People were rightly shocked to see the headline
‘Life or Death’ – ‘Top Doctors say life support now being rationed’.
This story in the Sunday Business Post by Susan Mitchell went on to state – “Doctors forced to make ‘tough decisions’ and prioritise some critically ill patients”. It is clearly stated in the article that the “crisis stems from a shortage of intensive care beds in hospitals”.
I want to preface my concerns about the problems relating to the Intensive Care Units, by stating that the vast majority of people who use the public health system in Ireland, have an extremely positive experience.
So let’s look at what has been said about ICU care.
Dr Tom Ryan, President of the Irish Hospital Consultants Association, two weeks ago noted that “we are effectively rationing life support”. Tom Ryan is a Consultant in Intensive Care and Anesthesia in St James’s Hospital and he is a senior medical professional who knows what he is speaking about.
Dr Emily O’Conor, President of the Irish Association for Emergency Medicine and Consultant in Emergency Medicine at Connolly Hospital Blanchardstown, said that doctors were having to make very “tough decisions” about which critically ill patients to prioritise.
I could quote from the INMO, SIPTU and other unions on the frontline in intensive care units. The IMO and the College of Surgeons have repeatedly warned about cuts in bed capacity and the impact on patient safety.
So what does “unnecessary risks” or ‘tough choices” mean Minister? The absence of a post-operative bed in ICU means that critical life-saving surgery is delayed, deferred, or God forbid cancelled.
No doctor ever wants to be in this position – it runs contrary to our Hippocratic oath, contrary to the Guidelines from the Medical Council, contrary to the reason many of us decided to get into medicine and healthcare.
Doctors routinely have to sit down with family members and loved ones and say, that in their professional opinion, having reviewed and assessed all of the options, that the likelihood of survival is slim.
Some of us, have to give this bad news thousands of times in our professional lives. I remember the first time I had such a conversation and I can assure you Minister, it never gets easier.
I never thought that one of these reasons might be that an ICU bed was not available.
In 2018 when we are told by Government that we are the richest in Europe, with the fastest growing economy in the Eurozone, there is something profoundly sick about the fact that ICU beds are being “rationed”.
That is why the type of problems, being experienced within the Intensive Care Units is so alarming. The failure to provide emergency surgery because of the absence of an ICU bed is a nothing short of a national scandal.
There can be no surprise that there is a shortage of ICU beds, it was highlighted in 2009 for the HSE, but since then cuts of €576 million have been made to the capital budget for acute hospitals in the last 10 years.
What makes it worse in the case of ICU, is that it directly impacts upon serious elective surgery, such as cancer, and also hinders Doctors from escalating a really medically sick patients care, for example a patient with pneumonia.
Knowing what I know, and speaking to the people on the frontline, I can only conclude that medical outcomes have to be compromised and people are dying as a result.
This is a very serious thing to say Minister – but it is unfortunately the case. People are dying as a result of the absence of ICU beds.