What cutbacks do to patients

The knock-on effect of bed closures is cancelled procedures and distraught patients, writes RONAN McGREEVY

The knock-on effect of bed closures is cancelled procedures and distraught patients, writes RONAN McGREEVY

THE ANNOUNCEMENT last week of the closure of 52 beds in Beaumont hospital as a result of financial cutbacks is likely to make a bad situation worse for patients waiting for operations.

In the first half of last year 9,000 operations were cancelled. The figures for the second half of 2009 have not been made available because of civil service industrial action, but are likely to be about 20,000 in total for the year.

Cancelled operations are a source of unending misery for patients. In January, Nicola Doyle (44) from Greystones, Co Wicklow, was supposed to have breast reconstruction surgery a year after she had a double mastectomy.

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Surgery was to have been performed on January 15th, but two days beforehand she was told there were no beds available because of the bad weather.

“I was devastated,” she says. A cousin had come from Australia to look after her children for the six weeks’ convalescence needed after the operation.

“I was so angry and distraught. I had prepared myself mentally for this nine-hour operation. A cancelled operation is just a bureaucratic inconvenience to the health system. They don’t realise how devastating it is psychologically – this affects my husband and children too – and how difficult it is to arrange childcare at short notice.”

Worse was to follow when the operation, which was rescheduled for last Friday, was cancelled because of staff shortages. She was given a new date for September, nearly two years after the original mastectomy.

Unlike many patients who have had operations continually cancelled, Doyle refused to accept the explanations given by the hospital. After meeting hospital management last week, she was given a new date of June 4th.

Doyle says she is pleased that the deputy chief executive of the hospital, Phil O’Neill, has understood her feelings about the issue and brought forward a date for the rescheduled operation.

Not every patient is as forthright. Many suffer in silence because of a feeling that rocking the boat would make them even less likely to get the operation they require.

“People are frightened to say too much because they feel it will affect their care and they ask us if they are going to be struck off,” says Brigid Doherty, a patient advocate with Patient Focus. “Some people are reduced to begging and others to going into hospitals and shouting at the staff to get their voices heard.”

Fine Gael health spokesman Dr James Reilly says the closure of beds in Beaumont hospital is emblematic of the problems across the health service as cutbacks begin to hit frontline activities.

There have also been bed closures at the Midlands Regional Hospital in Tullamore, Merlin Park Hospital in Galway and Sligo General Hospital where a nurse warned last week that bed closures will have a knock-on effect on elective surgery.

Dr Reilly also claims that a 60 per cent increase in delayed discharges last year is the equivalent of taking two hospitals the size of St James’s out of the system annually.

He says the human cost to each of the 20,000 patients who have their operations cancelled annually is often not considered by the hospitals involved.

“Behind every patient is somebody who is waiting in pain, who has to build themselves up for an operation, the family are also built up, arrangements are made, time is taken off work and then there is all that turmoil and upset to have everything cancelled at the last moment,” he explains.

“It is just reflective of a system that is self-serving and run by bean counters who don’t have any care for the human element that is involved. It is supposed to be a health service not a health system.”

He believes the willingness of health professionals to do their job is being undermined by hospitals’ management.

“I find it incredible that highly qualified surgeons can arrive in on a weekday morning with a willingness to operate on several people and find that they can only operate on one because there aren’t beds available or there is not an intensive nurse available,” he says.

“These are management issues. It is reflective on something that Niamh Brennan said in [The Report of the Committee Chaired by Prof Niamh Brennan on Reform of the Health Service], what we have in our health service is not an ethos of management, but an ethos of administration.”