Friday 18 January 2019

Pizza cake, Leo

 

Taoiseach Leo Varadkar on a hospital visit.
Taoiseach Leo Varadkar on a hospital visit.

If the Taoiseach knows what needs to be done, why doesn't he take the HSE top job, asks Maurice Gueret, who reviews a fascinating new book on St James's

No takers

It's seven months since Tony O'Brien announced that he was going to stand down as HSE director general. As I write, we seem to be no closer to a midwife delivering a successor. CervicalCheck and a Leinster House witch-hunt conspired to bring the DG's resignation forward at the end. But just as he predicted, there have not been many applicants for his job. The Government actually knew of Mr O'Brien's exit plans back in 2017, so the delay in appointing a permanent DG looks like a case of nobody suitable wanting the position. The salary isn't bad. In fact, it's about the same as that of the Taoiseach. The job may suit somebody who worked for many years in emergency departments and "knows from experience" what's wrong. Somebody who has a track record of getting the most from their staff over the Christmas holidays. Santa might deliver more staff pizzas from Domino's on Christmas Eve, and there would be more celebrities on duty to lift staff morale on Christmas Day. We don't need more beds, or more resources. We only need what the candidate calls best practice. Come on, Leo. You know it all. You always have. Surprise us, and take up the HSE reins yourself.

Nurse Gargan

St James's Hospital and I go back a long way. As a teenager in Dublin, my weekend and summer job was as a nurse's aide on the long-stay wards. If I was Minister for Education for a day, I'd scrap the nonsense of HPAT aptitude exams and make such ward work mandatory for anyone who wanted to be a medical student. You learn more of humanity and humility in a few months with a mop in hand, than you do in six years on a college treadmill. I remember working on the top of hospital 4 in July 1982. It was a sunny weekend, and the death of Nurse Bridie Gargan was made known. The St James's nurse had been brutally murdered as she sunbathed in the nearby Phoenix Park. It was a numbing weekend for the hospital, and for Ireland.

Prefab blues

There's a new book out on St James's. It's too big for the average stocking, but would be a valuable present for anybody who has ever had a connection with the hospital. Written by Professor Davis Coakley and Mary Coakley, The History and Heritage of St James's Hospital, Dublin (Four Courts Press) is a great read, with extraordinary maps, photos and illustrations dating back to January 1706, when 124 vagrants were apprehended and brought to the new City Workhouse on Dublin's west end. Like many hospital histories, it focuses heavily on doctors, and rather too lightly on nurses. My personal memories of

St James's date from the decade of the 1980s, when much of its educational output, and indeed outpatient care, was dished out from wholly unsuitable prefabs that littered the campus. School pupils in Ireland weren't the only ones to be blighted with sub-standard, cheap, and wholly unsuitable accommodation. Thankfully, a fine new hospital emerged from the garden huts, and very soon a spaceship-like children's hospital will complete a modern campus. It's all a very long way from a place that once accepted anonymous foundlings, some trafficked from Scotland, in a revolving cradle at its gate.

No returns

I wrote recently about the NHS crutch amnesty in the UK. My inbox suggests that amnesty is perhaps not the correct word in Ireland. Our throwaway health services have no appetite for recycling barely used equipment. A patient in the sunny south-east tells me that her local hospital refused the return of perfectly good crutches, citing hygiene. A mum tried to return crutches and an expensive support-boot to Crumlin hospital after her daughter's fractured ankle had healed, but was told: "No thanks, they cannot be re-used." Madness, she rightly declares. A retired nurse tells me that she tried to return two wheelchairs, three walking frames and five pairs of crutches to the HSE. She was told they couldn't be re-used because of health and safety! Clearly, the NHS in the UK has dropped high-and-mighty standards for common sense. I'm interested to hear your stories about how easy it is to return unopened and unwanted medications to the health service. My impression is that Irish pharmacies are better at accepting these, but do patients expect or receive refunds for returns?

My email is mgueret@iol.ie.

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