Warnings ignored - Staff left on a dangerous frontline

JUST as the warning to the Health Services Executive about defective cancer screening equipment at Portlaoise began to slip from the frontline of public consciousness another tragedy predicted by health professionals has come to pass.

A patient at a psychiatric day-care centre went on a knife rampage on Thursday, stabbing two doctors and leaving one — Dr Ananth Pullela — fighting for his life. Witnesses at St Anne’s Psychiatric Day Care Centre in Limerick compared the scene with something you might see at an abattoir.

That an attack of lethal nature was anticipated by four consultant psychiatrists who wrote to the HSE in Dublin — just last month — deepens the sense of outrage surrounding so many of the scandals in the health services.

If it were the first or second instance of the HSE being warned about the consequences of either cuts or inaction it might not be so enraging but it is just one in a series of unacceptable and dangerous blunders.

Already this week we saw the tremendously dignified appeal from cystic fibrosis sufferer Orla Tinsley who pointed out that because of government inaction her life span, and that of all cystic fibrosis sufferers in Ireland, is likely to be reduced.

She spoke of the inadequacy of services for cystic fibrosis sufferers despite the Taoiseach singing a commitment to open specialist-care beds “in his own name” almost two years ago.

It is difficult to understand how anyone involved in our health system could not feel a sense of outrage and shame when faced with the articulate criticisms of Ms Tinsley.

It is difficult to avoid the sad thought Ms Tinsley might become the next Susie Long — a very sick and impressive woman who might have to endure less if our health system was efficient and equitable.

The four psychiatric consultants predicted the absence of secure psychiatry beds would mean reduced treatment for patients, enormous risk to their families and similar, possibly fatal, threats to staff in existing, low-security facilities. How right they were.

There have been unrelenting and significant cuts in the funding of our psychiatric services in tandem with moving as many patients as possible to community-based care. However, in a denial of reality that might have come from the pen of JK Rowling, the funding needed to ensure this project might have the slightest chance of success has not been put in place.

The anger felt at the fact psychiatrists predicted Thursday’s assault is compounded by details released by the Psychiatric Nurses’ Association yesterday.

They welcomed the signing, after protracted negotiations, of a compensation scheme for nurses in the mental health services injured by assault at work.

The PNA have published research which demonstrates that physical assaults on psychiatric nurses are a daily occurrence. In 2001 there were 859 assaults, in 2005 the figure was more than 1400.

So, the potential for violence in the service has been well flagged yet we have people working on the frontline of our caring professions exposed to this kind of unacceptable threat.

HSE chief executive Professor Brendan Drumm has said the Limerick attack had nothing to do with a shortage of beds either in Dublin or Limerick. He also said the HSE is moving toward a day-care service based in the community.

The HSE’s credibility is at a very low level; how could it be otherwise? Scandal after scandal, story after story of treatment denied or delayed, of dire predictions realised all met with nothing more than a promise of reform.

The situation is simple enough: we do not have an acceptable health service and those charged with managing it — ministers or officials — seem to live in a parallel universe where the urgency, imagination and determination needed to confront the issues seems absent.

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