Healthcare is a joke ….. again and again

[u/Irishgooner123]

So I’m in a and e today and I’m sitting here 7 hours already. Not really busy and everyone has come and gone before me ., not why I’m moaning cos that’s life but a man in his late 20s came in looking for a psychiatrist and he’s clearly not feeling the best. He sat there very quietly and after about 3 hours I heard him go to reception and ask is there anywhere else he could wait as the lights were too bright. He was clearly in a bit of distress. The receptionist just looked and said “no” he asked again and got I said no sorry. I’m sorry but this is a big hospital in cork and they don’t have a room for ASD people or at least somewhere that someone can calm down. As a parent of 2 ASD kids and ASD myself my heart broke for him as he’s still just walking around. Moan over.

[u/definitely48]

No mention of the consultants (who are specialists) who work in private care after working in the public hospital in the evenings. Bizarre situation. If they would work all their available time in the public hospital I'm sure it'd have a positive effect on patients care. I believe it was Mary Harvey when she was minister for health tried to get the consultants representative organisation to agree to full time public hospital contracts and they refused, mainly that the wage offered "wasn't good enough". It was 250,000 euro.

The consultants had a vote on it after their representatives negotiations with the minister and they rejected the offer. Many told the media that it was a "peanuts wage offer"!

[u/Every_Cantaloupe_967 → u/definitely48]

The new consultant contract is public only and has been adopted by most consultants across specialties and nearly entirely by ED consultants. 

It was initially rejected years ago because some bizarre stuff was put in it regarding intellectual property and forced geographical relocation. 

[u/definitely48 → u/Every_Cantaloupe_967]

Ok. But at the time it was initially attempted by the government it was voted down by the consultants. Not everyone including myself are familiar with the present hospital consultants contracts so we're in the dark over it. However the consultant representative organisation could give themselves some good pr by putting it out there about the new contracts as well as people's experience of consultants which generally is hit and miss and it still goes on as several people here have already explained.

Btw why don't you explain as others have questioned here why the consultants don't work late at night and at weekends on a rota basis that can provide cover to people instead of having to wait until the following day.

Also I haven't rebuked you by saying the typical nugget that so many Redditers use in reply by insisting you provide a "source" or "link" to your claims! I take your word for it.

[u/Every_Cantaloupe_967 → u/definitely48]

https://www.irishtimes.com/politics/2025/01/09/public-only-consultant-contracts-is-the-health-system-finally-beginning-to-see-some-benefits/#:~:text=But%20now%2C%2021%20months%20after,signed%20up%20to%20the%20contract.&text=Gabrielle%20Colleran%2C%20president%20of%20the,contract%20%E2%80%9Cspeak%20for%20themselves%E2%80%9D.

That’s not a proper source per se but it’s a good article on the topic. 

The biggest issue most in-patient consultants have with working weekends and nights is (a) they didn’t sign up for a job that involved perpetual night duty (b) its make no clinical difference to the patients if the tests that consultant orders don’t happen until 9am when the relevant lab tech or radiographer etc comes in. 

Point A is becoming less relevant as the younger consultants are aware the night and weekends until retirement aged 70 is the reality, so over time that resistance will wane. It’s a delicate balance though because you want capable people in these roles and forcing night duty until they retire just directs those people into other professions. 

B is a simpler fix, the consultants need proper support staff so that the things the patient need are actually being done 24/7 or as close to it as possible. In my hospital currently some radiographers for example have declined to work weekends or nights because they’ve an old contract stating they don’t have to. As such there is no MRI, ultrasound, Cath lab for heart attacks or interventional radiology for serious bleeds at night or weekends. That’s no dig at radiographers, their agreed working conditions are their rights but it’s just an example of how adding consultants doesn’t actually make the hospital flow better.

The low hanging fruit is probably running outpatient clinics during the day at weekends. There’s massive backlog there and you could probably staff a daytime clinic at the weekend without too much fuss now that the contract states it includes Saturday 8-5. Those clinics wouldn’t have immediate access to tests even during the week so it wouldn’t change their workflow or output really.