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'People say I'm in a privileged position. I don't consider cancer a privilege'

The government created a single-tier health service at the beginning of the crisis, but criticism of the contracts is ramping up.

Image: Shutterstock/sasha2109

GERRY KENNEALLY IS 64 years old. He was diagnosed with bladder cancer in October 2017.

Since then, the Celbridge resident has had eight operations. He’s had a kidney removed, and has had tumours removed from his bladder. He’s been through rounds of chemotherapy. 

Every three months, he gets a screening to check if any tumours have returned. 

His next screening is due in June. He and his wife had paid for VHI health insurance for many years, so Kenneally was treated as a private patient from his first diagnosis.

Private and public patients alike have had uncertainty thrown up around aspects of their care since the onset of the Covid-19 pandemic in Ireland.

All non-urgent elective procedures were stalled at the beginning of the pandemic, adding to some already-long waiting lists in the public setting and this was among a number of knock-on effects of the pandemic on the health service. 

Now, Kenneally  not sure if that scan will go ahead and also if it will be at the Beacon where he has had his previous treatments. “The whole idea of not knowing is awful,” he told TheJournal.ie. “People say I’m in a privileged position. I don’t consider cancer a privilege. 

I’ve worked all my life, and paid for my VHI – but I’m not a rich person.

One-tier health service

At the onset of the Covid-19 crisis here, the Irish State effectively created a one-tier health service by taking private hospitals into the public system from mid-March.

The Taoiseach has told the Dáil this arrangement is costing €115 million a month. The agreement in place is aimed at freeing up capacity to deal with the potential upsurge in Covid-19 cases.

However, figures from the HSE have shown that much of this capacity within private hospitals has not been used and some doctors have been critical of the arrangements made, particularly around contracts. 

For public patients, some cancer screening programmes have been curtailed and politicians have called on the private hospital capacity to be used to reduce long waiting list in the public hospital setting. Furthermore, it is claimed that due to the capacity of private hospitals not being used, public patients aren’t accessing that healthcare that is costing the State €115 million a month. 

Late last month, consultant cardiologist Dr Crochan O’Sullivan told RTÉ’s Morning Ireland that the State’s private hospital deal was a “bad deal for the taxpayer, a bad deal for the doctors and a bad deal for patients”. 

O’Sullivan, who is now a temporary HSE employee after signing the contract, said he has had to cancel his own patients until he becomes an independent practitioner again later this year.

He added: “In the meantime, I will be seeing patients on HSE waiting lists who will be seen based according to need, which I’m very happy to do.

“But it must be realised that this contract was unilaterally imposed upon us by the Department of Health.

We would like a service-level agreement where we could give some time to the HSE and work with public patients, but then we’d also like our own time to deal with our own patients and be able to meet the obligations on our own patients.

Oncologist Professor Frank Sullivan told RTÉ’s Today with Sarah McInerney on Friday that the current deal is “delaying services to cancer patients”. 

“It is well documented that delays in biopsies, early access and treatment is likely to have consequences for patients, and this could mean loss of life,” he said. “It is a very serious issue for all cancer patients be they public or private. This deal has been a disaster from start to finish, and the sooner it’s over the better.”

‘Not in the middle of a pandemic’

Kenneally is in such a position where he would like to be treated by the same consultant who has been with him every step on his journey with cancer so far.

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“I think it’s a great idea to have a one-tier health service,” he said. “But you don’t bring it in in the middle of a pandemic. You don’t lock out consultants with specialised skills.”

He emphasised the significance to him of having this doctor with him while he’s been fighting cancer.

“That relationship is crucial,” he said. “He’s seen me at my best, and my worst. For three years he’s seen me every day when I’ve been in hospital. Every operation, every scan. 

I remember one time I was in a dark place. All sorts do come into your head. I asked him ‘is this it for me?’. He told me ‘not on my watch’. That gives you the hope and belief to get there. He’s my ally in my battle to stay alive. My ally could be taken away by an arbitrary decision.

Kenneally – who worked in the health service himself as a mental health nurse and retrained to be a psychotherapist – said that everyone should have the same opportunity to get the same treatment going through a situation like he is in. 

With the money being spent on private hospitals by the State during this crisis, there has been further criticism that this capacity isn’t even being used as it could. On Thursday, Fianna Fáil’s health spokesperson Stephen Donnelly said it looked like time to cancel the contracts.

“The HSE and the Department of Health envisaged that private hospitals would be used for routine scheduled care in order to tackle the increasing waiting lists,” he said. “We are paying €115 million per month for empty beds, shut doctors’ rooms, dark operating theatres and unused diagnostic equipment. It really is the worst of both worlds.”

On Thursday, the Irish Hospital Consultants Assocation said that an increasing number of urgent non-Covid patients were being prevented from obtaining the urgent hospital care they need as it called on the government to make this deal work for patients. 

For Kenneally, he just wants clarity so he can know who’ll be providing his care and if he can attend his planned scan for next month.

“19 June is my next scan,” he said. “I hope to have it. I’ve spoken to my doctor and that’s the scenario I’m planning for. 

In my position, I have a three-month life span. I go from one scope to the next. We’ve heard about the curve. I have my own cancer/anxiety curve. On 10 March, I got a clear report. My curve was flat. It usually happens that it stays like that for 11 weeks and I’m in good form. On the 12th week, the curve heightens and you start to worry they’ll find something. My curve of anxiety is shot straight up. Everyone deserves the best care. Everyone deserves clarity. That’s what I want too.

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About the author:

Sean Murray

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