On the one hand, this can’t be right, can it? On the other hand, Dr. Brendan McCann is just applying the available figures to the situation in his own hospital, and the results of that are, well, not pretty:
“In a series of private emails before Christmas, the Service Lead in UHW’s emergency department, Dr Brendan McCann roundly criticised the Health Service Executive and the Minister for Health, Simon Harris.
He highlighted new research carried out by two National Health Service doctors in the United Kingdom, which suggested that “1 in 83 patients waiting over 6 hours” die as a direct result of delays.
In an email on December 20th last, Dr McCann wrote “At UHW, this is about two a week or more than 100 a year. I would also point out that our waits are longer than six hours so the figure is likely to be higher.”
Staff “have been exploited cynically by leaders who understand that it is cheaper to herd patients like cattle” into an ED “bursting at the seams than admit them anywhere else that might give them some dignity”.”
To put these figures into context, what the Doctor is saying is that of those who wait for more than six hours for treatment, figures suggest one in every 83 will die as a result of waiting too long. The shocking thing here is that he’s saying that this means two people a week are likely to die in his hospital, which must mean that about 166 people every single week are waiting more than six hours for treatment. That’s unbelievable, and yet it has not been disputed.
And Waterford is just one hospital. If these figures are replicated roughly evenly across the country, you’re looking at thousands of preventable deaths every year, and millions and millions of hours spent waiting on treatment in hospitals.
It should be pointed out that in terms of deaths, the figures are clear, but speculative. What does that mean? It means that if the research in the UK is correct, and 1 in 83 die as a direct result of delays, then yes, thousands of people are dying in Ireland because of delays. But the figures are also speculative. How do you measure, for example, whether someone who dies of pneumonia died as a direct result of a delay in treatment? There’s simply no way to be certain. The UK figures are sort of a conservative “best guess” scenario. They could be vastly overstating the problem. They could also be understating it.
What is clear, though, is that thousands of people are not being seen for treatment in Ireland inside the recommended timeframe, and that many of those people are statistically having their lives put at risk as a direct result of that. If there was a sign up in A&E saying “if you have not been seen inside 6 hours you have a 1 in 83 chance of dying”, there would be riots in most of our hospitals. And yet, that’s the truth.
Dr. McCann is fairly clear about where the blame lies for all of this, also:
“In the email sent to the Clinical Lead for Medicine and Emergency Medicine, Donncha O Gradaigh, Dr McCann said staff have faced “years of inaction from directorate and management level regarding our daily chaos”.
“How long would you continue to come to work under the conditions that we experience every day? How long would management last? We have had no meaningful support from management regarding these issues – ever.
“The staff in the ED have been exploited cynically by leaders who understand that it is cheaper to herd patients like cattle in an ED bursting at the seams, than admit them anywhere else that might give them some dignity.”
“Some patients are being housed in offices next to the ED even though many wards elsewhere are taking care of just one extra patient each: “There are plenty of places in this hospital more suitable than our office. Why do we house 90 per cent of the excess all of the time?”
Dr McCann was contacted for a comment about the emails and replied that they were “internal emails between hospital staff, but he absolutely stood over the content of them”.”
That part in bold (emphasis mine) is a good question. If you have ten wards in a hospital, why not move some patients from A&E to the other wards while they are awaiting treatment? It might make them more comfortable and alleviate overcrowding. These are things that seem fairly obvious to doctors and nurses working on the front lines, but never seem to occur to health service management.
Is it possible that the core of the issue is that hospitals in Ireland are managed by officials who rarely if ever actually set foot inside the hospitals themselves? The kind of people who, through no real fault of their own, see patients as numbers on a spreadsheet, and not actual real people who need to be looked after?
Either way, none of this is very encouraging. The best case scenario in this story is that the UK figures are wrong, and that fewer people than they think die as a direct result of unacceptable wait times.
But it’s equally possible that they’re wrong in the other direction.
Here’s some free advice: Don’t get sick. And if you’re not sick, and you can stretch to affording it, get yourself private health insurance.
It might save your life.