Laura Harmon: When CUH raises alarm on patient safety, the Government must listen
Of course, CUH employs more people than it did five years ago. The population has grown. Demand on the health service has increased. The needs of many patients have become more complex. File picture: Denis Minihane
The warning from Cork University Hospital chief executive Jennifer Kearney about staffing and patient safety should concern everyone who depends on CUH.
When the person running one of the country’s largest hospitals says she doesn’t believe it is safe to head into winter with the current uncertainty around staffing, the minister for Health should listen.
Instead, minister Jennifer Carroll MacNeill publicly challenged CUH management, questioned how the hospital is using its existing staff and suggested it should be doing more with what it already has.
That might make for a political row, but it does little for the patients and families dealing with understaffed services or for the doctors, nurses and other healthcare professionals trying to keep those services going.
One example tells us a lot about what is happening. CUH currently has one paediatric neurologist working four days a week. Clinicians say the hospital needs at least two full-time consultants. With waiting lists growing, CUH found a consultant in Belfast who was willing to travel to Cork and see 30 children with complex neurological needs.
A specialist had been found. The children had appointments. Yet because approval was not secured in time, they were left waiting and the appointments did not go ahead.
For the families involved, this is not a debate about staffing figures or budgets. It is their child waiting for care they know is needed. For clinicians, it means knowing what could help a patient and being unable to provide it because the necessary staff are not available.
And this problem is not confined to one service. Shortages of radiographers can mean delays in getting scans. Too few physiotherapists can slow a patient’s recovery and discharge from hospital. Nursing vacancies increase the pressure on the nurses who are already there.
I have also raised the need for a more joined up approach between the minister for health and the minister for further and higher education in relation to workforce planning and course planning.
Behind every vacancy there is a consequence for somebody. Senior clinicians and managers have publicly backed Jennifer Kearney. I support the fact that she has drawn attention to this and raised the alarm for patient safety.
It is also worth noting the intervention of Jim Daly, a former Fine Gael minister of state for health and now chief executive of the Irish Hospital Consultants Association. He has said that CUH’s concerns need to be listened to and has described the staffing cap affecting the hospital as dysfunctional.
The INMO have also repeatedly raised concerns. The hospital’s chief executive is raising concerns, senior doctors have backed her, nurses have highlighted staffing gaps and the organisation representing hospital consultants has also spoken out.
CUH management has identified 172 priority posts it says are needed ahead of winter. The Government’s response has focused heavily on the fact that overall staffing and spending have increased. But that does not answer the problem CUH is raising.
The Government’s response does not solve the problem if children cannot get timely access to services today, if scans are being restricted and patients are waiting longer to leave hospital because key staff are missing.
Of course, CUH employs more people than it did five years ago. The population has grown. Demand on the health service has increased. The needs of many patients have become more complex.
What matters is whether CUH has enough people, in the right roles, to provide safe care to the patients coming through its doors today. That is the problem with imposing staffing limits from above.
A hospital can have an obvious need for a particular doctor, nurse or health professional and still find itself unable to fill that post. We should be planning our health service around the needs of patients, not forcing hospitals to make decisions based on a number decided elsewhere.
While there has been some movement with consultant appointments being progressed since the alarm was first raised by the CEO of CUH, this does not answer the wider staffing concerns.
There is also the question of the new surgical hub at CUH which the HSE intends to open in September but indicated that it will only operate partially because not all of the posts will be filled on time. We saw a similar situation last year when the new endometriosis hub was opened and it didn’t have all staff hired to run it at full capacity.
Of course there must be accountability for public spending. Nobody is arguing otherwise. But accountability in our health service must also include whether people can get safe and timely care when they need it.
When the people running a hospital, supported by senior clinicians, tell the Government that staffing shortages are putting services under serious pressure, the first response should be to establish exactly what is needed and how those gaps can be filled.
Given the clear disagreement between the minister and senior management and clinicians in CUH, an independent assessment of the hospital’s staffing needs would now be a sensible step and the HSE should publish any safety assessments underpinning staffing caps.
More broadly, we need a health service that can plan beyond the next budget, properly fund services over several years and recruit staff according to what patients need.
Jennifer Kearney and the clinicians and managers who have supported her have done the public a service by speaking openly about the pressures facing CUH. The minister should listen to what they are saying.
There is too much at stake for patients, their families and hospital staff. The minister’s job is not to win an argument with CUH. It is to make sure CUH can safely care for the people who depend on it.
- Laura Harmon is a Cork senator and Labour Party spokesperson for Disability and Further and Higher Education
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