ticking over and hope that not too many people come to too much harm.

Resources are often promised, but seldom delivered, to improve hospital services at crucial pressure points, or to fund community and primary care to a proper level take pressure off hospitals and keep patients out of hospital.

Until this key issue can be resolved, everything else we are told or retold by Minister Reilly and his junior ministers is essentially window dressing.

And as for universal healthcare by 2016 (to be run by insurance companies no less), dream on.

88% rise in treatment waiting lists

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via Groundhog day for our failing health system – irishhealth.com.

Is your womb safe in his hands?


Ladies  is your womb safe in his hands?

2

 

Given the recent record of the Irish health service the advice is stay away from anything that comes under the remit of Dr.James Reilly the Minister of Health. You have a better chance of survival with the grim reaper

Health Minister James Reilly gets stuck in a lift


Health Minister James Reilly gets stuck in a lift and does his nut!!!

download (6)

 

yesterday at 3:36 pm

At the launch of a new mental health facility today in Dublin, Minister James Reilly ended up stuck in a lift for 20 minutes.

We don’t know if Minister for Health James Reilly is claustrophobic but he was certainly tested on that score today.

The Fine Gael man was attending the official opening of the Phoenix Care Centre in Grangegorman in Dublin when the lift he was in got stuck.

As you can see, thanks to this tweet by journalist Sara Burke (@sburx), his predicament drew quite a crowd.

Reilly lift

 

Various reports suggests that Reilly was trapped for between 10 and 20 minutes before emerging to officially launch the facility.

Rumours of sabotage from disgruntled public service workers are only the tip of the Twitter joke iceberg on this one.

via Tweet of the day | Health Minister James Reilly gets stuck in a lift.

via Health Minister James Reilly gets stuck in a lift.

Minister’s aide set up probe into Reilly care centre links


THE top civil servant in the Department of Health launched a probe into his own minister, Dr James Reilly, in the wake of the controversy over the decision to locate two primary care centres in his constituency.

Ambrose McLoughlin, the department’s secretary general, ordered an investigation after revelations in the Irish Independent that a supporter of Dr Reilly owned the site of a proposed primary care centre in Balbriggan, Co Dublin.

The revelation that Mr McLoughlin moved to investigate his own minister will heap further pressure on Dr Reilly, who has faced criticism over his handling of the Savita Halappanavar tragedy and HSE overspending.

Informed sources said it was Mr McLoughlin’s “sole decision” to launch the probe and Dr Reilly was aware it had been launched.

The move by Mr McLoughlin to initiate an investigation into the matter came as Mr Reilly was facing intense scrutiny over the controversial decision.

It also followed junior health minister Roisin Shortall‘s resignation after Dr Reilly bumped two towns in his constituency up a priority list for primary care centres.

via Minister’s aide set up probe into Reilly care centre links – National News – Independent.ie.

via Minister’s aide set up probe into Reilly care centre links – National News – Independent.ie.

Reilly is Breaking the Law


Breaking the Law Is Criminal

Minister for Health James Reilly is breaking the law and rejecting international human rights principles by failing to remove an upper age limit for an allowance to people with disabilities, according to a report by Ombudsperson Emily O’Reilly.

REILLY THE CRIMINAL

Minister for Health James Reilly is breaking the law and rejecting international human rights principles, by failing to remove an upper age limit for an allowance to people with disabilities, according to a report by Ombudsperson Emily O’Reilly.

She says it, “raises fundamental questions about the strength of our commitment to international human rights norms.

The continued failure of the department to tackle this issue, suggests it has a very weak sense of the importance of supporting human rights principles and indeed, a very weak sense of the rule of law and of its obligation to act in accordance with the law.’

Ms O’Reilly further said, “I have sympathy for the Government and the rest of us who are about to come under the cosh with €3.5 billion reduction in terms of the money that can be spent on public services but I think it is simply unacceptable for the State to act outside the law. 

I think basically they are trying to string this out. They have to remove the cap.” 

Ms O’Reilly also said, that when the scheme was originally introduced in 1979 the upper age limit was legal, however when the Equal Status Act became legislation in 2000, the State could no longer discriminate on grounds of age.The report also says the O’Reilly’s department, has been operating a scheme for the past 12 years, on the basis of a condition that was illegal and that it has known to be illegal for the past four years. Despite having agreed last year to remove the upper age limit from the scheme, it failed to do so. As a consequence, it has knowingly allowed the scheme to continue in operation on the basis of an illegality.

via Reilly is Breaking the Law – Indymedia Ireland.

via Reilly is Breaking the Law – Indymedia Ireland.

News Bites


Minister of Health

Minister James Reilly welcomes the introduction of the morning-after pill for things you wish you hadn’t said and done.

The pill will be available over the counter and will be marked under the brand name “Apology”.

====================================================

ITGWU

ITGWU objects to the introduction of controversial day shift working. A protest rally will take place outside the Dáil tomorrow evening to voice disapproval of this concept.

========================================================

Alcohol awareness week set for Ireland next year

Ireland will have a week dedicated to highlighting the intoxicating benefits of Jameson’s, Guinness, and Magners cider

==================================================

Minister of Finance

Michael Noonan stands by his pledge to lower cost of fillet steak, caviar, and tiramisu for the middle classes. However, he did hint that all state benefits paid to the working classes would have to be slashed to facilitate this concession. Wild applause was heard from Leo Varadkar.

The Taoiseach

Enda Kenny knelt in the confessional and said, “Bless me, Father, for I have sinned”.

“What is it, Enda?”

Enda said, “Father, I have committed sin. Every a day I suppress the truth from the public. The priest turned, looked at Enda, and said, I have good news. That isn’t a sin – it’s only a mistake” sure have we not being doing that ourselves for years.

Gilmore bypasses Reilly on children’s hospital decision –


 

TANAISTE Eamon Gilmore is carrying out his own research on children’s hospital locations in a sign of a breakdown of trust in Health Minister James Reilly.

The behind-the-scenes moves illustrate just how poor the working relationship is between Dr Reilly and the Labour Party.

As a result, Mr Gilmore’s advisers are talking with the various bidders and compiling their own file on where to locate the new national facility, the Irish Independent has learned.

Mr Gilmore’s desire to be informed independently of the decision-making process follows the controversy over Dr Reilly’s selection of primary care centres. “He does like to get his own information.

“Based on recent events, you can’t say it’s surprising,” a senior government source said.

The children’s hospital will be the largest capital infrastructure project agreed by the Government.

The race for the facility is neck-and-neck between St James’s Hospital and James Connolly Hospital in Blanchardstown, with the Coombe in third place as an “alternative” and the original site in the Mater Hospital in fourth.

“James’s and Blanchardstown stand out, followed by the Coombe and then the Mater,” a senior government source said.

Dr Reilly has got an expert report back assessing the options for the hospital.

The Dolphin Report, named after its chairman Frank Dolphin, didn’t rank the different locations, leaving it up to Dr Reilly to make a recommendation.

The decision is due to be agreed between Taoiseach Enda Kenny, the Tanaiste and Health Minister before being brought to Cabinet for ratification.

But the trio has yet to meet, with no date scheduled for the discussion.

Despite Mr Kenny saying a fortnight ago that the decision would be taken within 10 days, there is no sign of it coming to Government.

Dr Reilly will formally take the decision to his cabinet colleagues with the endorsement of the Taoiseach and Tanaiste.

Mr Gilmore’s officials have had meetings with a number of those involved in the various bids. There has also been specific information requested from bidders.

via Gilmore bypasses Reilly on children’s hospital decision – National News – Independent.ie.

via Gilmore bypasses Reilly on children’s hospital decision – National News – Independent.ie.

The Troika Questions the Children’s Referendum as Being Wasteful of Public Funds


The Troika said last night in Dublin that funds were not readily available to pursue the self-governing process in Ireland, and until the economy improves, the Government should consider postponing all referendums’ and elections. When questioned if this procedure was democratic the retort was you can’t afford it.

They added if this wasteful process continued they would consider withholding further draw down of funds.

The Taoiseach Enda Kenny and the finance Minister Michael Noonan believed they understood the concerns of the Troika and would re-examine the proposal.

When questioned further on the Democratic process Michael Noonan stated that really is a question for the Taoiseach but believed that the process was safe in the hands of the government.

The Taoiseach when quizzed on the matter believed that it was of the utmost importance to maintain Ireland’s credibility with the world’s financial decision-makers, and he would not stray from this route to satisfy the whims of a minority.

The Troika felt that in certain areas, there was on display extremely high levels of incompetence. One senior source claimed the Troika has been “spooked by James Reilly the Minister of Health. They believed Reilly is the boldest boy in the class. Being well-qualified masters, they believe control of the class is of the utmost importance.
They are, likewise, concerned at the worthlessness of the ministers at the core of Government and the overall perceived lack of leadership.

They stated they would support a referendum as to who should rule Ireland.

They are also willing to fund and support a new party called the Bilderberg group. They felt this group knew how to mop up what money remained and to restore Ireland to prosperity but only after a long and intense period of deprivation.

On behalf on the Irish people, The Taoiseach apologised for the gross ineptness of the government.

Enda on the Front Cover of Playboy


Speaking in the Dáil,the great imbecile Mattie McGrath appeared to get confused as to what magazine the Taoiseach appeared on the cover of last week.

“To see our Taoiseach, on this front page of Playboy magazine, I wish him well, I voted him as Taoiseach, but I expected a lot different of him,” he said.

First it was Time magazine and now Playboy what next? This person will stoop to anything for a bit of PR

 

 

Taoiseach denies James Reilly will have final say on children’s hospital location – National News – Independent.ie


UNDER-FIRE Health Minister James Reilly will not have the final say on the location of Ireland’s new national children’s hospital, the Taoiseach has insisted.

Enda Kenny said the Government would take on board recommendations from the minister but, ultimately, it would make the final decision as a whole.

“The Minister for Health will bring his recommendations to myself as Taoiseach and to the Tanaiste in the next 10 days, and the Government at Cabinet will make a decision,” said Mr Kenny.

Dr Reilly will deliver his recommendations, following the findings of a report from an expert group, to government within the next fortnight.

It is reported that he is likely to recommend Connolly Hospital in Blanchardstown as the most suitable site for the new hospital.

The group, appointed in March, was made up of doctors, architects and planners and chaired by former Health Service Executive (HSE) chairman Frank Dolphin.

It considered more than 40 bids for the site, including Connolly, the Mater Hospital and St James’s Hospital.

The Taoiseach said Dr Reilly had reflected on the Dolphin report and that the Department of Health carried out its own reviews.

The Health Minister will make his recommendations based on those findings.

Dr Reilly appointed the special review group earlier this year after An Bord Pleanala rejected controversial government plans to build a 15-storey building on the Mater site in north Dublin.

The planning appeals board argued that the original planned 74m-high building over 100,000 sq ft was too large and out of place with the Georgian city skyline.

It has been estimated that €33 million has been spent on the 400-bed project to date. Around €200 million in funding was earmarked from the sale of a National Lottery licence, with the winning bidder tied to an upfront payment.

It was originally anticipated that the new national children’s hospital would be completed by 2016. Following the last setback in March, Dr Reilly insisted that the Government would do its best to ensure as little delay as possible.

The minister has been under continued fire over recent months following a string of controversial decisions including health cuts proposals and an embittered relationship with a junior minister that led to her quitting.

Opposition TDs and two MEPs from his own party, Labour, also called for his resignation.

via Taoiseach denies James Reilly will have final say on children’s hospital location – National News – Independent.ie.

via Taoiseach denies James Reilly will have final say on children’s hospital location – National News – Independent.ie.

The Central Bank to Move Premises


This morning the Central bank announced that it would move premises within the next twelve months. A spokesperson for the bank stated they needed a location more suitable to today’s working environment. A site outside the city centre has been located.

A statement from The Taoiseach office said that the friends of Dr. James Reilly were not involved in the ownership of this site

The death of James Reilly Minister of Health


Enda Kenny and James Reilly the Health Minister are out on the golf course when all of a sudden, Reilly collapses .He doesn’t seem to be breathing, and his eyes are glazed. Kenny whips out his phone and calls the emergency services. He gasps Reilly is dead! What can I do? The operator says calm down. I can help. First lets make sure he is dead. There is a silence then a shot is heard. Back on the phone, the guy says “ok  now what”

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