Dead are left to decompose in corridors yet we can find millions for a hospital cost debacle

A powerful broadside after a grim week in health

IF you’ve been in a hospital lately, you may have noticed a triple spiral displayed on the walls. It’s called an End of Life Spiral, and it’s displayed in the clinical area to let staff know that a patient is dying or has just died. The three spirals are supposed to represent the cycle of birth, life and death. They’re set in a white circle that symbolises infinity, and they’re coloured purple to signify solemnity and spirituality.

The symbol lets staff know they should foster an atmosphere of tranquillity and respect, avoid using their mobile phones and be prepared to meet people who are grieving.

This has been going on for more than a decade now, since the HSE began a partnership with the Irish Hospice Foundation to improve the standard of end-of-life care in hospitals. It’s such a laudable exercise in compassion really, and it must have helped thousands of people to cope better with their own death or that of their loved ones. Since it was set up in 2007, some 45 hospitals have signed up to the ‘hospicefriendly hospitals’ programme.

Among the participants is University Hospital Waterford (UHW), where news emerged this week that end-of-life care can also involve being left to decompose in a corridor.

By way of a quick recap, four consultants pathologists complained in a letter to the chief executive of the South/Southwest Hospital Group (which runs Waterford) about conditions at the mortuary. There was not enough refrigeration and consequently the dead were left in corridors, their bodily fluids leaking on to the floors, decomposition proceeding at a pace that necessitated closed-coffin funerals. The whole thing caused ‘unspeakable trauma’ for the bereaved, the consultants wrote.

THE details were bad enough, but there were two aspects to this story that made it a thousand times worse – the way it came out, and the way it was treated after it came out. After receiving a tip-off that this letter existed, local paper the Waterford News & Star submitted a Freedom Of Information (FOI) request to the South/Southwest Hospital Group to get its hands on it.

The FOI request was denied on two grounds. First, the letter was said to contain ‘matter relating to the deliberative process of the HSE in relation to the upgrade of the mortuary at UHW’ (and a very long deliberative process that has been, but more on that in a moment). Second, its release would be ‘contrary to public interest’ – which, if I might paraphrase, can be taken to mean ‘people would get upset’.

After that, an anonymous whistle-blower sent the letter to the Waterford News & Star anyway and, yes, people got upset. And then, suddenly, the deliberative process of the

HSE – all but imperceptible for some 15 years now – went into overdrive.

By Friday evening there were suddenly short-term, medium-term and long-term plans in place to deal with the Waterford mortuary crisis. A mobile refrigerated unit is to be up and running within the next two weeks. A small extension to the mortuary will be ready in eight to ten weeks. And the long-term plan for a new mortuary will be seen through within two years. What a spectacular flurry of activity.

Remember, the need for a new mortuary at Waterford was identified as far back as 2004, and that the idea has been lumbering its way through capital approval and planning processes ever since.

Remember, too, that the letter from the four pathologists was sent last October, and nothing happened on foot of that either. Nothing happened, in fact, until people got upset, which proves that the sudden sense of immediacy here has very little to do with dignity in death and very much to do with damage limitation.

But let us not pick on Waterford. UHW is just one of the many hospitals that have been stretched way beyond their capacity by the determined centralisation efforts of successive governments.

Let’s take Limerick, for instance, where reports earlier this month revealed that there were more patients on trolleys in University Hospital Limerick than in all nine of Dublin’s acute hospitals put together.

Even though a brand new Emergency Department opened at UHL in 2017, you must still wait hours to be seen, and to those hours you must add the hours it will take you to get to the hospital in the first place, because its catchment is so unfeasibly huge.

LOCAL press reported on Thursday that staff in the Emergency Department at UHL were apologising to patients because there were no pillows. One man told the Limerick Leader that he’d gone on an errand of mercy to Penneys and bought 30 pillows for patients. This is pretty anecdotal stuff admittedly, but still: the idea that there would not be enough pillows in a major acute hospital in Ireland does not stretch anyone’s credulity, and that alone is shameful.

During the prolonged period of austerity, people tolerated a certain amount of adversity in public healthcare. It was

understood that there was not enough money to pay for the kind of first-class health system we wanted. And it was also understood that if we could afford it, we would have it.

There is the money now, and if you doubt that for an instant then I urge you to cast your eyes yet again over the budget for the National Children’s Hospital (NCH), where the overspend alone would pay for a little over 80 mortuaries in Waterford at their projected cost of €5.6m apiece.

The public hospital system is so often described as a ‘war zone’ that the cliché has lost almost all meaning. People who use it are assumed to be exaggerating. But consider this: the sick being triaged over and over again to the back of the queue because worse cases keep on turning up; the dead left lying around; urgent, last-minute phone calls being placed to the manufacturers of mobile mortuaries; a propaganda machine in overdrive; pillows a laughable luxury. How else are we to describe it, but as akin to a war zone?

Thanks to the Children’s Hospital debacle we now have irrefutable proof that money is not the problem here. Not only is there enough money to spend on health, there’s enough money to waste on it.

So the pressing question now is, what is the problem, and just how shocked and angry and traumatised do people have to get before it’s solved?