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'Two friends died by suicide': Doctors say 'profoundly dysfunctional' health service takes huge toll

Consultants have said staffing and resource issues are impacting their mental health and compromising patient care.

File photo
File photo
Image: Shutterstock/Rungruedee

HOSPITAL CONSULTANTS HAVE said Ireland’s acute hospital system is at “breaking point” due to staffing and resource issues – compromising the care patients receive and taking a toll on the mental health of staff.

The Irish Hospital Consultants Association (IHCA) yesterday launched its pre-Budget 2020 submission, calling on the government to urgently address record waiting lists and the “unacceptable” number of patients being treated on trolleys.

IHCA members at the launch also spoke about the impact staffing levels and conditions have on doctors’ wellbeing. 

Dr Gabrielle Colleran, a paediatric radiologist at Temple Street and Holles Street hospitals in Dublin, said the stress of their job can take a “huge personal toll” on doctors.

She said burnout and depression are major issues among healthcare workers, noting that she has lost two friends to suicide.

“I personally have two physician friends who have committed suicide in their 30s. That has a huge impact, [medical workers] have a higher rate of suicide, we have a higher rate of depression, we have a higher rate of marital breakdown.”

Colleran said doctors often have to work very long hours, missing out on time with loved ones as a result.

“Last week, to give you an example I was in work until nine or 10 o’clock multiple nights, so I missed bedtime with my kids … I started working at half seven or eight those mornings.

So when you’re doing those kind of long days, it usually impacts on your ability to do simple things like get enough sleep, get the exercise you need, get the downtime and the family time.

Colleran said people who choose to work in healthcare “tend to be empathetic and caring” and can be deeply affected by the “profoundly dysfunctional” conditions they work in.

‘Horrendous’ 

Colleran previously worked in the US and said that while there are many issues with the healthcare system there, particularly in terms of inequality of access, she was better able to do her job there than in Ireland. 

“Any patient who needed anything, I could do it for them straight away, the most they ever waited was a week. Whereas here, I’m doing prioritisation for MRIs and ultrasounds, and I see notes from parents saying, ‘child missing school because of this’, ‘mom is a single parent and works full time, but will take unpaid leave for any cancellation at any time’.

And I’m reading this, thinking this is horrendous, the stress this parent is under, what this child is suffering. I’m totally limited in what I can do about it just because literally if I could clone every consultant in my department, we’d just about have enough people to meet the demand. It’s hugely demoralising.

‘Accustomed to misery’ 

Dr Laura Durcan, IHCA Vice President and a rheumatologist at Beaumont Hospital in Dublin, also previously worked in the US and said when she returned home to Ireland in 2016 she was “astonished” by how many patients in Ireland are treated on trolleys.

“When I came home from America first I was just astonished and I apologised to every person that I saw on the trolley and I said, ‘This is not okay that I’m seeing you this environment’.”

Durcan said in the past three years she has “become accustomed to the misery” that is regularly treating patients on trolleys.

“We have kind of learned to accept that, but it’s not okay. We should be putting in incident reports every time we see one single person who’s been on a trolley for 24 hours, we should be doing that.

But the truth is that we’re all so busy moving on to the next person or sorting out that person, we just become accustomed to the culture that this is how it is. And it’s not okay, they should be treated better, we should do better. It’s miserable.

More than 9,500 patients across the country had to wait on trolleys for a hospital bed last month.

Colleran noted that some patients die while on a trolley, saying this is simply not good enough.

“For some patients, that’s their last journey. So when you talk to families of patients who died on trolleys in EDs, there is a real lack of dignity in that, and that stays with those families. And we have to we have to do better,” she said.

In its pre-Budget submission the IHCA noted that one in five consultant posts (500 positions) are currently vacant or filled on a temporary basis. The IHCA said this is having a huge impact across Irish hospitals and mental health services, namely:

  • The number of additional patients waiting to see a hospital consultant is growing, on average, by 7,000 patients per month since the start of 2019
  • 200,000 more patients are now waiting to see a hospital consultant than was the case in 2014
  • The number of life-enhancing elective surgeries in public hospitals have more than halved (54%) from 197,817 in 2012 to 91,815 in 2018
  • The cost to the State in resolving adverse outcome claims under the Clinical Indemnity Scheme has ballooned to €246 million from €62 million in 2013

In a bid to tackle this, the IHCA, which represents over 95% of hospital consultants, said the government needs to significantly increase investment in acute hospital and mental health services in Budget 2020 – which is due to be unveiled next month.

The Department of Health had not replied to a request for comment about the IHCA’s recommendations at the time of publication.

The government yesterday published the HSE’s spending plan for the next three years – 250 projects are due to be delivered at a cost of €2.1 billion, including 480 new beds. 

An IHCA spokesperson said that while elements of the plan are welcome, “it will deliver less than promised under the National Development Plan, particularly on beds”. The NDP promised 260 new hospital beds each year from 2019 to 2021, totalling 780 beds. 

Need help? Support is available:

  • Samaritans 116 123 or email jo@samaritans.ie
  • Aware 1800 80 48 48 (depression, anxiety)
  • Pieta House 1800 247 247 or email mary@pieta.ie (suicide, self-harm)
  • Teen-Line Ireland 1800 833 634 (for ages 13 to 19)
  • Childline 1800 66 66 66 (for under 18s)

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About the author:

Órla Ryan

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