‘Explosion’ in flu cases putting strain on local doctor services
Children and young adults most susceptible to outbreak which has already claimed three lives
AN ‘explosion’ in the number of flu-like illnesses has put a huge strain on general practices in Ireland, said Dr Padraig McGarry, president of the Irish Medical Organisation.
Rapidly growing numbers of flu cases will affect the capacity of hospitals to cope with their normal workloads of planned procedures, Dr McGarry warned.
The early arrival of the flu season deepens the hospital bed crisis which was further highlighted by the forced cancellation of vital chemotherapy sessions for children fighting cancer at Crumlin’s Children’s Hospital.
The mother of 10-year-old Alex O’Shaughnessy revealed publicly her son was among several children whose chemotherapy has been delayed several times due to a lack of hospital beds.
The numbers of flu-like illnesses more than doubled to 37.5 cases per 100,000 population in the week ending December 8. Three people aged over 65 have died so far of flu-like illnesses.
“It was like someone pushed a button in the middle of last week and it just exploded,” said Dr McGarry, a GP working in Co Longford.
Children and young adults are among those most hit by the strains of viruses now circulating in the community.
“The kids who are presenting at the moment are children with the RSV virus. There are some with influenza. And there are a lot of other minor RSV viruses that are troublesome, not necessarily debilitating but they would add significantly to the workload in general practice,” he said.
“We also see a huge increase in attendance in outof-hours. The good thing is there has not been high presentation of cases among the chronically ill.”
Dr McGarry added that many people in at-risk groups have been vaccinated.
People with chronic illnesses who suffer from flu-like illnesses often need hospital care and that “will place strain on an already over-strained system. Unfortunately, there just aren’t enough hospital beds,” he said.
Those patients admitted to hospitals with flu-like illnesses are going to displace other would-be patients listed for planned procedures.
“Those people on the lists are not getting procedures done and will be added to the never-ending waiting lists.
“Every year it is the same problem. They have a plan to open beds to mitigate the effect. The difficulty is trying to plan for the unknown and when is flu going to hit. Now it has hit all of a sudden,” Dr McGarry said.
He went on to speak of “a perfect storm” brewing in the health service caused by the lack of hospital beds and a lack of hospital consultants. Every year, an extra 20,000 people reach the age of 65 and this cohort will need an increased amount of hospital care. But the increase in numbers of over-65s is not being matched with the required number of new hospital beds.
Coupled with the failure to fill 500 hospital consultant posts because of pay cuts for new consultants, it has resulted in this “perfect storm” of problems in the health service, he said.
Dr McGarry said there have been some outbreaks of flulike illnesses in some groups who have been vaccinated.
“The current vaccine contains H1N1 and H3N2 and also an influenza B but there was an outbreak of some additional influenza Bs that might not have been included in the vaccine. But you will always get that type of thing,” he said.
The Irish Hospital Consultants Association said the impact of this year’s flu “is exposing the Government’s complacency over the past nine years and its failure to investing in our public hospitals”.
“The reality is that we have an insufficient number of hospital consultants and acute beds to provide essential care to patients.
“The IHCA has repeatedly called on the Government over the past nine years to provide the necessary capacity to treat patients.
“The Government’s failure to do this has resulted in a growing and unacceptable dependence on trolleys to treat critically ill admitted patients, and record waiting lists for hospital care,” said the spokesman.
He said hospital capacity deficits and the shortage of consultants was forcing hospitals to shut down essential day-to-day services such as chemotherapy treatment and chronic pain management for children in Crumlin Children’s Hospital.
Similar service restrictions are a regular occurrence throughout all of our public hospitals, he said.
A spokesperson for health minister Simon Harris told the Sunday Independent agreement has been reached between the National Treatment Purchase Fund and the HSE to fund an extra 190 beds in a number of hospitals.
ON Tuesday, the IMO concludes an historic ballot of consultant and nonconsultant hospital doctor (NCHD) members. This is seeking a mandate for action, up to and including industrial action, in our battle to save the health services.
Doctors do not want to strike, and the welfare of patients is of the utmost importance to us. However, our hand has been forced by a Government that has overseen a concerted campaign over the past seven years to dismantle the health service’s frontline staff, to the detriment of patients across the country.
The simple yet appalling reality is that our health system is at breaking point. There are more than 500 consultant posts in Ireland that are either unfilled or staffed on a temporary basis, and we currently have the lowest rate of medical specialists per capita in the EU.
The statistics on our health service make for exceptionally grim reading. Even if our 500plus empty consultant posts were filled, we would still need 1,600 extra consultants to meet current demand, and certain specialties are experiencing consultant shortfalls of up to 72pc.
Added to that, half of the country’s 92 public health doctors and a quarter of our GPs are due to retire in the next five years and we have posts advertised that attract few or no applications.
If the flight from the health system continues, hospitals will have to close as there are just not enough doctors to treat patients.
We have already lost one generation of doctors to emigration — we cannot lose another.
The biggest reason for this huge shortfall among consultants is the unfair and indefensible 30pc pay disparity between consultants based purely on when they were appointed.
The figures do not lie: the Government’s own spending review from this year, entitled Health Workforce Consultant Pay and Skills Mix, 2012-2017, says that, “on average, there is approximately a 32pc differential in salary” between consultants appointed before October 2012 and those appointed after that date.
The HSE and by extension the Government are culpable because they have let this situation fester.
This is having a monumentally negative effect on the health service, with both newly qualified consultants and our NCHDs leaving the medical register or emigrating in droves to escape this pay inequality.
This is backed up by statistics. A recent survey carried out by the IMO showed that 83pc of NCHDs said pay disparity at consultant level will impact on their decision on whether to apply for consultant posts in Ireland.
We are in the midst of an epidemic that shows no signs of slowing down. The number of doctors withdrawing from the medical register rose to 1,453 in 2018, which was an increase of 38pc on the previous year.
Of those, 70pc were aged 44 or under and 69pc said that they planned to practise medicine abroad.
These doctors see no future in an Irish system that places no value on either the welfare of its patients or the wellbeing of its workforce.
Unfortunately, the knock-on effects on patients are plain to see. There are almost 800,000 people on hospital waiting lists, with a further 165,000 waiting for vital imaging services, such as MRI and ultrasound. The daily rate of patients on trolleys around the country is regularly above 600.
All this is ahead of the annual winter pressure that will wreak further havoc on our beleaguered system.
To make matters worse, the HSE has essentially admitted that its staffing crisis is unsustainable: people are being given the derisory advice to
“be clever” about their healthcare choices during the winter months, with the executive advising the “walking wounded” to go to injury units rather than hospital emergency departments.
However, the solution to this problem is there for all to see. It would cost approximately €20m per annum to reverse this consultant pay inequality. Compared to the millions the Government is wasting every year on vanity projects and failed initiatives, this is not excessive — especially when you consider that the Government is spending roughly four times that amount on locum agencies to deal with the shortfall in the first place.
Anne O’Connor, the chief operations officer of the HSE, has said that “this winter will be more challenging [than previous years] in terms of numbers and activity”.
That is a severe understatement. To put it more bluntly, this Government’s policies have created a consultant recruitment and retention crisis that is putting people’s lives at risk.
We have balloted for industrial action because we need to open this Government’s eyes to the reality of life in our hospitals and remember that we can reverse this appalling trend by allocating funds where they are needed most. We cannot wait any longer. We need more doctors for better care.
‘We cannot wait any longer. We need more doctors’