Statements on Acute Hospital Services - 20th October 2005

Statements on Acute Hospital Services – 20th October 2005

Mr. Norris: I agree with Senator O’Brien in
complimenting the House and its political staff on
getting this debate scheduled so quickly. It does
a public service that this matter be so ventilated.
It is very useful and I am glad we are having the
debate. I wonder whether the Tanaiste, Deputy
Harney, now regrets so courageously taking on
the poisoned chalice of the Health and Children
Ministry. It certainly was a courageous decision
and confronting this task provides many headaches.
She is right in saying that the whole system
of health delivery needs to be reviewed.
The specific tragic case of Mr. Walsh is an
appalling event. One would first of all have to
send one’s sympathy to his relatives. First they
had the incidence of his illness and then they had
to stand impotently by while he was locked into
a kind of lunatic bureaucracy. I understand Mr.
Walsh was already known to suffer from a peptic
ulcer, which creates certain indications. I would
have thought he should have been put into intensive
care immediately. This kind of bleeding is
amenable to fairly simple treatment through
endoscopy whereby a tube is inserted and the
bleeding is cauterised, which is successful in 80%
of cases. Without this procedure it is almost
always fatal. It is not a major, sophisticated, complicated
complicated
or difficult operation to undertake. It
astonishes me that people stood idly by while this
man apparently bled to death.
We need to get all the facts — I understand a
report is due and we must await judgment. It
would be quite wrong to judge specific individuals
or name anybody at this point. While I do not
always agree with Senator Mansergh, he was very
wise in what he said on the Order of Business
when he brought to mind the simple parable of
the good samaritan and asked whether in these
kinds of conditions someone who found a man
bleeding to death on the side of the road would,
as they used to say about the American health
service, first feel his wallet to see if it was still
beating and then just look around and decide if
there was an inhibition here to prevent him being
helped for various reasons. Senator Brian Hayes
asked a very pertinent question in wondering
where this inhibition came from. It seems clear it
did not come from a political source. It may have
come from within the hospital. It is appalling and
astonishing that a surgeon who intervened courageously
to save life on a previous occasion was
reprimanded and chastised. This is not a good
indicator for the health service and these matters
need to be clarified.
We also need to consider the insurance
situation. We need to ensure that not only are
those medical staff, who courageously intervene,
covered and given political protection by being
supported when they take such action in the line
of their work, but also that they are not subject
of the threat of enormous financial loss. For
example, a surgeon might intervene in the case of
a person who was already beyond saving. Then,
as happens frequently in other jurisdictions, the
well-intentioned surgeon is slapped on the wrists
and taken to court. A few years ago in America
a woman collapsed beside a swimming pool with
a ruptured appendix. A doctor operated with an
ordinary domestic knife and saved her life. Her
grateful response was to sue him and receive
$750,000. We must protect medical personnel
against this kind of risk.
We should not use these matters to excoriate
particular politicians, to hold them directly or
personally responsible, or to score political
points. We should have in mind the
general welfare of the community. I
welcome that the Taoiseach in the
other House made it clear he would stand against
these kinds of personal accusations by saying: “I
will not accept that there should be political
accountability every time a person dies anywhere
in our health service.” He is right and we, as politicians,
on all sides should support him in this
matter.
I remind the House that we are perishable
goods. Death is inevitable. One hopes to
accomplish it with the minimum of trauma or suffering.
I am not referring to the situation of Mr.
Walsh which is a separate business. Sometimes
the impression is given in this country that people
believe they are entitled to live forever; that if
they get a cold the local TD is responsible; if they
have an operation the Minister is responsible;
and, if they die the Government should fall. This
is not realistic. Our health service is not as bad as
we make out. There are difficulties in delivery,
there is appalling bureaucracy, there are too
many managers and the Hanly report should be
implemented.
On this I disagree completely with Senator
Leyden who spoke from the Government side of
the House and who attacked Professor Drumm. I
say, thank God for Professor Drumm and his
clarity, forthrightness, decency and honesty in
addressing a situation. We should leave it to him
and not attempt to interfere politically in the
interests of our own little backyard. I am sickened
by what I see on all sides of this House. Every
party is involved. Every party wants to save its
own hospitals but what they mean is they want to
save their own seats. This is not about a hospital
but is a popular voting issue that calls for people
of courage. If the political leadership is not forthcoming
from the political parties, then I urge
Members not to attack people like Professor
Drumm who know what they are talking about
and have the experience. The Government
should not waste its time appointing somebody
with expertise if it will not listen to it. I agree it
is a situation which needs discussion. Professor
Drumm is perfectly correct in his view that one
cannot have five hospitals with a huge range of
expertise and duplication within a small area.
I remember the situation 30 years ago when the
Minister for Education was giving lessons about
the proposed university merger involving Trinity
College. The argument was that duplication was
not desirable and in some ways that was valid; it
is certainly valid in terms of the delivery of
hospital services. However it must be ensured
that people can be brought rapidly from one
hospital to another and that beds are available.
There should be a computerised system to show
where beds are available. There should be correct
ambulance transport and properly trained personnel
to ensure people do not die in ambulances.
I urge the Government Members not to go
against Professor Drumm and his courageous
involvement and intervention in this matter.
There is clearly something wrong in the
hospital system within this localised area. It is
astonishing that this man was denied treatment in
a hospital; it would be a different matter if he
could not get to the hospital. Senator Brian
Hayes referred to another situation where a person
was denied admission to a local hospital. The
staff of the referring hospital decided they could
not bear the repetition of having to stand by and
watch a patient bleed to death so they took it
upon themselves to telephone the senior administrator
of Cavan General Hospital who was in bed
in the early hours of the morning. He instructed
the staff to admit this man. Why did that have to
happen? What is the ethos and where is the
notion of the hippocratic oath?
I do not know if the oath was ever administered
to doctors but it is something in the popular
imagination, like the 1916 declaration about cherishing
all the children of the nation equally. The
public has the idea in its head that a medically
qualified and trained doctor will do everything
possible to keep people alive. It could be that this
oath no longer exists but the ethos should. We
should feel confident that if we are in distress or
at death’s door, at least a proper, civilised effort
will be made to spare our lives.
We are all perishable goods, our time is short
and we might as well get used to it. The best we
can hope for is reasonable treatment and an easy
passage out of this world because that day will
come. We must be realistic. Our demands on the
health service are increasing every day to totally
unrealistic dimensions, particularly in the view of
people of my generation. I remember when
people would die of an inward pain and nobody
quite knew what it was. People accepted the realities
of life.
Realistic plans must be implemented. The
Hanly report will improve the situation. If Professor
Drumm states a modified form of the
Hanly report is required then he should not be
attacked politically but should be congratulated
on telling people the truth. It may be difficult for
politicians in their own constituencies to tell the
truth but Professor Drumm should not be
attacked for doing so.