Tuesday 23 January 2018

Hospital radar - can we get a live map of hospitals?

Live, real-time information on every aeroplane in the sky gives an idea to Maurice Gueret, as he eyes up a bargain hospital

Flight path of Ryanair flight FR3884 bound for Malta from Luton, London (Photo: FlightRadar)
Flight path of Ryanair flight FR3884 bound for Malta from Luton, London (Photo: FlightRadar)

Lying in wait for a recent sunny dawn, I was enjoying the good-morning tweets from our feathered friends. Soon the early bird flights started up at Dublin airport, and I wondered if it might be possible to identify each overhead plane, just as one can identify a visiting bird. Following a quick google, I was on my way. Flightradar24 is a live website that tells you exactly what planes are flying above you.

It will tell you the type of aircraft, where and when it came from and where it's off to. The basic service is free of charge. I don't think they provide passenger lists, but professional plane spotters can avail of a more complicated service for a fee. It's fascinating to look at a map of our little isle and see how few aeroplanes actually use our lonely airspace compared to the Continent. An idea strikes me. Could we construct a live map of hospitals and health-service personnel to see exactly where they are all the time? Could the 30 nurses at a clinical meeting spare a half-dozen colleagues to attend a pinch-point or bottleneck in the system? Is there a good reason for four medics being asleep in the doctor's residence while the emergency department is bedlam? Pigs might fly.

The INMO says that nurses are the only ones who actually do any work in our hospitals. They get down and dirty to dig holes while the rest of the health service look on. The INMO had the grace to issue a delayed apology for the internet meme which implied that specialist colleagues and junior doctors didn't really do any work at all. But I think the fiasco exposed the mindset of alickadoos who are attracted to this sort of inter-union rivalry in the first place.

I was writing recently about the thousands of patients who don't turn up at outpatients each year. One staff member wrote to tell me that her Dublin hospital sends automated reminder texts to all patients two weeks before their appointments, and again seven days before. They also get letters. And she rings them up to confirm. And they still don't show up. A doctor wrote to tell me that some hospitals are now employing 'Clear the Waiting List' crews and that these blow-ins have an alarming tendency to view patients as the enemy. More seasoned hospital staff will recognise that some patients simply die or get admitted elsewhere.

Another correspondent got close to the nub of the problem. John has a long-term illness which merits regular public-hospital attendance. He gets text reminders, but has a problem calling back to say he cannot attend. The phone lines are invariably engaged. He looked into the matter further and discovered that all the text reminders are sent at precisely the same time each day. He suggests that hospitals stagger the texts over the course of each day, or else hire a dozen people to man the phone lines in the hour after the text going out. Not rocket science. More important than that. There are solutions for most of the difficulties in our health service. And it's patients who are more likely to have them than the mandarins, the medics and the men and ladies in unions.

The Irish Medical Journal has recently gone the way of the world. You can no longer get a paper copy for love nor money. The esteemed journal has gone online-only, but its research papers are as topical and useful as they always were. In the latest edition, the orthopaedic crew at Galway University Hospital has been looking at farm fractures in Ireland over the last 10 years. There are at least 200 bones broken every year by farmers and their families that require admission to hospital. Fractures of the wrist and hand are the most common, followed by breaks of the ankle, foot and the lower leg. Next most common among farmers are chest injuries to the ribs, breastbone and thoracic spine. Half of all fatal injuries happen to those over the age of 65, and there is another graphic spike for young children. Fifty per cent of farm deaths are caused by tractors, farm vehicles or other machinery, while the next biggest categories are fatal injuries from livestock, drowning, gas, falls from a height or timber-related accidents. The authors note that attendance at safety courses can be as low as 22pc and suggest that older farmers need to be targeted with safety messages, or, indeed, their spouses do. Good advice.

One of the finest Victorian buildings in the country is up for sale at a knock-down price of €780,000. Not bad for 130,000 square feet of history. St Senan's Hospital has overlooked the lovely town of Enniscorthy for almost 150 years, and provided refuge for mental illness for generations of Wexford folk. An urban myth grew up that the hospital was mistakenly built on the architectural designs of a Maharajah's palace in India. It wasn't, but the beautiful edifice is still very much Enniscorthy's Taj Mahal. My grandfather had a job offer as resident medical superintendent there just before World War II, but chose to ply his trade in Monaghan instead. Psychiatric needs in Monaghan were greater, and the golf course was more challenging. The lucky new owner may find out whether it is truly haunted or not. I remember hearing a story about a long-stay female patient who kept going missing on nurses during the month of December. After a few years, her whereabouts in the run-up to Christmas was discovered. She would peacefully sit inside the life-size hospital crib and watch the world go by. Wise woman.

Dr Maurice Gueret is editor of the 'Irish Medical Directory'


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