Tuesday 18 December 2007

Horror Street

The experience of Bean Thomaltaigh and I in two Dublin hospitals before and after the birth of our son four months ago confirms the general perception of the Irish Health Service. The medical staff were friendly, professional, and effective throughout. With few exceptions, clerical and administrative staff ranged from the incompetent, through indifferent, to downright rude. For an outside observer the combination of dire communication, pitiful information management, and lack of direction would be comic. For patients in long queues, often worried or distressed, it is nothing short of horrific. A few examples will suffice.

On the day of our three month scan at Holles Street, pregnant women queued standing on a stairway after first cramming through a tiny, stuffy prefab at the rear. We had seven separate interactions with five staff members, three of whom were clerical. We were asked the same set of questions four times (Yes, I counted). Is this your first baby? How many weeks? Have you diabetes? And so on. Then we’d pass to the next person who again started from scratch as if we’d just walked in the door. At one stage we filled out a form with all of these questions. No one wanted it later, they just kept on asking the same questions. A nurse pointed us down a corridor but there was confusion about which doctor would see us and where. During Bean T’s medical examination a woman burst in the door before anyone had time to answer her one-touch knock. So much for privacy. She then grabbed an enormous bundle of dog-eared files from a table. So much for technology. Thankfully we had no specific medical problems that day. Otherwise the warlike chaos would have completely broken us. As it was, like others, we just raised our eyes and sighed.

On the the night Bean T’s waters broke, while waiting in the foyer at Holles Street, a woman in the early stages of labour burst into the bleak Victorian reception area with her partner. The woman was breathing heavily and while in no immediate danger of giving birth, the couple expected to be reassured and directed towards some kind of hospital care. Instead a porter in a woolly jumper nervously asked “how often are they coming?”. When the woman said “every 10 minutes”, the man turned away and said “take a seat, you’ll be alright”. The couple looked at each other in bewilderment wondering whether they had arrived in a warehouse or the National Maternity Hospital.

A few weeks ago my son needed a lactose intolerance test. Bean T brought him to Crumlin Childrens hospital and provided the sample as instructed. As she headed out the door the receptionist must have noticed something was missing in the discharge forms. She shouted after Bean T “Come ‘ere, sorree, come ‘ere, ya need ta…”. So much for manners. Worse still, after weeks without word from the test Bean T phoned to be told in indifferent tones that the record of the test had been lost. Well well, what a surprise. Perhaps a dog-eared file was whipped out the window by a thieving breeze. When Bean T persisted, asking for a double check, she was eventually told that no, in fact the results hadn’t been lost, but there was insufficient material in the sample for proper analysis. We obviously weren’t going to be informed about this until we came looking. How utterly depressing. I really feel for those undergoing more serious testing or treatment in this gruelling environment.

These are but a handful of instances which back up the perception that the entire system is a shambles. Organisation, direction, and accountability are absent. Instead of compassion, patients get contempt, by the shovelful. For sure there are many decent people working hard at all levels. But whether through lack of resources, lack of moral, or otherwise, a culture of shameless indifference to the patient has taken hold. It really is the medical version of Fawlty Towers and it’s a national disgrace.

2 comments:

Vince said...

well 'tis a bit of a knot, an' the sword, which was given does not seem to have been used with the vim and verve which was hoped.
Not much point, reforming a knot around and through the first. I wish that woman would realise that 'twas a sword she was handed an' not a needle.

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