The Taoiseach caused a stir last week when he said that staff in the health service must work full time over Christmas. With the health service in crisis and the overspend unprecedented, it does not seem like an unfair request from the country’s leader. Yet the question has to be asked as to why the Taoiseach has to get involved at all? A rare row broke out around our kitchen table. The views ranged from the Taoiseach’s statement having pitched the public against all the hard-working nurses and doctors, to my own of understanding of why people should not take leave at the busiest time. Leo Varadkar did not say that people had to forfeit leave, just that there should be a full complement of staff and services available.

Anecdotal stories

On radio programmes, there were anecdotal stories about hospitals practically closing down for at least a week in previous years. One father outlined that his son waited from 22 until 29 December to see a consultant last year. That is not right. Apart from the risks to his health, he was also taking up a bed that someone else might have needed. Tim and I have been in A&E on a number of occasions with Diarmuid when he has needed urgent critical care. Both of us have stories to tell of receiving wonderful care from consultants, nurses and doctors. But unfortunately we also have the horror stories. There was one time when I couldn’t get anyone’s attention for several hours while Diarmuid got extremely ill. I would not want to be in that situation again. Christmas is a time of flu. The numbers of people on trolleys is forecast to rise to 1,000/day. None of us want to be one of them, but we could be.

We assume that the problems must be management issues. The frightening thing is that the A&E situation is not improving. There are not enough beds.

Doctors and nurses obviously felt aggrieved. They too, spoke out. One doctor said he had worked Christmas Day on 13 out of the last 15 years. Obviously, there are two ends of the spectrum and the normal practice in hospitals probably lies somewhere in between.

Cartoon by Clyde Delaney.

Winter planning

Winter planning for the health service is absolutely necessary. On the farm our busy time is during the spring. There is an unwritten rule that none of us will take time out during that period. It’s just good planning. I was listening to Bobby Kerr on Newstalk, on the Ivan Yates show. A man sent in a problem. He had a fashion retail business but his staff had indicated that they did not want to work 26-29 December. Yet those days ranked among the busiest during the year. Bobby was quick to advise the man that he had issues and that he needed to urgently sit down with his staff and have the conversation where he would let them know leave on those days was not possible.

There are obviously urgent conversations that need to take place. One of them has to be around understanding why so many of the doctors and nurses we train leave our shores as soon as they can. They cite long hours and poor pay.

Consequences

The result of last week’s altercation means that politicians are having a field day blaming each other. Sadly, many of the voices have themselves been in charge as ministers. If 1,000 people end up on trolleys over Christmas, the public will immediately think that there are too many staff on leave and will unfairly blame the hard-working nurses and doctors. It’s the wrong focus. So much of the health system works extremely well. It beggars belief as to why the A&E crisis continues to worsen.

The public can only look on in desperation and in fear of needing to attend the service. The answers lie with the Government.