Health package didn’t arrive in time to prevent Evelyn’s tragic end

The Health Service Executive (HSE) has initiated a “comprehensive review” of its service provision in the case of bed-ridden Evelyn Joel who died in Wexford on Saturday last.

Whatever they may find, or recommend, it is already tragically too late for Ms Joel, who was only 59, and whose death is also being investigated by the gardaí.

Much has been made by the Tánaiste and Health Minister Mary Harney of the €150 million allocated in the Budget for improved services to care for the elderly in the community.

It is preferable, she maintained, that elderly people be cared for in their own homes, among their own families where possible, rather than in expensive nursing homes.

She’s right; but families need professional back-up to provide such care which is not currently available.

Ironically, she promised increased home-help and home care packages which would allow thousands more older people remain in the “dignity of their home” while requiring special services.

Already suffering from multiple sclerosis, Evelyn Joel was not attended by dignity either at the time of her death or in the months leading up to it.

Instead, bewildering circumstances of horrific proportions that shocked the local community and the country at large marked her untimely end.

Whatever those inquiries may determine, one fact cannot be denied: in one of the wealthiest countries in Europe, if not the wealthiest, the system did not help Evelyn Joel.

No matter what home care or home-help facilities may be promised for the future, the fact remains that, right now, the elderly living at home are a forgotten people as far as the Government is concerned.

According to the Irish Association of Social Workers (IASW), there are only 18 social workers in the entire country to look after the tens of thousands of elderly people living at home.

In these circumstances it was inevitable that a victim like Evelyn Joel would emerge. It’s miraculous, or fortuitous, that there have not been more.

Combined with the pitiful lack of social workers is a natural reluctance to get involved in somebody else’s problem.

In this case, it seems extraordinary that neighbours in the estate, as well as the powers-that-be, were unaware of her existence.

Yet in 2002, a Department of Health report recommended that 32 senior case worker positions be filled.

On Wednesday last, Mary Harney was afforded the latitude of almost a page in this newspaper to expound on what she considered would amount to an ideal health service.

Before dreaming aloud of the kind of health service she would like to see here - as would everybody else - she dealt briefly, very briefly, on what she achieved as health minister last year.

Apart from the waffle, the achievements of the past 12 months, as she saw them, were enumerated in a single paragraph which, objectively, may have been over-stated.

In relation to this year, Ms Harney, ever the optimist, said her agenda was innovation and reform to improve services for all patients - insured, uninsured, self-insured; public and private.

The central test she set for this policy was whether it would deliver a better service for public patients, with value for public funds.

Surprise, surprise - she discovered that her policy met this central test. The test she set for her own policy.

That test, or the policy, must be crystal ball-based because how else could the minister conjure up a Utopian health service from what we have at present.

Public patients and the uninsured will probably need to call into the local credit union, or a branch of the Bank of Scotland, to arrange for travel abroad, probably to Cuba.

Otherwise, how, or where, are they going to experience improved services?

Come to that, the same applies to those who can afford private health insurance because improved services are largely a figment of the minister’s imagination in view of the fact that they don’t exist at the moment.

TÍR na nÓg looms into view as a possible - probable - destination because the Tánaiste said she wants our taxpayer-funded hospitals to be focused totallyon one objective: excellent patient care.

“I would dearly like to achieve a situation where patients were admitted to our public hospitals based on their medical need only, not on how much they could pay.”

There was, I thought, rather a wistful air to that sentiment. She would, as she said, dearly like to achieve it, but in her heart she knows what the reality is.

What’s more, those hundreds on trolleys in hospitals all over the country know what the reality is.

For instance, she declared that (her wish) was a key factor in the approach to the new public hospital consultant contract.

But we don’t have a new public hospital consultant contract. We don’t even have new public hospital consultants!

Not only is such a contract for new public hospital consultants non-existent, but the minister practically declared war on the existing hospital consultants unless they gave in immediately to her diktat.

Now let’s forget about the minister’s crystal ball for a moment and enter the real world of Irish hospitals.

Consider what members of the Irish Nurses Organisation (INO), who actually deal with the problems, are being forced to do to highlight those problems.

Because the conditions at hospital A&E units throughout the country are so dire, the INO is organising a postcard drive to bring this fact to the attention of the minister.

On Wednesday last, their figures showed there were 347 patients on trolleys in hospitals all over the country and, on the same day, 514 beds were closed.

Trolleys have become such an integral part of our hospital service that the INO maintains a trolley-watch. Just as well somebody does.

The nurses’ organisation intends to overwhelm the minister with this campaign and has produced an initial print run of 100,000 postcards which they hope will be sent to her office.

The cards can be returned freepost to the INO who will have them delivered to the Tánaiste.

Anybody who had to endure one of those trolleys, or who had an unfortunate relation who did, should be more than happy to drop a line to Ms Harney.

Naturally, the HSE disputes the INO figures, but of the two I’d have more faith in the nurses.

It must be remembered that in September, 2004, Ms Harney demanded the health portfolio in the cabinet reshuffle and proclaimed her intention to straighten out the crisis in the A&E units, while also looking after the care of the elderly.

She also announced a 10-point plan to tackle the A&E crisis, which still remains a crisis well over 12 months since she announced she was miraculously going to make it disappear.