VHI shock caps bad week for health system

The shocking announcement last week of massive hikes in premia for the many tens of thousands with VHI health insurance policies capped a bad week for the Irish health system, as record numbers of patients languished on trolleys as they awaited admission to hospital wards around the country. The Irish health system is once again in crisis but it looks like thousands more people may well have no option but to take their chances with the creaking public health system following the VHI's decision to raise its charges, in some cases by as much as 45 per cent, causing extraordinary anger among the elderly and families who feel they can no longer afford the 'luxury' of private health insurance, for which they have paid dearly over the years. They, in particular, will look with fear and trepidation upon the chaotic scenes in emergency departments (EDs) up and down the country in the past week where patients remained on trolleys for days on end, in some cases. The National Consumer Agency has described the VHI price rises as extraordinary in the current climate and Fine Gael's health spokesperson Dr James Reilly said the hikes were an utter betrayal of the VHI's most loyal customers. Unsurprisingly, the VHI has found itself haemorrhaging customers to other health insurers since last week's announcement. But VHI is just one part of a dysfunctional health system in freefall, with hospital EDs seeing unprecedented numbers lying on trolleys last week in hospitals all over the country, including Our Lady's Hospital, Navan, and Our Lady of Lourdes in Drogheda. Patients in hospitals described conditions as “nightmarish†and “horrendousâ€, with no privacy and inadequate toilet facilities. Many had to wait several hours just to be seen by a doctor. With EDs severely overcrowded, almost 1,700 beds remained closed in wards throughout the country as a result of budget cuts and staff shortages in all regions. The rise in swine flu cases has also been a factor in the renewed pressure on the health system but it has been a minor one, insists the Irish Association of Emergency Medicine (IAEM). The failure to provide adequate hospital bed capacity to deal with the current acute workload is the primary problem, hospital doctors insist. The only solution is to re-open closed beds to relieve pressure on the emergency departments, where treating patients in overcrowded conditions risks exposing them to further viruses such as swine flu, and is detrimental in general to the health of all patients. However, opening up closed beds costs money, which is simply not there, the HSE says. But surely it will not save money in the long term if having beds closed results in people dying or if they are forced into prolonged hospital stays with complications as a result of their time spent in an overcrowded ED? According to the IAEM, international studies have shown a direct link between overcrowding in hospitals and emergency departments and increased mortality and morbidity rates. If this country couldn't manage to change the situation in the good times, it has little chance of doing so now unless a new way of looking at the problem is introduced. Both Fine Gael and Labour have promised a new model of healthcare funding. Dr Reilly says he is confident there are sufficient resources within the current 'health envelope' to pay for FG's FairCare plan, and he believes there are huge efficiencies and savings to be made within the current hospital system. Labour, too, says there are ways of alleviating the overcrowding problem within existing budgets but admits fixing the issue will require more funding. However, all these pledges and promises in election literature are of scant consolation to patients who are forced to endure days and nights on hospital trolleys, and few predict any easy solution to this most intractable of problems in the immediate future. However, for the sake of those who are sick or who will get sick over the coming months, the political will must be harnessed to deal with these problems head-on, and the public will be looking to the next government to make good on its promises to make Ireland's health service more efficient and better able to cope with the periodic spikes which see it go into meltdown, particularly at this time of year.