Saturday 21 July 2018

Rude health: Barking mad

Hospital parking needn't be the headache we are used to, says Maurice Gueret, if we can control the 32nd Dail

Microchips are the best way to permanently identify pets
Microchips are the best way to permanently identify pets

Maurice Gueret

New laws came into force on Thursday compelling dog owners to microchip their pets. Pound owners, mutt lovers and animal wardens all emitted a happy bark of relief. Vets, too, are content with the extra work.

But I have a nagging doubt that this animal-loving legislation didn't go far enough. Regardless of age, breed or coat, couldn't we also have microchipped the 157 newly elected beasts of the 32nd Dail? Reports have been circulating that many of them simply went missing during the vital trick of forming a new government. They are, in the main, quite docile creatures who perform well in the ring for their masters. Neutering is not a humane option for those who misbehave, but the microchip might save the State a small fortune in everyday expenses. Signing in has long been a pre-requisite for the paying of politician's expenses. But this has led to the common practice of signing in, followed by a quick walkies. Political pups and bruisers often attend for a quick sniff or to cock a leg, before marching out on the grass for another hair-raising mileage claim. Back in my health-board days, we became well-accustomed to meetings that began to empty out after five minutes. And I know to  my own cost that the poodle who pointed out this feral behaviour was never the most popular pooch in show.

I mentioned hospital parking last week and the €4 charge that one regional institution was extracting from visitors after just 20 minutes munching grapes. To be fair, the first 20 minutes were free, but all hospital departments and wards are architecturally designed to be at least a 20-minute maze of corridors away from the pay station. This free-period policy is interesting because it does allow the theoretical possibility of avoiding the charge completely. First, the patient being visited needs to be wheeled down to the main concourse. One visitor sits with them while the other conducts clinical U-turns every 19 minutes in the car park. In this fashion, you can visit completely free of charge as often and for as long as matron allows. I was also surprised that all the wheelchair car spots were subject to the usual car-park fee. My understanding of disabled parking badges was that on-street public parking facilities were free to those who had them. Have we become too mean to extend this courtesy to public and private hospitals too?

One difficulty with hospital parking is that no attempt has been ever made to provide a clear or transparent service. There are huge variations in prices, policing and dispensations. Hospitals tend to contract-out these responsibilities to private companies and these contracts rarely make it into public view. I recall from my health-board days that one major hospital had an excellent arrangement with a local shopping centre, which allowed staff to park there in the morning. A mini-bus was provided to bring them over to work, and doubtless the nurses and doctors did a bit of shopping there after their shift. But the hospital car-park company didn't like the arrangement and felt it was doing them out of money, so they insisted that the service was brought to an end. Rightly or wrongly, the first and last impressions most patients and their families have of hospitals are made in their car parks. These experiences should be fair and transparent, and ignored at a hospital's peril.

This month's Irish Medical Journal has some new, excellent research from the headache clinic at Cork University Hospital.

Over 1,000 visitors to Munster chemists who had gone in looking for something for a headache were questioned about their symptoms and preferred treatment. Two results caught my eye. One was how few patients with frequent headaches had ever sought a medical diagnosis; the second was how commonly products containing codeine were sought. Doctors are increasingly identifying medication-overuse for headache where codeine-based products can actually cause the development of chronic daily headache, not to mention dependence. The study also showed that simple aspirin is very much under-appreciated, considering it is among the first-line treatments of tension headaches and migraine.

My own lifelong research into the human condition continues, and I am always happy to receive pithy observations at or post to PO Box 5049, Dublin 6W. What stops me sleeping is a new personal project between me and my little black Moleskine. I have been documenting things that keep me from a good night's sleep. There are eight entries to date. In no particular order, they are wines from Chile, Chinese food, a glass of milk before retiring, a closed bedroom window, dog in the bed, warm nights, the Garda helicopter and having to write Rude Health the next morning. Please do let me know anonymously of your own personal causes of insomnia and we'll see if there are any interesting matches. What stops me snoring is a separate lifelong struggle being worked on by other members of the family.

My quest for the most exciting nursing home in Ireland, one with the greatest potential for extracurricular activities continues. A Galway reader tells me of a care centre in Connemara that is right beside the church, the pub and the beach. Sounds very promising indeed. Throw in a 1980s-theme disco, high-speed internet and a rowing boat, and we could set that date for 2043.

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

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