It’s easy to say otherwise, but the truth is that our healthcare system is getting better
This week I’ve been reflecting on human wisdom. They defeated the 2011 referendum on granting investigative powers to the Oireachtas committees.
I have observed several Health Committee meetings over the past few months. It could be a forum for thoughtful conversations about politics. Instead, it is used by certain politicians to treat healthcare executives with performative contempt.
Holding government officials accountable is fair enough, but it’s often a counterproductive exercise in competitive outrage, accusing officials of bad faith. It was a new low on Wednesday in the dispute over Tony Holohan’s transfer to Trinity College.
So anyone who predicted in 2011 that politicians would crawl over each other in search of a headline instead of the truth was right.
Too bad, because I believe in politics. But this kind of politics doesn’t get us anywhere.
The good news is that the committee circus continues, but so does the hard work of reform. Bit by bit, despite the constant attacks, health officials are working their way through the titanic task of making things better.
On Tuesday I was in Ballincollig, Co Cork where far from headlines and hysteria I saw how small steps make a big difference in the delivery of health care in Ireland.
I met GP Suzanne Kelly and Liam Killeen, her spirited and energetic 91 year old patient.
Liam is in great shape coming out of two tough years of Covid isolation with his wife Kitty. He has tackled the garden, trimmed and mowed hedges.
We chatted to James J Fox about his fascinating career in duty free and the relief of getting back to normal activities like attending the show. I love men like Liam with their dancing eyes and zest for life.
Liam has a heart condition and as a result has been recruited into the HSE’s new CDM or Chronic Disease Management programme.
Under the old system, patients like him were treated in hospital outpatient clinics.
But hauling people to a hospital for a routine check-up is inefficient and not necessarily effective. Hospital doctors are better off treating acutely ill patients, and meeting a stranger in a crowded clinic does not lend itself to good health care. things are missed.
A key goal of Sláintecare is to bring patients into a primary care setting outside of the hospital.
The CDM program does this by removing people with type 2 diabetes, asthma, chronic obstructive pulmonary disease (COPD) and heart disease from the hospital to have their condition treated by their family doctor.
What I really like about this system is that nothing is left to chance.
dr Kelly showed me how carefully the program was designed when Liam’s CDM file opened on her screen.
Patients receive two appointments per year for a full examination. The risk with a check-up is that it becomes a superficial five-minute conversation. To avoid this, the system guides the GP through a series of questions and tests that need to be completed.
For example, one question is whether the patient is taking their medication as prescribed. That simple prompt proved vital to Liam. He told Suzanne that he felt so good that he stopped taking his medication.
So they had a conversation where Suzanne explained how the drug worked and if Liam was feeling good, showing that it was working, not that it was unnecessary.
It was a really important conversation because if the question hadn’t been asked and answered, Liam’s condition would have caught up with him and he would inevitably have been hospitalized.
He told me his father went into the store one day and died of a heart attack. He was only 62.
Good healthcare has given Liam more life than his father for nearly 30 years, and counting.
Keeping patients healthy and out of the hospital is the goal here, and it’s working.
I couldn’t help but notice the warmth of Suzanne and Liam’s relationship. When a doctor knows their patient well, the standard of care is so much higher.
This relationship is often not possible due to the lack of general practitioners. Suzanne told me that her father, Dr. Peter Kelly has been a General Practitioner in Fairview, Dublin for 45 years.
He’s from the old school who worked a five and a half day week and often off-duty.
Younger general practitioners like Suzanne have a completely different practice.
Like many colleagues, she works part-time as a family doctor while also pursuing a specialty. She is the national director for integrated care for diabetes. Producing enough GPs to keep everyone on their feet in this new world is a huge challenge.
Training to become a general practitioner takes years and is therefore a slow process, but the number of positions has increased from 193 in 2020 to 233 this year and is expected to increase to 351 by 2026. So progress is being made again.
I say that because there are people in this country who want to tell us that nothing has changed and will never change, because the people at the top have no interest in reform. cynicism sold.
But Sláintecare is not an overnight drama. It’s a stubborn march through legacy systems and recruitment challenges, gradually implementing effective new programs like CDM.
The public beatings make headlines but are just a distraction.
The real news is that Liam Killeen is alive and well at 91 and Dr. Hopefully Kelly will keep him that way for many years to come.
https://www.independent.ie/opinion/comment/it-is-popular-to-say-otherwise-but-the-truth-is-that-our-health-system-is-getting-better-41623687.html It’s easy to say otherwise, but the truth is that our healthcare system is getting better