Dangerous Enough To Cause Death: Have I Got Your Attention Now?

I normally try to steer away from medical issues - local Councillors after all were taken out of the governance of hospitals and I feel I ought to concentrate my efforts on areas over which I have (or try to have) some role or influence. But I'm about to break that rule. Why? Because people seem to be dangerously unaware of what is going on out in Waterford Regional Hospital (WRH). And what is happening out in WRH is, quite frankly, dangerous.

Dangerous is a much abused word these days. But for the purposes of this article I mean 'dangerous' in a pretty conventional sense: dangerous to health and indeed life. The health and lives of our loved ones and ourselves. Dangerous enough to cause death. Have I got your attention now?

Like other politicians I have gained access to some data about WRH which I have read with increasing concern. When you read quotes from senior, respected medical personnel which state that 'Patients in the Southeast have a real and appreciable risk of being blinded...' - it pretty much makes you sit up and take notice! People will go blind in the Southeast? And then I read about the withdrawal of vital drug therapy for serious asthma patients and then onto the really startling quote that 'mortality and morbidity in our catchment population will increase....' Now they have got my attention. And despite the fact that I have no formal role in the health system I find I have to raise my voice.

People will be blinded and die in the Southeast as a result of the cuts now being forced on WRH. That's the stark, simple message. (And yes folks, it's 2012 - in the first world in case you are asking yourself the same question I asked myself!)

Here are some interesting figures.

Waterford Regional Hospital has a budget of €145 million.
Cork University Hospital has a budget of €277 million.
St. Vincent's University Hospital has a budget of €215 million.
Midwestern Regional Hospital has a budget of €145m and
University College Hospital Galway has a budget of €259m.

No big issues there? No? Well perhaps if you look at the next set of figures you might think a little differently:

Between Inpatient Discharges, Outpatient attendances and Emergency Department Presentations the hospitals treated the following numbers of patients in 2009:

Waterford Regional Hospital treated 212,521 people. (Budget €145m)
Cork University Hospital treated 220,346 people. (Budget 277m)
St. Vincent's University Hospital treated 184,520 people. (Budget 215m)
Midwestern Regional Hospital treated 210,946 people. (Budget €145m) and
University College Hospital Galway treated 291,089 people. (Budget €259m)

Pretty startling stuff. And there's more:

Waterford has 1,761 WTE (Whole Time Equivalent) Staff, while CUH has 3,329, St. Vincent's has 2,462, the Midwestern has 1,906 and Galway has 3,188!!!

The discrepancies are stark. And there's even more with
+ huge differences in Intensive Care/High Dependency Beds numbers;
+ ridiculous comparisons in Cardiology provision versus procedures;
+ numbers of Cardiologists - two in WRH performing 2,452 procedures versus 6 in St. Vincent's performing 1,740 procedures (I mean, hello???);
+ no 24/7 Interventional Cardiology (don't have a heart attack or stroke out of hours if you don't mind), and many other unfavourable comparisons.

I don't want to go into figures ad infinitum as it becomes confusing. But suffice to say that WRH is funded very poorly in comparison with most other hospitals - on almost any measure you care to take.

This situation has now become critical. I would like to pose a number of questions which I would like to see the HSE (and the Minister for Health) answer.

These include:

1. Why is WRH so chronically underfunded - and how can this be justified?
2. Why can the obvious efficiencies which have been effected at WRH not be rolled out across other hospitals?
3. Why are WRH being punished for performing so spectacularly well?
4. Can continued patient care across all specialities to International Best practice standards be guaranteed?
5. What specialities have been or will be reduced and/or eliminated as a result of further budget cuts?
6. What happens patients who have a heart attack or stroke out of hours?
7. What happens to patients who need Implantable Cardioverter Defibrillators?
8. What drug treatments are to be or already have been discontinued or withdrawn?

And there are millions more questions culminating I guess in the bigger questions of how many people will suffer more, will wait longer for treatment? But I digress. We are suffering from nothing short of medical apartheid in this Region!

While the budget cuts are not the fault of the HSE, their implementation and management is. And asking WRH to implement more cuts this year is equivalent to asking an anorexic to go on a diet!

And here's a few more questions that lead directly to the door of the HSE South management in Cork....

Why has the Southeast Region been split into two ISA's (Integrated Service Areas) of WATERFORD/WEXFORD and KILKENNY/TIPPERARY, thereby duplicating governance and clinical structures aswell as doubling administration? Do they realise that a billion euro motorway has been constructed which now means that Kilkenny is 30 minutes from Waterford? Thirty minutes!

What politics is afoot amongst the medical community that means that resources and medical provision is downgraded across the entire region at the expense of having multi-hospital provision. So, for example, instead of having one unit in the Regional Hospital, accessible from across the region, 24 hours a day, 7 days a week, for victims of heart attacks - we have 9 to 5, Monday to Friday provision in several locations? Surely this is an example of a lack of clinical leadership at best - and downright idiocy at worst? It means that the entire region suffers! What's the old question 'cui bono'? Who benefits? I'd sure like to know - because it certainly isn't the patients in Wexford or Kilkenny or Tipperary or Waterford.

With the upcoming appointment of a new Clinical Director, will the new person be appointed for the Region or will the artificial split be maintained?

Why has no-one in the HSE South the 'kahunas' to Manage the Southeast as a coherent region with proper provision in the Regional Hospital to service the medical needs of the region 24/7? And I'm not even getting in to the whole Capital investment debacle.

So, if I could just have those questions answered, that'd be great.

Oh and the big question too of course: HOW MANY PEOPLE WILL DIE?

Having had a little experience of the HSE during my year as Mayor I don't have high hopes that these questions will be answered, or God forbid, addressed. But somebody, somewhere higher up the food chain might, just might, start asking them too.

Isn't this a great little country all the same, where we have pledged to pay €3 billion a year, every year for God knows how long, to save...wait for it...no not peoples lives - to save the banks?????

I'm sorry but there is something almost biblically wrong with that. Something rotten at the core of a system that prioritises banks and money over people and life itself.

And I'm saying now: not in my name. That is all.