Category Archives: Health

An Irish Doctor recounts 9/11

Posted on by
In memory of 9/11

In memory of 9/11

On the 10th anniversary of this Global tragedy, we remember all who suffered that day and since as a result of the Twin Tower attack in New York.

Dr Muiris Houston recalls his own personal experience of 9/11, and how he was only 350 miles away on assignment in the city of Toronto, Canada, when the terrorists attacked.

 

It is an absolute given: the events of 9/11 irrevocably changed the course of world affairs since the terrorist atrocity took place 10 years ago this week.

As well as the Iraqi and Afghanistan wars, one can relate the incredible debt problems presently affecting the US, at least in part, to the fiscal demands of fighting global terrorism.

Mind you, as a new book, Eleventh Day, by Anthony Summers and Robbyn Swan points out, Iran and Saudi Arabia were probably more culpable in the run up to 9/11 than Saddam Hussein was, but sin scéal eile.

For me personally, the events of that fateful morning are even more deeply etched in my brain cells because I was on assignment for The Irish Times in Toronto, Canada.

Former editor, Conor Brady, was keen to run a week-long series on the health service, with a particular emphasis on how Ireland compared with other countries, such as France, Germany, the UK and Canada.

I was delighted to take on the Canadian assignment; I had worked for three months in Newfoundland in the 1980s and was (and still am) a keen fan of the country’s egalitarian approach to health and social issues.

Earlier that week I looked in depth at cancer and cardiac services in a number of the city’s teaching hospitals, greatly facilitated by Dave McCutcheon, the former CEO of Tallaght Hospital who was running Toronto’s Sunnybrook Hospital at the time. I had also researched primary care and emergency services and now it was time to talk to the politicians and bureaucrats.

Ministerial cancellation
On September 11, I had an early-morning appointment with the Minister for Health for Ontario. When I arrived at the ministry I was asked to wait while officials raced around me in what can only be described as a controlled frenzy. Sensing something unusual was afoot, I sat in reception trying to figure out what was going on.

Eventually I was told the Minister couldn’t see me because of a developing situation in New York, which was likely to require the transfer of large numbers of burns patients to hospitals in Ontario. At this point I knew nothing about an aircraft flying into the first of the Twin Towers. So I left and wandered in to the nearest hotel to get a cup of tea and to reorganise my day. The Toronto International Film Festival was on at the time and so I joined a throng of people watching TV in the lounge.

On the television one of the Twin Towers was burning. Tuning in to the conversations around me, I learned that a large aircraft had flown into the building. Initially people spoke as if it had been an unfortunate air accident, but it was quickly pointed out by commentators that the flight path looked more deliberate than accidental.

Terror struck
More and more people arrived, and at one point I looked to my left and saw a famous actor beside me. His instantly recognisable trademark malevolent look was staring at the TV with absolute venom. In response to a number of comments on the TV indicating we were witnessing a terrorist attack on New York, and as we watched George Bush being told about the event in front of children at a school he was visiting, the actor snarled at the TV. “Nuke the b******s!,” he said, before marching from the room.

Of course, the situation got far worse with the aircraft hitting the Pentagon and the President being whisked off to Air Force One to ride out any further attacks. Fascination turned to fear; strangely, it was the closure of all North American airspace that shook me most. Here I was on the far side of the Atlantic, due to travel home in 48 hours, with some people openly speculating about World War 3. As I walked from the hotel, I wondered if the QE2 still did transatlantic trips.

That night found me curled up on a sofa, glued to the TV in the basement of a college classmate’s house in the Toronto suburbs. Staying with Frances and Paul was so much more bearable than a lonely hotel room on that apocalyptic night.

In the end, I was on the first British Airways flight to leave Toronto after the airspace was reopened that weekend. But the new reality hit home when we got to Heathrow. Armed police officers questioned us individually as we emerged from the plane. And the luggage I had checked through to Shannon had now to be picked up in a Heathrow car park and rechecked in person onto the Aer Lingus flight.
The post 9/11 world order had commenced.

CAO points for Medicine are up again

Posted on by
Leaving Cert Students

Leaving Cert Students

 

 

 

 

 

 

 

 

 

 

 

According to the Irish Medical Times, the points requirement for undergraduate medicine is up again, following the recent initial round of Central Applications Office offers for third-level courses.

 Trinity is up 10 to 741, the RCSI is also up 10 to 733, UCD is up 13 to 738 and NUI Galway and UCC are up nine points to 729 and 734 respectively.

A big change in course preference has emerged among students. CAO points required for entry to courses in science, technology and agriculture have increased dramatically, as students opt for programmes with better job prospects.

The points needed for courses in arts and business, meanwhile, are in decline, as are places on courses associated with the construction industry.

In contrast, science and computer courses, which have traditionally struggled to attract students, are booming.

The requirement for entry to science at UCD is up again this year to 455.

Five years ago, school-leavers could secure a place on the course with fewer than 300 points.

Exercise – the only way to go!

Posted on by

Exercise - The Only Way to Go

Exercise - The Only Way to Go

 

Exercise – the only way to go! Described recently as a “wonder drug”, I think it is something we all know at the back of our heads!

 

UK Cancer Support Group Macmillan, are supporting the idea that those who are recovering from cancer should be prescribed an exercise regime as soon as they feel ready,as opposed to being told to rest. New studies have now shown that exercise have a dramatic effect on the disease returning, which supports the notion that Exercise really is the only way to go!

 

Following a review on over sixty studies, exercise can only benefit your health and mood. Patients undergoing treatment, who were physically active at the same time, had great effects on their  physical wellbeing and their mood, the study has said. “Long term, it is an effective way to help recover physical function, manage fatigue, improve quality of life and mental health, and control body weight,” said the ‘Move More’ report.

Research has also shown that there can be a significant reduction in recurrence of the cancer disease. For example:

·         Where women on the study who have suffered with Breast Cancer with 150 minutes p/w exercise have a 40% less recurrence rate

·          Bowel Cancer suffers recurrence rate have been slashed by 50% with 6 hours per week.

And the list goes on.

The benefits of exercise are limitless, and studies have now shown another level for those suffering with cancer.

Cancer is a heart breaking and physically gruelling disease, but if something like going for a walk, a cycle or a light swim a few times a week can only benefit you then why not? Exercise is the only way to go.

So get out there and enjoy the fresh air – a novel idea is to bring the kids and make a family day out of it! You may not even realise how much you are doing even by simply bringing the kids to the pool!

 

 

 

 

 

 

 

1 year maximum on Hospital Waiting Lists

Posted on by
Waiting Lists to be reduced

Waiting Lists to be reduced

All public hospitals are being instructed to ensure they have no patients waiting more than 12 months by the end of the year. The Minister for Health Dr James Reilly has also announced changes in the role of the National Treatment Purchase Fund (NTPF), which will take place with immediate effect (Irish Medical Times)

 

These changes are another stage in the implementation of the Government’s health reform agenda and follow on from the establishment of the Special Delivery Unit, the Minister said.

Besides the waiting list instruction, there are two other main three changes involved. The NTPF will target particular backlogs rather than routinely accept referrals of patients waiting over three months. The requirement that the NTPF purchase 90 per cent of treatments in the private sector is being ended.

“When I announced the setting up of the SDU, I said that the role of the NTPF would be changed to support the mission of the new Unit. The SDU led by Dr Martin Connor is already putting systems in place to track, monitor and manage patient flows through the hospital system.  I intend that the resources of the NTPF, and by that I mean not just financial resources but also its data systems and highly-trained and experienced staff, will now be fully aligned with the SDU,” the Minister said.

The NTPF is entering a transition phase. It will continue to fund patient treatments but will be shifting its focus to target waiting lists more strategically, to deliver more treatments for the funds provided and to incentivise hospitals to manage their lists proactively in the interests of patients.

The SDU is carrying out a detailed analysis of the management of elective and non-elective care. However, it is already clear that individual hospitals can do more to reduce maximum waiting times for their patients.

“It is  unacceptable that hospitals leave some patients on waiting lists for very long periods of time, safe in the knowledge that the NTPF will eventually pick up the tab. I will no longer tolerate this attitude to patients – hospitals need to become accountable for the listing decisions of their surgeons. As part of the changes I am announcing today, I am requiring all hospitals to ensure that they have no patient listed as waiting over 12 months for treatment by the end of the year. Where they fail to do so, the NTPF will source the necessary treatments and the hospitals’ budgets will be reduced by a corresponding amount in 2012,” the Minister said.

“I want a system where the patient and taxpayer get the greatest return on scarce resources consistent with quality and safety. The NTPF will purchase treatments wherever it gets the best value in either the public or the private sector. I want the NTPF to drive a hard bargain on behalf of patients without regard to the location of the treatment,” the Minister said.

The SDU will be introducing a more focused strategy to target treatments for patients. This will require new data systems, a new accountability framework and a sustained focus by clinical and management leaders in hospitals to reduce the lists from their present level and prevent them building up again. As part of these changes, the Minister has decided that for the remainder of this year, the NTPF will no longer routinely accept referrals for those patients waiting over three months, as at present. It will still provide treatments for patients but will target specific backlogs.

Follow-up treatments for existing patients will be provided, as is the normal practice.

The NTPF and the SDU are already working in close collaboration, the Minister said. The NTPF capability will be a core part of the SDU’s performance management role in holding public hospitals to account. The changes being announced today lay the foundation for this transformation and introduce the concept of rigorously-enforced maximum waiting times.

These maximum waits will be systematically reduced in the coming months and years to “deliver the goal of eliminating excessive waiting lists from the Ireland health economy,” the Minister said.

Recruiting more NCHD’s will reduce overtime bill

Posted on by
Recruiting NCHD's to reduce overtime bill

Recruiting NCHD's to reduce overtime bill

The HSE will end up with more NCHDs in certain specialties than the number of existing vacancies after it allocates trainee doctors currently being recruited from India and Pakistan, Irish Medical Times exclusively reports.

 

Correspondence seen by IMT reveals that this is as a result of a deliberate plan taken at corporate level and with backing from senior management.

“As part of the allocation of Indian/Pakistani doctors from the centralised recruitment process, an additional number of doctors are being allocated to certain specialties in excess of current vacancies,” states the letter dated July 8.

According to the correspondence, the corporate motivation is to reduce overtime pay or eliminate agency cover, enhance compliance with the European Working Time Directive (EWTD) and improve the quality of services and working lives of doctors.

Some of the country’s largest rural and regional hospitals are set to spend up to 10 times more than the 2005 figure on agency workers to fill staff gaps this year. Despite HSE plans to reduce spending on agency workers, costs continued to rise steadily in the first three months of 2011.

As of July 4, HSE-centralised NCHD recruitment had received 1,791 applications over five rounds from February 28 to June 30, with NCHD vacancies at July 11, the date of the changeover, at 150.

The plan to hire an excess amount of NCHDs has been agreed by the National Directors with the Regional Directors of Operations (RDOs), IMT understands. Whole Time Equivalent (WTE) ceilings will not be an issue in circumstances where there is evidence that significant savings in agency/overtime can be achieved.

In line with the correspondence, sent to some local managers and clinical directors and copied to RDOs, the amount of doctors allocated would be determined by the numbers of new employees arriving from India and Pakistan. At the end of May, the Executive said more than 240 doctors from India and Pakistan had applied for visas and legislation to introduce a new classification of NCHDs has now been passed.

Local hospital management were requested, in the correspondence, to review their overtime/agency expenditure and EWTD compliance by specialty and to advise by last Friday (July 15) if this allocation could be utilised to reduce or eliminate overtime and agency costs or to enhance EWTD compliance.

The HSE expressed appreciation that this additional allocation could potentially involve changes to rosters or changes in cross-specialty cover, which in turn could generate negotiation with staff representatives.

St Columcille’s Hospital, Loughlinstown – Services to close?

Posted on by
Loughlinstown Hospital facing closure of services

Loughlinstown Hospital facing closure of services

There have been calls on Health Minister James Reilly to clarify the Government’s position on the future of services at St Columcille’s Hospital in Loughlinstown.
It had been suggested that the 24-hour Accident and Emergency unit would close and the hospital would only operate a daytime minor injury service.
The Irish Nurses and Midwives Organisation (INMO) warned that any attempt to transfer A&E services from Loughlinstown Hospital would have serious consequences for the quality of patient care.
It was pointed out that those who currently live in the catchment area of St Columcille’s would have to travel to the nearest A&E department at St Vincent’s Hospital.
In February, the HSE told the Health Information and Quality Authority (HIQA) in a report that it planned to remove 24-hour emergency services from St Columcille’s Hospital in Loughlinstown later this year.
 The Government and the HSE both denied claims made in recent media reports about the future of the A&E department at St Columcille’s.
In an adjournment debate in the Dail on Thursday (June 16) Deputy Brian Hayes (FG), speaking on behalf of Minister Reilly, said: “There is no plan to cease any of the current services at St Columcille’s Hospital.
“However, the configuration of services is constantly reviewed and from time to time rearranged to improve access and quality of service and minimise risk to patients.”
In a statement the HSE added: “There is no date set with regard to the cessation of any current services at St Columcille’s Hospital.”
Phillip McAnely is the representative for the Irish Nurses and Midwives Organisation (INMO) at Loughlinstown Hospital.
He did not believe that St Vincent’s Hospital would have the capacity to deal with the transfer of patients from St Colmcille’s Hospital if the A&E department in Loughlinstown closed.
“I want the Minister for Health and the HSE to review the decision to close the Accident and Emergency department at the hospital,” he said.
“Closing a busy A&E department and winding down services to transfer them to another A&E department – where over 60 people were waiting in its A&E department this week and regularly has 40 people waiting – just doesn’t make any sense. This does nothing to help health service reform.
“The loser in this has to be the patient,” he added. “Anyone who shows up at an emergency department needs emergency attention. Already the wait time for patients at St Vincent’s is unacceptable.”
Stephen McMahon, the CEO of the Irish Patients’ Association, criticised the HSE’s handling of the issue and said that it should consult with patients and local communities around the country on the downgrading of services at smaller hospitals.
“You can’t just transfer large volumes of patients from one hospital to another without making sure that they have the resources,” he said.
Cllr Denis O’Callaghan (Lab) tabled an emergency motion on the issue at the Dublin Mid Leinster HSE health forum meeting last week. His motion opposed any proposal to close the A&E at St Columcille’s.
In response to the motion, a HSE official said in a written reply that at this juncture no final decision had been taken with regard to the future of Emergency Department Services at St Columcille’s Hospital.
Meanwhile, Richard Boyd Barrett of People Before Profit warned that he would mobilise local support to campaign against any move to close the A&E department at St Columcille’s.
“Four years ago the people of Dun Laoghaire and surrounding areas marched and petitioned to keep St Michael’s Hospital open,” he said. “This pressure worked and we kept our hospital in Dun Laoghaire. We are going to have to do the same again to ensure that we keep the current services in Loughlinstown.”
There was nobody available at the Department of Health to comment

More weight on our minds and bodies………

Posted on by

 

Stop the Spread

Stop the Spread

When Irish Medical Times reported only two years ago (early July 2009) that surgeries for morbidly obese people alone could cost the public almost €6 million every year by 2019, one could have been forgiven for assuming that the issue could be put on the backburner for a while.

However, this major expense, due to the need to meet a rising demand for weight-loss procedures across the country, appears to be fast becoming a reality. This makes effective health promotion increasingly relevant.

In February, the Healthcare Section of the Institution of Occupational Safety and Health’s Ireland branch hosted an event in Dublin, placing seriously obese patients on the health and safety agenda.

The issue of how seriously obese patients can be better cared for from home to hospital and through to discharge was discussed, bringing to light the extra burden that severe obesity places on the health system.

Dr Sue Hignett, a Senior Lecturer in the Healthcare Ergonomics and Patient Safety Unit at Loughborough University, UK, presented on ‘Bariatric patient handling’ together with Lucy Canning, Manual Handling Co-ordinator at the Mater Hospital. She spoke about the need to design equipment (stretchers, scales, lifters, walking and bathing aids, beds and theatre tables) to allow health or social care professionals to properly look after plus-sized patients.
Dr Hignett said although the UK and Ireland have pockets of excellence, most organisations were less well prepared with the necessary procedures and equipment.

A new awareness campaign by all-island food safety body Safefood called ‘Stop the Spread’ aims to prevent overweight from developing into obesity in the first instance.

Unlike previous efforts to get people to find out their BMI, which required complex calculations, the advertising campaign encourages people to simply measure their girth around the belly-button area as a first step to ‘stop the spread’. Having a waist size greater than 32 inches for a woman or 37 inches for a man is a clear indication they are carrying excess weight.

Prof Donal O’Shea, who runs an obesity clinic at Loughlinstown Hospital, Co Dublin, said focusing on waist circumference was moving the battleground for the fight against obesity into the overweight category.

“That’s really important, because you can make a difference much more easily when you’re just overweight,” commented Prof O’Shea, adding that a measuring tape would not go around patients by the time he sees them in his clinic, where there is now a three- to four-year waiting list for assessment, because they are so obese.

The campaign follows research commissioned by Safefood revealing that being overweight was a much more common problem than we thought, with only 38 per cent of people believing they were overweight when in fact 61 per cent were carrying excess weight.

It also addresses the ‘social contagion effect’ of obesity. The Director of Health and Nutrition at Safefood, Dr Cliodhna Foley-Nolan, explained: “We’re all part of social networks and are influenced by the appearance and behaviour of those around us. Being overweight is now the norm and this norm is widespread in our communities throughout our families and friends. We need to stop the spread of this health epidemic by encouraging and motivating ourselves and others to reassess their own waist and weight, take realistic steps to tackle any excess weight, and begin to live a healthier future.”

Are we measuring up?
While Minister of State at the Department of Health with responsibility for Primary Care Róisín Shortall lauded the two-year Safefood campaign for its simplicity, it has, however, not been without its critics.

Labelled a ‘shock and awe’ campaign by some, critics have warned that the campaign, inspired by a similar Australian drive in 2008 called ‘Measuring Up’, was offensive.

Personal weight problem
Dr Foley-Nolan, however, maintained the €450,000 campaign would continue, despite some negative feedback, and was not intended to cause offence but was a direct and forthright way of getting people to address their personal weight problems, which cost Ireland €0.4 billion annually.

While it will take time to assess the campaign’s impact, a review of the Australian equivalent, conducted prior to its extension from 2010 for a further four years, showed that waist measurement was widely acknowledged as an element of weight overall, indicating that there has been some cut-through of the ‘Measure Up’ campaign (Irish Medical Times)

A sad farewell to Brian Lenihan

Posted on by
A sad Farewell to Brian Lenihan

A sad Farewell to Brian Lenihan

The deputy leader of Fianna Fail and former Minister for Finance, Brian Lenihan, has died of pancreatic cancer.

He was 52.

Mr Lenihan was diagnosed with cancer of the pancreas at the end of 2009 when he was Minister for Finance under the former Fianna Fail-led government. He confirmed the diagnosis in a statement in January 2010.

 Despite undergoing intensive treatment for the disease, he continued in the job under former Taoiseach, Brian Cowen.

He later contested the Fianna Fail leadership after Mr Cowen’s resignation, but lost out to Micheal Martin.

Mr Lenihan was first elected to the Dail in 1996, following a by-election caused by the death of his father. He served the constituency of Dublin West. He became Minister for Justice in 2007, before being made Minister for Finance in 2008.

His time in the finance office will be remembered for among other things, tough budgets, the foundation of NAMA, the bank guarantee scheme and the signing of the EU/IMF bailout.

In the election earlier this year, he was the only Fianna Fail TD to retain his seat in Dublin. Since then, he had been serving as deputy leader of Fianna Fail and the party’s finance spokesperson, however his health had severely deteriorated in recent weeks.

In a statement, Micheal Martin said he was ‘deeply saddened’ by Mr Lenihan’s death, who he described as having fought a ‘brave and courageous battle’ with a serious illness over the past 18 months.

“In all of this time, Brian never once flinched from his public duties and he showed an unceasing and untiring commitment to tackling the economic crisis facing this country. Even when receiving debilitating treatment, Brian continued to work assiduously in the best interests of this country,” Mr Martin said.

He added that as a ministerial colleague, Mr Lenihan ‘had my complete admiration’.

“He was quite simply brilliant and often in a league of his own.”

Mr Lenihan died early on June 10 in his west Dublin home. He is survived by his wife, Patricia, and two teenage children. (IrishHealth.com)