Donie's Ireland news Thursday

Patients on trolleys in Irish hospitals is still a big problem, say our nurses

 

The numbers of patients on hospital trolleys has fallen generally over recent months but nurses have said the problem is still significantly worse than when it was declared a national emergency in 2007.

On the opening day of its annual conference in Killarney yesterday, the Irish Nurses and Midwives Organisation also said care had been compromised by the departure of thousands of nurses from the health service who had not been replaced.

Analysis carried out by the union showed that, nationally, the number of people on trolleys in the first four months of 2012 fell by 17 per cent compared to the same period last year.

The union also said over 2,400 public beds were closed around the country. Of these 1,300 were acute beds, with the remainder being continuing care beds.

General secretary Liam Doran said while good work was happening, there was much more to do.

He said it was no surprise that there were still a number of “black spots” with regard to emergency department overcrowding.

“You simply do not have enough bed capacity to cater for demand. That means the trolley figures are getting worse in some hospitals but those same hospitals have significant bed closures. This cannot continue if we are to address the overcrowding problem.”

Mr Doran said 5,000 nurses had left the Irish health system in the last 3½ years, and 2,000 in the past year.

He said no amount of reassignment, reconfiguration, rerostering or redeployment could cover the gaps.

Mr Doran said such gaps were increasing. “It is the view of the executive of this organisation that care is now being compromised. And senior management in the system are not listening to nurses and midwives as they articulate their concerns about patient care and the ability to meet demands of patients; to provide the full care plan drawn down for patients.

“Management have their own pressures but they have to give more primacy and priority to nurses and midwives at the frontline who say, ‘we are too short, we are now in an unsafe environment where safe care cannot be provided on a 24/7 basis’.”

Asked about where care was being compromised, Mr Doran said in some facilities for the elderly one nurse was looking after 30, 40, or 50 patients for 16 hours a day with one healthcare assistant because staff were not replaced. He said individual examples would emerge during the conference.

Mr Doran said that among the reasons for the fall in the numbers on trolleys was that the Department of Health’s special delivery unit was requiring local hospital management to accept that this was a problem that had to be managed on a full-time basis. He said, in addition, funding was being provided to open some extra beds.

Mr Doran also said some hospital managers had been trying to “hide” the extent of overcrowding by putting those on trolleys into inpatient wards, a practice that was supposed to be reserved for major emergency situations.

While the numbers on trolleys fell in most areas over recent months, the study found there had been increases at the Mater in Dublin, the Mid-Western Regional Hospital in Limerick and Our Lady of Lourdes Hospital in Drogheda. He said Drogheda was “downsized too quickly”.

Ireland’s Tourism industry hails the retention of the 9% VAT

     

The tourism industry in Ireland has welcomed the retention of the lower 9 per cent VAT rate across the sector until the end of next year.

The VAT rate on services sectors such as hotels, restaurants, leisure centres and attractions was reduced from 13.5 per cent last year as a “temporary measure” to boost demand. Minister for Tourism Leo Varadkar yesterday confirmed the lower rate would continue until the end of 2013 at least.

Adrian Cummins, chief executive of the Restaurants Association of Ireland, said the next 18 months would be crucial for the sector.

The Irish Hotels Federation said the news meant hotel managers could now plan properly for next year. Its president, Michael Vaughan, said the rate cut had already provided a huge boost to the sector.

“It provides much-needed visibility and clarity, which will enable international tour operators to plan their 2013 trips to Ireland with greater certainty on pricing.

“The 9 per cent VAT rate gives tourism enterprises a key competitive advantage when marketing Ireland as a tourism destination, particularly in the run-up to The Gathering in 2013, which is to be Ireland’s biggest-ever tourism initiative.”

Niall Gibbons, chief executive of Tourism Ireland said that in recent years, “perceptions of the value available here among overseas consumers have improved and we know that a recent survey by hotels.comshowed that Dublin hotels are now the least expensive in Europe.

“Tourism Ireland is placing significant emphasis on value, to drive home to potential holidaymakers everywhere our message about the superb range of offers and value available in Ireland.”

Unnamed Public Hospital faces fine for not clearing its waiting lists

       

A public hospital is facing substantial fines for failing to meet Government targets for treating patients on its waiting list.

The chief operating officer of the Department of Health’s special delivery unit, Tony O’Brien, said it was in significant discussions with one institution about the extent of the penalty to be imposed.

He said all the relevant information had to be obtained before a final figure could be decided upon.

Mr O’Brien said the potential for the fine arose because a number of patients remained untreated at the end of March, having been on the waiting list for 12 months. He declined to identify the hospital concerned.

Under measures announced earlier this year, the Department of Health said hospitals that did not meet its target of treating patients on their waiting lists within one year would face potential fines of €25,000 per case per month.

Alternatively, hospitals would have to pay for the patients waiting longer than one year to be treated elsewhere.

The Government’s target for the maximum period on waiting lists is to be reduced to nine months from September.

Mr O’Brien said the hospital in question was not University College Hospital in Galway, which had the largest number of patients waiting longer than 12 months at the end of last year.

“Galway has been in what we call ‘special measures’ since it failed to meet targets for waiting lists last December. We are working with them very actively to ensure they meet the September target and it would not be very fruitful to impose incremental penalties on them as they go along.”

Beaumont Hospital, which had more than 80 patients waiting over a year for treatment according to figures released by the HSE in February, said last night that it had cleared its waiting lists.

Speaking about the controversy over the hiring of outside experts by the special delivery unit, Mr O’Brien said it had brought in people with specific expertise and a track record elsewhere. He said the benefits of that would be seen over time.

Mr O’Brien also said that more beds would be provided at Our Lady of Lourdes Hospital in Drogheda, where a capacity issue had been identified. Funding for 11 more beds would be forthcoming. He said where it was clear a hospital did not have the right capacity this needed to be addressed.

One man is arrested over Cork to Mallow harness race

    

One man has been arrested and investigations against a number of others are continuing after the Cork to Mallow road was used for a harness race on Saturday.

A video of part of the race, on the main Cork to Mallow road, has been uploaded to YouTube and to a number of other social media websites.

The road is one of the busiest commuter corridors in the country, handling an average of more than 15,000 vehicles per day.

At around 7am last Saturday morning, part of the road was turned into a race track involving two horses pulling distinctive two-wheeled sulky carts and riders.

The dangers were obvious. At one stage, four vehicles lined up across the road. At another, one of a number of following vehicles narrowly missed an on-coming articulated lorry and trailer.

Several cars travelling in the opposite direction to the race had to drive onto the hard shoulder, as other drivers overtook the riders.

Gardaí were contacted and the race was stopped. They say a full investigation is now under way.

Gardaí are appealing to motorists who were on the Cork/Mallow between 7am and 8am last Saturday to contact them.

They say they have identified a number of the people involved and say they are satisfied they are members of the Traveller community.

Permanent TSB Bank’s chief executive apologises to customers for mistakes

          

The new chief executive of Permanent TSB is writing to more than one million customers apologising for past mistakes and saying that the bank’s €4 billion Government bailout “could have been used much better elsewhere”.

Jeremy Masding, the UK banker appointed in February, is saying, in a letter being sent to customers over the coming weeks, that he is determined to rectify these mistakes.

“As a result of some of the bank’s decisions and actions, the Irish taxpayer has had to invest substantial funds when those funds could have been used much better elsewhere,” he writes.

“Many of the bank’s customers have suffered financially because of the impact of decisions which should not have been taken. I apologise for the mistakes which were made and I am determined to do all in my power to rectify them.”

Mr Masding said that the bank, which is 99.2 per cent State owned, would “act responsibly to protect the investment which the taxpayer has made in the bank”.

A spokesman said Mr Masding felt it was critical at the outset to acknowledge the bank’s unacceptable performance in recent years and “to apologise to taxpayers and customers for the mistakes”.

The Government effectively nationalised Permanent TSB last year by injecting €2.7 billion following last year’s stress tests of the banks. A further €1.3 billion will be raised through the Government’s purchase of Irish Life.

The troika and the Government approved a plan last month to carve a good bank out of Permanent TSB by moving about a third of its €34 billion in loans to an internal bad bank to be run down.

Minister for Finance Michael Noonan has said that Permanent TSB has the potential to become a “third national bank” to compete with Bank of Ireland and AIB.

In his letter Mr Masding says that a new, “more humble” Permanent TSB will emerge over the coming years. He said the bank would work to start lending again and help customers in arrears.

“We understand that being in arrears is stressful. We have a wide range of options available to help everyone in this situation.”

The bank would review mortgage rates regularly to ensure they were “as competitive as possible”, he said.

Donies all Ireland news Tuesday

HSE cuts putting some much needed drugs out of reach for some of Ireland’s patients

   

Hospitals are unable to stock certain drugs due to a diminishing budget for medicines,

The decision by the Department of Health to make the cancer drug Ipilimumab available was welcomed last week. But it is just one of many drugs doctors have been unable to prescribe for their patients.

Since January this year, the National Centre for Pharmacoeconomics (NCPE), which measures value for money, has assessed 16 drugs. Most were recommended for further evaluation, two were recommended for release and three were found not to be cost-effective.

Among those deemed not cost-effective was Rivaroxaban. It, and a similar drug, Dabigatran (as pictured above), are used to prevent stroke and embolism. Both are alternatives to Warfarin, which is cheaper and has been on the market for many years.

Dr Joe Galvin, cardiology consultant at the Mater hospital, says Dabigatran had been available until last autumn when it was withdrawn, except for patients already on it.

For most patients Warfarin is effective, Dr Galvin says, though it does require blood tests to control its levels. But for some, it causes bleeding and can be dangerous.

“I’ve had some patients who’ve had major bleeds even though they have been going to the Warfarin clinic [for blood tests],” he says. The drug can be affected by diet, Dr Galvin says, whereas Dabigastran is stable. He understands the financial constraints, but says it would be useful if there was some mechanism to petition the HSE on behalf of individuals who really need the drug.

Noel Horgan, consultant ophthalmic surgeon at the Royal Victoria Eye and Ear Hospital says he can no longer obtain Ranibizumab, used to treat patients with age-related macular degeneration and diabetic eye disease. Though it was available up to the end of last year, most hospitals in the country no longer stock it because of its cost.

“It is proven to be of real benefit in improving or preventing vision loss in diabetic patients,” he says. “There are young diabetic patients who are potentially at a disadvantage because of lack of access to it.”

Hospitals are taking another drug of similar chemical composition, used intravenously to treat cancer and still being purchased, and subdividing it into vials for use as an eye treatment. But it has not been licensed for that purpose.

He says there should be ring-fenced funding to treat people with the condition and better negotiation on pricing.

“At present, the best we can do for patients is offer them an unlicensed treatment,” he says.

Oncologist and Senator Dr John Crown says there are cancer drugs other than Ipilimumab that should be available, including Cabazitaxel, for treating prostate cancer. It was judged not to be cost effective by the NCPE in March this year. He says the model being used to assess cost effectiveness is flawed and simplistic.

“Cancer drugs should not be measured by cost per year of life saved. They should apply that to press secretaries and PR consultants and to Hiqa [Health Information and Quality Authority] before they apply it to cancer drugs,” he says.

Director of NCPE Dr Michael Barry believes we are going to see more and more pressure on the system as more high-cost medications come down the pipeline. “With a diminishing budget the real task is to satisfy patient demand,” he says.

There should be more use of performance-based risk-sharing schemes, he says, in cases where drugs are only effective for a small number of patients. A drugs company could pay part of the cost of treatment and the HSE could pay the remainder.

“If the patient is responding we’ll continue to pay; if not the HSE gets the money back,” he says.

Chief medical officer at the Department of Health Dr Tony Holohan believes prescribing should be reduced. We spend €2 billion a year on drugs, he says, and there is a wide variation in patterns of prescribing by GPs. The level of antibiotic and statin prescription, to reduce cholesterol, is “of concern” he says. And some GPs prescribe expensive brands when cheaper versions are available.

“There is a lot of expenditure that could be redirected to new drugs,” he says. There needs to be a “root and branch look at total expenditure” on drugs, he says, and evidence-based prescribing must be introduced.

We keep adding to the cost base, but no one would want to see services cut to fund drugs, he says.

Ireland breathes a sigh of relief as the 100 year old Tortoise returns home to his lettuce

 

Florentine enjoys some strawberries and lettuce after returning home

He’s the twitter tortoise who had all of Ireland looking for him but today Florentine, the 100-year-old family pet finally found his way home.

Florentine escaped from his home in the south Dublin suburb of Rathgar in the early hours of Saturday morning.

The Eogan family, who have owned the tortoise for the last 40 years, took to social media in an attempt to find him.

The hashtag #rathgartortoise began trending on twitter across Ireland.

Florentine’s story went viral with all the major media outlets in Ireland following the story.

The tortoise escaped through a side gate which had been inadvertently left open by his owners. He has been living with the Eogan family since the early 1970s.

Cliona Eogan, said today: “Yes he is home, he was covered in muck, we think he might have buried himself in the neighbours garden.

“It is totally unusual for him to do that, we can only assume that it’s due to the weather.

The 100 year old tortoise became an internet hit when he went missing

“The reaction across Ireland has been unbelievable – we never expected that it would take off like this. Florentine is loving his new-found fame and all the attention.

“Now he is home we have given him some of his favourite foods as a treat – lettuce and strawberries.”

Cliona’s mum Fiona had made an appeal for help to find the tortoise earlier in the day on BBC Radio Ulster’s Talkback programme. She told host Wendy Austin the family was worried Florentine would be “run over or get stuck in a drain.”

Well wishers took to twitter after news of his safe return broke. @Hollygray10 said “I’m so happy the #rathgartortoise has been found safe and well.” @CultHeritageIrl added “The Irish Nation breaths a sigh of relief as Florentine the tortoise is found.”

Florentine is now recovering in his garden and enjoying his new found celebrity status. The Eogan family are just pleased he returned before they had to ‘shell’ out for private investigators.

Zinc remedy: a great fix for the common cold?

    

For years, researchers have remained dubious about zinc as a remedy for the common cold.

New evidence, however, suggests that oral zinc may shorten the duration of cold symptoms – if patients can stomach the treatment.

A study published in the Canadian Medical Association Journal found that nausea was a common reaction to oral zinc preparations.

Of 2,121 participants in 17 randomized controlled trials, about 17 per cent of people taking zinc remedies experienced nausea, while about 35 per cent said zinc left a bad taste in the mouth.

On the plus side, zinc lozenges appeared to shave 1.6 days off the usual seven-day cold. But oral zinc did not reduce the severity of cold symptoms, such as sneezing, coughing and congestion, says Michelle Science, an infectious diseases physician at the Hospital for Sick Children in Toronto, who co-authored the study with researchers at McMasterUniversity in Hamilton.

Although the study suggests that oral zinc may reduce the duration of the common cold, she says, “there is not enough evidence to recommend its use in children and only a weak rationale [for use] in otherwise healthy adults.”

The treatment regimen may be unappealing to cold sufferers, she adds. At the onset of cold symptoms, participants in most of the trials sucked on a zinc lozenge every two hours when awake. “Some people may consider it to be onerous,” Dr. Science points out.

The remedies in the trials consisted of zinc alone and not in combination with other minerals. The trials included three different formulations: zinc acetate, zinc gluconate and zinc sulphate.

The researchers found that zinc acetate, in particular, and treatment regimens that resulted in higher total daily doses of ionic zinc – the form of zinc released in the body – seemed to have the most beneficial effects. But the studies varied greatly in their methods and results, says Dr. Science, who emphasizes that further research is needed.

“At this point it’s difficult to make a firm recommendation on the dose or formulation that’s optimal for use,” she says.

An earlier study by Harri Hemila of the University of Helsinki in Finland found that some forms of zinc are not readily available to the body, whereas zinc acetate appeared to be a highly effective cold remedy.

In Dr. Hemila’s analysis of 13 placebo-controlled studies, three trials showed that a daily dose of zinc acetate greater than 75 milligrams shortened the typical seven-day cold by four days.

Many supplements sold in Canadian pharmacies do not contain zinc acetate, however. And cold sufferers need to weigh the discomfort of coughing and sneezing against the risk of nausea and the bitter experience of sucking on zinc lozenges all day.

“The decision to take zinc should take into consideration the questionable benefits balanced with these potential adverse effects,” Dr. Science says.

The loss of the (kippers) and coping with the empty nest Syndrome

      

‘I WAKE up each morning to silence and I still can’t believe it. No alarm clocks ringing. No one running up and down the stairs. No screams of ‘Where did I leave my keys?’ In the kitchen everything is just as I left it.”

“The children are gone”

What comes next are two little words that stopped me in my tracks: “What bliss.”

Oh. Where are the nostalgic memories of making sandwiches for the little mites, of sticking plasters on their knees and all that sort of thing?

Isn’t that what is supposed to go with Empty Nest syndrome? Sentimentality, tears, what am I going to do now?

Anne Ingle’s version of Empty Nest syndrome in her Blog is listening to her jazz records all day if she feels like it, having her dinner whenever she wants, eating whatever she likes and even going to the pictures with her friend – in the afternoon if you don’t mind – and having tea in the Gresham.

Actually, Ingle is not some strange, Medusa-like figure just because she enjoys the fact that the children have moved out. Researchers have found that most parents find the empty nest experience quite liberating.

Their level of happiness in the marriage will have dropped when the first child was born and rises again when the last child leaves. That’s also backed up by research.

We don’t have children to be happy but to fulfill some deeper need.

Stress is more likely to come, not from the empty nest but from the crowded nest. In other words, the children have grown up, but they have not left home.

And these kippers (Kids In Parents’ Pockets), as they are called in Britain, are more likely to be men than women.

There’s lots of them about. EU figures would suggest that almost 60 per cent of males and more than 40 per cent of females aged 18-34 live with their parents.

You might argue that going to university lengthens the time spent living in the family home, but note that the age range goes all the way up to 34. What are they doing, PhDs?

How to get rid of them? With luck, love steps in. People involved in a “consensual union”, as Eurostat elegantly calls it, rarely live at home, even in Ireland.

I wonder if the role of matchmaker, á la John B Keane, could be revived in a modern setting to get stay-at-home guys fixed up with someone who will take them out from under their parents’ feet? I’m sure many a parent would be happy to pay the fees.

It’s the guys who will have to be fixed up because, as I mentioned, the women are more likely to leave the nest.

By the way, according to a European quality of life survey in 2006, about 12 per cent of women aged 18-34 describe themselves as living as lone parents compared to 1 per cent of men.

What all this says to me is that young women are growing up an awful lot faster than young men when it comes to engaging with the challenges of adult life.

In Britain, about a third of kippers say they stay with their parents because of the cost of renting or buying property. But some others stay for free food, laundry services, accommodation, television, internet – yes, it’s a long, long list.

Matchmakers aside, what’s to be done? What if kippers were expected to pay their way if they were in employment, in other words, contribute to all those invisible costs they never think about? And what if they were expected to get out the Shake ’n’ Vac and clean the house on a regular basis?

Would that help? Probably. Is it too much to ask? Probably.