We spend billions on health and then treat frail patients like waste

AN ELDERLY man is in his bed in the geriatric emergency unit of a hospital. It is four o’clock in the morning. He is wakened from his sleep by paramedics and told he is being discharged and must vacate his bed.

Suffering from dementia, he becomes agitated and confused, and he refuses to go. And so they call security staff. They actually call in the heavies to drag an old man from his bed in the small hours of the morning.

If this happened in a developing country, it might just about be understandable. If it happened in a war zone, it might be explicable. But this happened in University Hospital Limerick last weekend. In the country with the ninth-highest health budget per capita in the EU, a country that spent a record €23.4billion on healthcare last year. We’re reduced to hauling sick, powerless old people out of their hospital beds because they are the low-hanging fruit when there’s pressure on the wards.

In 2020, we spent almost €3,000 for every single citizen on healthcare. If that money isn’t being used to care for vulnerable people, like old men near the end of their days, then where on earth is it going?

‘It is not our usual practice at University Hospital Limerick to transfer patients in the early hours of the morning,’ the hospital said in a statement in response to the Irish Daily Mail’s exposure of that old man’s treatment.

According to hospital sources, though, it is very much the usual practice in UHL. One source said: ‘UHL is packed and paramedics are back moving elderly and frail people out at three, four and five in the morning.’

They’re so busy answering emergencies that it’s only when things quieten down, at around 4am, that ambulance control can get around to managing discharges. Or, as that source put it, ‘paramedics are being forced to do clear-outs of elderly people in the middle of the night’.

Remember, these are people we’re talking about, old people who’ve worked and paid taxes all their lives, being ‘cleared out’ as if they were bags of hospital waste.

In this instance, the old man was spared being ‘cleared out’ because the security staff simply refused to lift a confused, agitated 80-something patient from his bed against his will. But other elderly patients who didn’t resist have indeed been removed in the middle of the night. And the practice that isn’t just distressing to these people and their relatives – ambulance staff are also upset and angry at what they are being asked to do.

I’ve got an elderly relative in hospital at the moment – fortunately, at least she’s not in UHL – and this account of the recent discharge of an elderly patient will strike fear into anyone in that situation, since the practice is clearly not confined to Limerick.

‘There was a woman in the east of the country I was bringing back to her home,’ a paramedic recalled. ‘It was half-four in the morning and she was in a total daze. We weren’t bringing her back to a nursing home where she would have had care; she was discharged to her own home. So we had to bring her back in the middle of the night and then just leave her. We didn’t know if she had anyone there to help or anything. We didn’t know. She seemed to be very confused and did not know what was going on…’

Now, I’m sure those paramedics didn’t just drive off and leave that old woman alone, perhaps in a cold and empty home, in the dead of night. Basic humanity, you’d expect, would ensure that they’d at least see that she was safely settled before they left, but that would clearly have involved them going above and beyond the job they were directed to do. As far as our healthcare system was concerned, once she’d been ‘cleared out’ of her hospital bed, she was on her own.

Commenting on the plight of the old man with dementia, yesterday Health Minister Stephen Donnelly said: ‘That absolutely should not have happened.’ If only the minister knew someone who could do something about this treatment of our elderly. Beyond decrying the incident, though, the minister said he was reluctant to make any other judgement until he’d had a ‘full briefing’ on it.

It is difficult to know what sort of spin any briefing could put on this episode that might make it understandable or excusable in a country that spends billions on healthcare every year.

The minister pointed out that UHL has had more investment than any other hospital in the country – it’s getting a new 192-bed unit, and has already recruited 1,000 extra staff since 2020 – and admitted it needs more. ‘But’ he said, ‘there must be reform in that hospital.’

Yet is there any reason to believe UHL, as it’s currently being run, would make better use of more resources than the investment it has had already? Why doesn’t the minister demand to see reform, and accountability, before giving it another cent? Otherwise, he’s just throwing more taxpayers’ money at an institution where it’s considered acceptable to call security to drag an old, demented man from his bed at four in the morning.