Monday 17 December 2018

Hospital crisis: Cash offer to GPs for elder care to ease beds crisis

Scheme aims to ease pressure on hospitals. Taoiseach remains silent on trolley crisis. Warning waiting patients face added risks

Hospital crisis: Patients on trollies in the corridor at St Luke’s General Hospital, Kilkenny. Photo: Tony Gavin
Hospital crisis: Patients on trollies in the corridor at St Luke’s General Hospital, Kilkenny. Photo: Tony Gavin

Philip Ryan and Wayne O'Connor

GPS will be paid new fees to visit nursing homes and call to the houses of elderly people as part of a new initiative aimed at alleviating the pressure on hospital emergency departments.

The payments will form part of the new GP contract which is being negotiated between the Irish Medical Organisation (IMO) and the Department of Health.

It is hoped the additional funding will result in more GPs regularly visiting nursing homes and reduce the need for staff to bring residents to hospital.

A Department of Health source said they would like to see GPs paid to become "area officers" for communities and have responsibility for all elderly people in their catchment area.

Minister for Health Simon Harris has also been given the green light to have GP fees included in the next round public sector pay talks.

Fees paid to GPs were significantly cut during the financial crisis but have not been discussed during pay talks.

Minister for Finance Paschal Donohoe reached an agreement with Mr Harris to have doctor's fees included in further talks on unwinding the Financial Emergency Measures in the Public Interest (FEMPI) Act 2015.

Mr Harris has been under serious pressure over his handling of the health service and the escalating trolley crisis.

Last week saw record numbers of people waiting to be treated while lying on trolleys in cramped hospital corridors.

Officials are now concerned these figures will increase over the weekend as more patients attend hospitals seeking treatment.

There was public outrage when it emerged 12 children were forced to wait more than nine hours on trolleys before they received treatment.

Yesterday it emerged Mr Harris has been advised the public health system will need between 7,000 and 9,000 more hospital beds in the next 10 years if urgent reforms are not implemented.

The HSE's bed capacity review also recommended implementing the reforms suggested in the cross-party agreed Slaintecare Report which outlines a major overhaul of the health system. The Irish Independent revealed yesterday that if the reforms were implemented, the State would need an additional 2,500 beds in the next 10 years.

The bed capacity report also recommends the construction of elective surgery- only hospitals and more investment in community medicine.

It is understood funding will be made available in the much-anticipated capital spending review for a number of elective surgery-only hospitals.

Taoiseach Leo Varadkar refused to comment on the continuing crisis in Irish hospitals yesterday when he attended the launch of a new Government-backed health initiative.

When asked by reporters if he would like to talk about the trolley crisis, Mr Varadkar responded that he was happy to launch the new 2018 Healthy Ireland campaign at Croke Park.

Labour Party health spokesman Alan Kelly urged the Government to set a clear timeline for the implementation of Slaintecare reforms.

"Today's reports on findings of the bed capacity review highlight the positive impact the implementation of Slaintecare reforms would have on our health service in relation to the hospital bed crisis.

"The report found that instead of needing up to 9,000 extra beds over the next 10 years, the implementation of Slaintecare measures would see that number reduced to around 2,500. At a cost of around €325,000 per bed, this would clearly represent a significant saving that could be redirected elsewhere in the health service.

"Reducing the reliance on our hospitals and investing in community healthcare would help to significantly reduce the pressure being placed on our hospitals and the demand for beds we are currently seeing. With the 10-year capital plan due shortly, we need to see a clear timeline for the implementation of these proposals - we can't afford to waste any more time," Mr Kelly added.

It came after patient and doctor groups said the hospital trolley crisis was rooted in years of failure.

They warned that patients are being exposed to further illnesses and accidents because of severe overcrowding across the country.

Irish Patients' Association chairman Stephen McMahon said the crisis was having a detrimental impact on patients who have had planned operations cancelled as a result of the hospital overcrowding.

"Overcrowding is undignified, unsafe and exposes patients to preventable risks," he said. "We normally see a post-Christmas surge and this has an influenza impact, spreads respiratory illnesses and can lead to slips, trips and falls.

"There are associated risks for 494,530 patients waiting for their first consultant-led appointment, or one of 80,894 people waiting for their planned operations."

The National Association of General Practitioners (NAGP) said the crisis was rooted in years of failure.

NAGP chairman Dr Andy Jordan criticised former health minister Dr James Reilly, who last week called for greater investment in primary care. He said the profession was blighted by young doctors choosing to emigrate and that a recruitment crisis looms.

"During Dr Reilly's time, GPs were forced to endure savage cuts, which continue to affect the delivery of care to patients," Dr Jordan said yesterday.

"A lot of fine words are being spoken about implementing the Slaintecare Report and a shift to primary care. The NAGP has yet to see the required money and reform commitment from Government to back that up.

"The last thing the health service needs is a lecture from a failed health minister."

Last night, the IMO claimed management at Connolly Hospital, in Blanchardstown, Co Dublin, wrote to staff informing them that medical and surgical interns will not be getting paid for overtime from tomorrow.

The email said interns should not be working before 8am or after 5pm and no payment would be paid for hours worked outside of this.

The IMO's Dr Paddy Hillery said interns are routinely expected to work outside of these hours.

A spokeswoman for the RCSI Hospital group last night said interns must seek approval before they can work or be rostered for any paid overtime.

"All NCHD's receive a salary based on their contract including overtime when it is incurred and rostered.

"Where unrostered overtime is incurred this requires authorisation by the designated consultant and where this occurs the necessary payment will be paid."

Sunday Independent

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