Going into the COVID19 Pandemic, our Health Care system was ‘fragile’ even to meet expected demand in 2020. On the day before the Republic of Ireland’s first case of COVID-19 was declared, on February 28th 2020 it was the 104th day of the IPA’s monitoring of the 2019/2020 winter period vs the previous year.
The source data we analysed from the Irish Nurse Midwives Organisations’ Trolly Watch.
So, on Feb 27th we had 73 days with more than 500 patients on trolleys and wards vs 28 in the previous winter.
Serious and sustained overcrowding had the knock impact on patient safety. It was, and still is an undeclared national emergency that has now been massively overshadowed by COVID-19.
This winter’s surge was planned for in the HSE budget, and demand was not much dissimilar to the previous winter. The HSE tried to control this surge with various escalation protocols to meet the demand; such as cancellation of elective surgeries, improving home care packages and the addition of 200 extra beds up to Match 2020.
Ireland has a very unfair two-tier health care system nowhere is this more evident than the huge waiting lists that have existed for many years despite so many political promises to the public in the mist of so many vested interests.
On the day before our first COVID19 case was recorded, our public waiting lists as per National Treatment Purchase Fund (NTPF) for February 2020 were.
Inpatient Elective waiting lists eg Hip Replacements
Total 0-3 Mths 3-6 Mths 6-9 Mths 9-12 Mths 12-15 Mths 15-18 Mths 18+Mths
66,705 27,709 16,119 7,901 5,301 2,934 1,959 4,782
Outpatient Appointment awaiting first Consultant led Appointment
Total 0-3 Mths 3-6 Mths 6-9 Mths. 9-12 Mths 12-15 Mths 15-18 Mths 18+Mths
558,554 158,173 100,174 70,468 56,537 36,944 30,358 105,900
International comment noted, that even if we met the Governments target time of treatment within 15 months we would still be the worst in Europe.
In addition to those waiting for access to treatment there are also many people with disabilities who often may need care from family, partners or health system.
The 2016 Census tells us that there were 311,580 Males with a disability and 331,551 Women.
Other vulnerable groups such as Asthma, Diabetes add a further 470,000 and 250,000 respectfully. In addition to this patient groups there are some 250,000 suffering from Depression not including other mental health illnesses.
To deal with this significant demand, red flags were raised about falling numbers of family doctors, consultants and nursing shortages.
This was the demand, and will continue to be during our handling of the COVID19 pandemic.
Patient’s and Health care service users, need a new Government to be formed. One that is built on transparency, solidarity and where the ask is ‘what can you do for your country’. Ethically we need to decide, that vested interests in all their guises can no longer command a disproportionate influence on consumption and use of resources, which will ultimately impact on fellow citizens.
In Healthcare delivery, The fragile domain of Trust must be protected, built on Performance and Accountability not PR and spin.