We seem to hear it almost every day, the NHS is in crisis. Hospital waiting times are up, bed spaces are down, mortality rates are increasing. In Ireland, the same thing is happening and the problem is staggering. Dr. Desmond Shearer has been working on the front lines and has penned a heartfelt response to the crisis and it’s nothing short of gut-wrenching
How did you get into medicine?
I went back to university to study medicine because I wanted to be like my father. He was a GP during a very troubling time in history and was a brilliant one by all accounts. He is retired now, but still a doctor. I have never seen him refuse help, healing or humanity to anyone, regardless of their affiliations, afflictions, affections and achievements or absence of.
What has been your experience of the crisis on the front lines?
I have not been a doctor for very long; nearly two years and yet it feels like a decade since I qualified. At the beginning of my career, I would introduce myself as ‘just the intern’ or ‘one of the junior doctors’. After being overheard by a number of colleagues I was told to simply introduce myself as a ‘Doctor’.
We don’t really wear epaulettes as health care workers, and patients don’t usually concern themselves with rank, they just want someone that can help them. We all do wear uniforms of sorts but it doesn’t matter what colour banner you have, be it nurse, porter, healthcare assistant, radiographer, paramedics, cleaner, doctor, physiotherapist, occupational therapist, social worker, kitchen staff, security and many countless more; patients will seek you out.
Whilst wearing your colours on the frontline of healthcare – you’ve seen the crisis and fought the daily battles.
What are the conditions like?
Too few staff
We don’t have enough staff. I get emails and text messages daily about empty slots in rotas that need to be filled all across Ireland. I did a six-month stint as a senior house officer in the Emergency Department of University Hospital Limerick and now locum there while studying and traveling. During those six months, we worked sixty to seventy hours a week. We would work for ten days in a row, get a day off and then work another eleven days in a row.
Lack of balance
My father had two strokes during those six months. He was two hundred and twenty miles away, in Belfast. I was allowed two days off to travel up and down and was asked to return to work within the same week. At that time I was keen to get on a training scheme, I wanted references, I wanted to impress. I don’t know how I returned to work.
Since qualifying, I have never been treated with such contempt and disrespect. In any other job I’ve worked, be it a barman, welder, mechanic or programmer, I’ve been able to establish a work-life balance and I was paid on time, as my contract stated, verbal or written. I am still waiting for payment for many hours I worked during those six months in the ED, along with a majority of the doctors I worked with during that time. Unsurprisingly some have left to work elsewhere.
Secondary to this, newly qualified health care workers of all banners do a required period of work before seeking a better quality of life overseas. It is understandable why.
Not enough beds
We don’t have enough beds. Smaller hospitals and their emergency departments have been closed. Services have been centralised to reduce costs. The increased catchment area has concentrated the pressure on University Hospital Limerick. This has resulted in overcrowded, understaffed wards along with an overcrowded emergency department – it seems it has now become acceptable for forty or fifty patients to wait on trolleys for four or five days before getting a bed ‘upstairs’ in the hospital.
Not enough space
We don’t have enough space. Where do we put all these patients that are confined to their trolleys, along with their family members? Trolleys sit end to end and side by side, with about half a metre to walk between them. The emergency department works twenty-four hours a day, every day of the year. The lights are on permanently. I am forced to breach patient confidentiality and common decency when I ask them about their medical history and details of their life – everyone is within earshot, everyone can hear and everyone can see.
Not enough food
Sometimes we don’t even have enough soup. I’ve listened to the kitchen staff offer food to the patients at meals time, “soup, sandwich, scrambled egg or salad?” As they move from trolley to trolley, items drop off the menu before the staff are half-way across the department floor.
This is unsustainable.
Why have you decided to make a public response to the health crisis?
Over one hundred years ago a document was written that promised among other things, “religious and civil liberty, equal rights and equal opportunities to all … and declared its resolve to pursue the happiness and prosperity of the whole nation and of all its parts, cherishing all the children of the nation equally.”
Every individual on this island and the future individuals of this island will eventually have contact with their health system in some shape or form; we will all be patients eventually.
I needed to highlight concerns about our health systems. There are many statements issued by politicians and agencies; I don’t want to add to that pile, it is mountainous and is breeding complacency.
How do we move forward?
The health service must heal itself before it can tend to others. It cannot cease to function however, so something must be done. Increase funding, increase resources available, increase staffing levels in all areas, increase the amount of infrastructure. This is a war of attrition that we will not win because we will all become patients.
What can I do?
Dr. Shearer’s account of the health crisis in Ireland is in no way unique. Across the UK we are also seeing the breakdown of our health service as resources are stretched and staff are pushed to breaking point. At what point do we, the people, stand up and demand better?
We have seen from the success of the Extinction Rebellion protests that it is the people who make a difference. Following the climate change protests, the UK government has now declared an environmental emergency, the first country to do so.
So what can we do as individuals to make an impact? Write to your MP/TD and demand better. Support the strike action of health professionals. Share stories on your social media to raise awareness of what’s happening.
Like Dr. Shearer says, we will all be patients at some point in our lives. When my time comes, I would like to have a functioning health service that I can rely on, not one in crisis. Wouldn’t you?