Turbulence in Health and Social Care: Ireland

This book is an accessible short description of the moving parts in the developments and changes in health services and social care in contemporary Ireland. Services in Ireland are placed in an international context and the data shows clearly that the overall health and social strategy is successful as shown by the life expectancy at birth being 80.8 years and for a female 84.7 years. Irish health care in 2018 was number 11 in the world versus 23rd for the UK. The pandemic outcomes provided further evidence of constructive engagement by the health and social services with public health measures. In the period 2020 to 2021, the excess mortality due to covid was 12.5 people per 100,000 compared to 125.8 in England and 131.8 in Northern Ireland. The very active campaigns to improve services in the disability area are highlighted as are efforts to recruit extra professional staff to deal with the lengthening waiting lists for assessment of needs to progress individual solutions to maximise development in those with disabilities. Changes and pressures in the system for childcare services are detailed and the painful fraught solutions are shown evolving over time. Preschool education and the pressures on Tusla the Children’s health agency are discussed and the shortages of staff listed. Slaintecare and changes in GP and consultant contracts are outlined and anomalies pointed out. The hugely expensive control mechanisms in hospital practices through the Clinical Director and Directorate systems are examined and cheaper alternatives suggested. A&E trolley and admission delay crisis is considered in detail. There is a linear increase in 30-day mortality for patients who remain in ED for more than 5 hours from the time of arrival. For patients waiting for 8 to 12 hours, one in 72 will die inadvertently. University Hospitals at Limerick and at Sligo and Letterkenny are used as examples of where the health services are seriously deficient. The bed shortage crisis is blindingly obvious. Health Information and Quality Authority unannounced visits reports are a template to improve to the medico-social empires in those regions. The same problem is right across the island. Women’s health issues and transgender equality issues are tackled in a factual manner. Hospital in the home and public health home services from nurses, physiotherapists and pharmacists with technological advances in near patient devices will be a core aid to community practices in the future. Advances in health care practices are a daily occurrence. This book forms a template to remind the reader of the wide panorama of changes. About the Author: William Tormey graduated from University College Dublin in 1974. He is a fellow of the Royal College of Physicians of Ireland and of the Faculty of Pathology at RCPI. He trained in Leeds University and is a Consultant Chemical Pathologist for 40 years at Beaumont and Connolly Hospitals in Dublin. He has three doctorates – PhD from Trinity College Dublin, MD from Ulster University and DMed from National University of Ireland. He is listed in 327 publications on Google Scholar and has 5619 citations. He is Editor-in-Chief of the Irish Journal of Medical Science since 2016 and has represented Finglas and Ballymun for 10 years as a member of Dublin City Council. He has published two books – ‘A Cure for the Crisis – Irish Healthcare in context’ in 2004 and Ten Years Hard Labour a personal political odyssey in 1994.