One small change: A healthcare researcher on how to make Ireland’s health system better

As our health system begins to return to normal activity levels following the Covid-19 pandemic, we would like to hear from doctors, nurses, paramedics, medical secretaries, hospital porters, canteen staff and others about one change they would like to see in our health system.

It can be something simple that annoys you, day in, day out, that is easily fixed, or it can be a small change in practice or attitude that would make life easier for everyone. (email: health@irishtimes.com with your suggestion).

Lauren Swan (Healthcare researcher at Trinity College Dublin)

“The one change I would like to see in our health system is greater recognition for homecare workers. In 2019, about 53,000 people aged 65 years and over were supported to remain living at home by homecare workers. This group of workers are described as being ‘the eyes and ears of the health system’. They are often the first people to notice sudden changes in those receiving care, from loss of appetite, sudden weight loss, forgetfulness or, simply put, identifying someone is no longer coping well. In return, we reward homecare workers with an average hourly rate of €12.

“While homecare originated as a service to help with domestic duties or provide social visits, today people receiving home support often have high-dependency needs. This can range from help preparing meals to assistance with personal care: showering and toileting. In a stretched system that allots homecare based on priority of need, the complexity of care being delivered has dramatically increased. Many homecare workers operate hoists daily, ensure diabetic service users receive their meals at the correct times and manage the prompting of medication for those they care for. Others will spend their working day supporting people with dementia and their families to maintain quality of life and independence at home.

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Essential care

“As a researcher working alongside homecare workers, I see a group of people going above and beyond each day. Many will work a schedule of 30-minute calls (worth €6 each) delivering care deemed essential to someone’s ability to remain living at home. They will be required to work split shifts, morning and evenings, assisting people to get washed and dressed for the day. Others will be required to be available to work from 9am-9pm every second weekend. They were asked to work through each wave of the pandemic, without the option of maintaining a social distance and were rewarded with a well-intentioned clap, but no designation on the initial healthcare worker Covid bonus payment list.

“There is no paid travel time between calls and, for a low-income group operating on public transport or bicycles, we expect them to show up for work in all-weather events. They deserve better pay and greater recognition for the invaluable work they do.”