Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

Dr. Healy mentioned it is not always possible to save the patient or that is what I got from it. It is if it is caught in time. That is the difference. Only the patients who walk or are carried into a surgery or emergency department are in the position to be able to identify their own condition insofar as they can. I recall a doctor in the old Eastern Health Board telling me that the patient knows best. It is a matter of conveying that to the medical person dealing with it. If the issue can be identified at a sufficiently early stage, it is simple.

Patients are often brought into emergency departments in the middle of the night who may have a pre-existing condition or have had surgery recently and they may not be feeling well. It is a question of the alacrity with which their case is dealt rather than sitting and waiting for an hour or five. It may be too late then because their condition has advanced to the extent that it is irreversible. A number of interventions could be made at this stage and they are very simple. A previous delegation has emphasised the issues to watch out for by GPs - and they generally do so but GPs have a big turnover – so they are aware that this could be the case. It might be too late to do anything about it in the morning. If it is 9 o'clock on a Friday evening, there is no good telling a patient to come back on Monday. It will not work that way. It is urgent and urgent now. I have mentioned at a committee meeting previously about how many of our emergency departments are grossly overcrowded, some with non-emergency requirements. That needs to be dealt with as well. Patients need to be segregated so that those who have a drug or alcohol problem get treatment but they go in one particular direction or another and are dealt with. Then there are patients who are there for another purpose, many of whom are in great pain. I have experience of this recently and saw how many of them are in really severe pain where it showed on their faces. The quicker they are seen and triaged, the better. That should be a full triage, not half a triage as often happens when the place is overcrowded and people can wait four, five or six hours and still not be treated or triaged. We need to change the situation so that those who appear to be in urgent need get online for treatment as soon as possible.

We do not know what happens in an emergency department until we go there ourselves and it can be quite an arresting experience. We can see for the first time what other people have seen and suffered before and repeatedly. I am repeating what was said in conversation on repeal of the eighth amendment when I had a row with a senior medical person who said that sepsis was very rare in this country and more or less dismissed it. That was four or five years ago. When I asked how many instances there had been in the past 12 months, he said three or four.