Monday 18 December 2017

Rude health: Harbour tragedy

Health and safety is more of a concept in Ireland than a reality, says Maurice Gueret, who has a few small suggestions

Flowers at the scene where five people drowned in a car that slipped into Lough Swilly in Buncrana, Co Donegal. Photo: Mark Condren
Flowers at the scene where five people drowned in a car that slipped into Lough Swilly in Buncrana, Co Donegal. Photo: Mark Condren
Dr Maurice Gueret

Considering the number of people we employ on this island with 'health and safety' on their business cards, benefits can be difficult to spot. The horrific death of five family members when their car slipped into the cold water of a Donegal harbour last month is a case in point. There are painful lessons that we must learn from unpredictable tragedies such as this, but the news that the pier was open to cars just days afterwards, without so much as a barrier or a warning sign, suggests that early intervention can be a very foreign concept to our public service.

Green algae is a familiar sight to boatmen, sea anglers and coastal walkers. It's abundant at this time of the year anywhere the tide washes over roads, paths or slipways. Coastal steps and angled slips where small boats are launched are common places to see it, but plenty of the growth also faces walkers on sea walls, such as the one out to Poolbeg lighthouse in Dublin. Green algae can be cleared quite easily with a power sprayer, but it has a tendency to grow back quickly and it is murderously slippery.

Antimicrobial treatments are easily available that can keep a surface relatively clear of algae for a season. Yacht clubs would be well familiar with what can be done, but in my experience public harbours are less diligent. Non-slip mats are another remedy. Boat and marine folk know never to drive onto green slipways, but weekend drivers do not, and why would they? Only now have they been alerted to the dangers that health and safety people should have known about for years.

The other emergency issue raised by the terrible drownings in Buncrana is what to do when a car is immersed in water. The bravery and actions of both driver and rescuer who saved the life of a baby in that tragedy cannot be commended enough. Old first-aid training manuals would talk about waiting for the car to fill up with water and only then trying to open the door to escape.

But I remember this being tried in 2008 by Richard Hammond on the BBC's Top Gear show. In controlled conditions, with a sub-aqua team and an oxygen mask for the presenter at the ready, he and his car were lowered into a giant vat of water. Hammond waited until the water was over his head and still couldn't open the door as the pressure inside and outside had yet to equalise. It didn't work and he had to be rescued.

The current and best advice is to get out of your car and get out quickly. Even using your mobile phone can reduce the odds of survival. Belts should be removed at once and attention paid to windows. Roll-down windows are rare now in modern cars, and the first thing to happen to a car in water is a short circuit of the electrics. Manufacturers should be obliged to include either a compact hammer or spring-loaded glass punch that is easily accessible and would shatter windows in an instant.

It would be some small offering to the family who suffered such immense loss in this disaster if we learned lessons that might benefit others in the future.

Some years ago, I was asked by medical students at Trinity to come back to the alma mater to make a speech at one of their student society meetings. It was quite a grand affair - speakers included TDs Olivia Mitchell and Liz McManus, who were prominent as their party spokespersons on Health at the time. Before the event, we were wined and dined at that fancy restaurant beside Dublin's Mansion House, and treated very kindly by the students. I recall thinking that they must have much bigger budgets than we had when we were student church mice.

The main organiser was an exceptionally bright and polite young man called Frohlich. It was an unusual surname, which I remember to this day, and I often wondered what he did. Well, I found out listening to the radio last month. Dr Frohlich is a specialist in anaesthesia and intensive-care medicine at the Blackrock Clinic in Dublin. The good doctor performed a very valuable service by alerting half the Irish population who have private health insurance that most of them do not have full cover for emergency situations in private hospitals.

I suspect a great deal of the insured population would have expected that if they were insured for a procedure in a hospital, they would also be insured should unexpected complications arise. This is plainly not the case, and our health insurance regulator could really do with getting the finger out and imparting this sort of information to the consumer.

Dr Frohlich has suggested that it be made mandatory that all health insurance policies would cover intensive care for all unexpected emergencies. I hope the minister and his Health Insurance Authority were listening, because many patients and policy-holders sat up to attention when they heard what Dr Frohlich had to say.

I have noticed in recent years that the health policies being issued by insurance companies are getting more and more complicated each year. It's a case of more and more information making the situation less clear. The renewal rigmarole has also changed. Subscribers are now encouraged to participate in a one-way taped phone call where trained operators overload them with vague checklists about cardiac procedures, orthopaedic complaints and ophthalmological operations, and then slip in a last-minute suggestion that they recheck their cover and contact them in advance if they need any extra treatments while in hospital.

This simply isn't good enough. When doctors cannot even understand their own health insurance policies, then what chance have their patients?

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

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