I met a retired nurse this week while on vacation. As we talked, she told me how sad she was at losing both of her children to Australia. One doctor, the other physiotherapist, they made their living in Perth.
oth left Ireland well before the pandemic and the long period without travel initially made the split worse – but she also showed her grown children that there can be a good life elsewhere without disrupting travel back to Clare.
Technology has softened the breakup, but their daughter now has two children and the desire to keep grandchildren close is strong.
“All that effort getting her through the goodbyes, getting points, getting through college — all a waste of our family’s time,” she said ruefully.
Ireland trains health workers for export. We’ve been doing this for decades. Our graduates gain further experience and qualifications in this country, but increasingly leave this later in their professional life – precisely when they have a lot to do in patient care and the further development of services, usually coincide with family planning and buying a house .
The pressure to find affordable housing and childcare here has been widely reported. Young, well-educated university graduates make life and career decisions in the belief that they deserve better living and working conditions.
In June, doctors who are members of the Irish Medical Organization (IMO) voted for industrial action to address long-standing problems related to insecure rosters, inability to take leave, pay and training support.
This week we saw the HSE apologize for failing to pay doctors at several hospitals. The message of casual disrespect this sends to professionals in their 20s and 30s is disastrous. It is a fundamental fact that our society recognizes the value of work through pay. This has long been a source of dissatisfaction among nurses – they are praised publicly for their trust and commitment, but they are not paid enough.
Irish people may see doctors as privileged. In terms of educational opportunities, it is true that health workers are privileged. What is less appreciated is the struggle of two parents — say, a nurse and a farmer — to get those opportunities for their children: the sacrifices made in the hope their adult offspring will do better, part of broader family life be and give back to our country; who will take care of us as we grow older.
The difficulties our health services face in recruiting are many. The system is paralyzed by inaction. Some actions require tough decisions, and that’s not the current culture.
Over the past month, many hospitals have been forced to continue services with just 75 percent staffing levels as younger doctors headed abroad for traineeships. Elderly people sitting in chairs for hours in the emergency department, children running out of development time due to a lack of disability assessment and support – urgent action is needed.
Similar to the eager focus that has been on Covid, I think daily health metrics could be reported. Public health and the services that it provides are a national concern, relevant to everyone concerned in terms of their quality of life and future expectations. Similar updates are in place for waiting lists and the number of patients on trolleys, but the information could be presented in more detail and with more context.
Many organizations use risk registers to mitigate and address service deficits. Not sharing this information with taxpayers and voters is disingenuous and creates a lack of trust.
Ireland has been chasing big tech investment and development. We also have an extremely tech-savvy population. The same technological resources are available to us to focus on health. Daily metrics and risk reports would not cause panic, they would share the burden of accountability and openness, and build respect and trust.
The public needs to know the magnitude of the healthcare recruitment crisis. You need to know why healthcare professionals are leaving, not just for a few years to gain experience elsewhere, but forever.
You also need to know that there are solid plans to reverse the trend. Providing this information to the public is honest and respectful and helps everyone understand why we are where we are.
Every medical student wants to do their best to take care of their patients. By doing so, they also protect themselves and ensure safe services for their families. When the balance is tipped, fulfilling your job and aspirations becomes too difficult.
The price is the migration of our healthcare graduates to countries where they feel valued and respected, but it’s a price everyone pays.
Suzanne Crowe is a pediatric critical care physician at Crumlin Hospital and President of the Medical Council
https://www.independent.ie/opinion/comment/public-deserves-to-know-extent-of-malaise-in-the-irish-healthcare-system-and-the-cure-41903905.html The public deserves to know the extent of the malaise in Ireland’s health system – and the cure