Thursday 27 October 2016

Terry Prone: Hospitals crisis is not only a money issue, it's about decency too

The scene in Beaumount
The scene in Beaumount

It's about money. It's about management. But above all, it's about decency and humanity and respect for human beings at their most vulnerable, and the examples of failure are legion.

The Herald yesterday revealed details of what a consultant called "institutional abuse" in Beaumont Hospital's emergency department, where sick people waiting for attention were afraid to go to the toilet for fear someone would steal their plastic chair.

On this very page months ago, I wrote about the disgusting, despicable, disrespectful treatment meted out to an elderly man in one of our major hospitals.

To name him, to even describe the condition he was left in where other patients and visitors could see him, would be to collude with the original treatment.

It does not seem that the poor man, left with an incontinence nappy hanging off him, was necessarily aware of what was happening to him.

But what kind of Ireland are we living in when we can only hope that an elderly, very sick patient is not aware of what the caring professions failed to do for them?

In the last few months we have seen older people with intellectual disabilities treated with a brutality that you wouldn't wish on your worst enemy, never mind inflicted on poor, fragile folk unable to defend themselves or to complain.

At the same time, we have learned of babies dying in ways that have forced the health system to go into overdrive and to involve Dublin maternity hospitals in the governance of those institutions where it happened.

The central tragedy in these cases is the loss of the newborn. But the ancillary tragedy involves the stories of a dead baby brought to its mother stuffed into a metal box and wheeled along in a wheelchair, matched with accounts from the grieving mother of being told not to cry because her overwhelming grief might disturb others.

Twenty years ago, I dealt with a couple whose baby had been stillborn. The father told of ducking into a sluice room to weep, on his own, and try to recover himself in order to support his wife.

Abandoned on a draining board in that sluice-room was his silent, naked, dead baby. He sank to his knees and cried, not for the death, not for the personal desolation, but for the disregard of his beautiful, perfect dead son, left there in the cold like detritus.

I gave lectures about it to medical and nursing students and watched them shake their heads, disbelieving that anybody could so treat a dead child or so mistreat bereaved parents.

That would never happen in the future, they believed, and I believed them. Yet the equivalent is still happening.

We should, as a nation, give vent to the cry that reporter let out of him, watching the 1937 burning of the Hindenburg and its passengers: "Oh, the humanity!"

Without the humanity to put yourself in the place of the suffering patient or in the place of the intellectually disabled resident in a home, medicine is no better than car mechanics. It is a matter of measurements, interventions and research, not of human beings entitled to dignity and self-respect.

That's where healthcare should start. That's what should never be lost. The simple respect for the humanity, the griefs, the disabilities of those of whom we take care. But the evidence is that it has been lost.


Not irretrievably, though. For every patient who has been brutalised and humiliated, another will surface to testify to the existence of health care professionals who go much farther than the extra mile, who cover the naked and who show gentleness first, last and always.

Cutbacks have created healthcare havoc and reversals of those cutbacks can improve the context. The citizens of Ireland should not have to buy respect for their humanity, they should not have to purchase gentleness by divvying up for private health insurance.

From the top down should go the insistent message that the capacity to empathise with suffering is the most important qualification for anybody who works in healthcare at any level.

It should be measured in every exam, monitored throughout every career - and its absence should be cause for instant action.

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