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Opinion: January 2009

Vision never changes

Terence Cosgrave | 31 January 2009 | Editorial

Terence Cosgrave writes that A Vision for Change is still an aspiration and very little is being done to implement it. I suppose it’s a common complaint that many people working within the health service — or stakeholders who take... Read more

Examining the end of a life

Paul Murray | 30 January 2009 | Guests

Paul Murray of the Hospice Foundation of Ireland writes that a new forum will examine attitudes to end of life in Ireland. What are the main issues at end of life in Ireland? This is the question being posed to... Read more

College of Psychiatry – a truly commendable step

Dr Amin A. Muhammad | 30 January 2009 | Letters

Dear Editor, About fifteen years back, I as a trainee in the Irish psychiatric system wrote a letter to Irish Medical Times about the need for a separate college of psychiatry. The other day, the news came to me as... Read more

Back to the basics of bedside care

Nycomed | 29 January 2009 | Guests

A care programme that has been implemented at a Michigan hospital is helping to develop communications between patients and healthcare staff and improve care levels Nurses working at a US hospital in Michigan are working to improve patient relationships by... Read more

Ban is 'cruel and degrading' to smokers

Dr Brendan O’Reilly | 29 January 2009 | Letters

Dear Editor, [Dr] Fenton Howell’s letter, ‘St Vincent’s to be commended’ [January 16, www.imt.ie/opinion/2009/01/st_vincents_to_be_commended.html], requires comment. This letter relates to the imposition of a total ban on smoking within the confines of the grounds of St Vincent’s from January 1... Read more

Bullying and harassment at work

Ann Brizzell | 29 January 2009 | Guests

Ann Brizzell of Beauchamps Solicitors writes that under the terms of the Safety, Health and Welfare at Work Act 2005, employers are obliged to provide a safe working environment for staff. Every employer has a responsibility to provide a safe... Read more

Nachrichten aus Wien

G.B. | 28 January 2009 | The Inside Back

My first few days in Vienna – I am here until the end of February – have me steeped in thoughts of language, expression and identity. While celebrating New Year’s Eve on the streets in sub-zero temperatures, I told a... Read more

Mid-west acute review 'flawed'

Dan Danaher | 27 January 2009 | Guests

Dan Danaher speaks to Kilkee-based GP Dr Tom Nolan about his opposition to the centralisation of acute care services in the mid-west region. The use of a population area with about 350,000 people to justify the centralisation of acute care... Read more

Awards scheme is food for thought for students

Dr Paul Stewart | 27 January 2009 | Guests

Dr Paul Stewart writes on the importance of food as medicine and he highlights an awards scheme for doctors and for medical students with an interest in nutrition. Food, the first generic drug, is also sometimes the first drug of... Read more

Middle classes feel the crunch

Dr Mark Hannon | 27 January 2009 | Mark Hannon

Dr Mark Hannon writes that the Government needs to encourage citizens to 'spend' Ireland out of recession, and not penalise the middle classes at every opportunity When the general public first became aware that all was not well with the... Read more

Hospital infections are not being tackled effectively

Dr Teresa Grahan | 27 January 2009 | Letters

Dear Editor, It is distressing that seven hospitals are now closed to visitors because of the norovirus infection (winter vomiting bug), but the complacency with which this news is greeted is even more distressing. The presence of this infection in... Read more

Health literacy needs to be addressed

Don McCormick | 26 January 2009 | Letters

Dear Editor, I saw your news item, ‘Health literacy won’t wait’ at http://www.imt.ie/news/2009/01/health_literacy_wont_wait.html. It’s wonderful that you are recognising health literacy initiatives, such as those you listed in the article. I would be interested in seeing the results of your... Read more

Mid-west changes can't occur without resources

Dr Mick Molloy | 25 January 2009 | Mick Molloy

Dr Mick Molloy says there is no point in dealing with averages — the HSE must consider the worst-case scenario when it comes to acute admissions. Another week, another report. Those who thought the New Year was going to start... Read more

Will Vatican teams have a ghost of a chance?

Dr Garrett FitzGerald | 24 January 2009 | Garrett FitzGerald

Dr Garrett FitzGerald writes that the Vatican's new crack teams, which will be sent out to investigate claims of religious apparitions, will be tasked with some very peculiar duties. In preparation for this learned treatise, I flew to London to... Read more

Physician, sometimes you can't heal yourself

Dr Nuala O'Farrell | 23 January 2009 | Guests

Dr Nuala O'Farrell writes that sometimes, doctors need to be patients too and that every doctor really needs their own general practitioner. Being a patient, even temporarily, can be a humbling experience for a doctor. I recently had a bad... Read more

Carers blind to their own needs

Dr Paul Heslin | 22 January 2009 | Guests

Dr Paul Heslin writes that carers must realise the effect that neglecting their own health can have on others around them. Mary was very stressed due to family issues. Her baby picked up on this distress and became irritable. Mum... Read more

Cowen simply not up to the task

Terence Cosgrave | 21 January 2009 | Editorial

Terence Cosgrave says we face several crises but do not have the leadership to tackle them. We can't even have an honest debate as we have mangled the truth for so many years, we do not know what it is... Read more

Mid-west hospital plan has backing of doctors — Burke

21 January 2009 | Guests

Dan Danaher speaks to Dr Paul Burke, who has responsibility for implementing the reconfiguration of hospitals in the mid-west region. The project director of the implementation team delivering the reconfiguration of hospital services in the mid-west, Dr Paul Burke, outlines... Read more

The reasons behind high drug costs

Gary Culliton | 21 January 2009 | Guests

Gary Culliton examines a new paper that indicates that medicine prices in Ireland are amongst the highest in Europe, and also demonstrates that generic prescribing rates have fallen significantly over the past decade. Medicine prices in Ireland are amongst the... Read more

Irish College formed for psychiatrists (at last)

Dr Dermot Walsh | 20 January 2009 | Guests

The recent establishment of a truly national body representing Irish psychiatrists — the College of Psychiatrists in Ireland — replaces the British-based Irish Division of the Royal College, which in recent years had adopted, confusingly and inappropriately, the title ‘Irish... Read more

Technician error found to have contributed to baby's death

Ed Madden | 20 January 2009 | Guests

Ed Madden, BL, looks at a recent UK Court of Appeal case in which the Court balanced the merits of imposing a hefty fine on a health service provider against the impact of that fine on the provider’s ability to... Read more

Innovation in health literacy

Terence Cosgrave | 19 January 2009 | Guests

Terence Cosgrave writes that helping patients to overcome health literacy problems can have major benefits. “Doctor, I think I’ve swallowed a bone. Are you choking? No, no I really swallowed a bone.”... Read more

Better asthma regime could save millions

Dara Gantly | 18 January 2009 | Guests

Dara Gantly reports on a Finnish model for treating asthma that could benefit Irish patients and the Exchequer. Hawkins House says... maybe? The Asthma Society of Ireland has submitted a draft submission to the Department of Health and the HSE... Read more

HPV vaccination: yes, no, yes, no?

Dr Jack Lambert | 17 January 2009 | Guests

Dr Jack Lambert, Consultant in Infectious Diseases at the Mater Hospital, says that linking essential healthcare to the vagaries of the world economy is wrong. A number of recent articles have focused on the human papillomavirus (HPV) vaccine. In my... Read more

Orkney gets TIA telemedicine

Helix Health | 16 January 2009 | Guests

An innovative telemedicine service that was launched in Orkney last July is using technology to improve care standards for stroke patients on the island. A specialist stroke telelink team in Orkney, one of the islands off the coast of Scotland,... Read more

Medical Miscellany

Terence Cosgrave | 16 January 2009 | Guests

It’s always good to start off the New Year with a bit of good news and what could be better than the fact that one of our columnists has decided to tie the knot and get married? Dr John Ryan... Read more

A strategic approach to breaking bad news

Rory Hafford | 16 January 2009 | Guests

Rory Hafford continues his series on medical communications with a look at the best ways to break bad news to patients. It started with a simple comment over dinner. My father said to me, “I’m having trouble swallowing.” It ended... Read more

MRSA prevalence in nursing homes higher than expected

Dr Mark Hennessy | 16 January 2009 | Guests

Dr Derek Hennessey reports on a recent study that revealed that nursing homes in Ireland have much higher rates of MRSA than previously believed. A recent study conducted in St Vincent’s University Hospital has revealed that the MRSA prevalence in... Read more

The mid-west centre

16 January 2009 | Editorial

It’s been just over a week now since almost 2,000 workers in the Dell plant in Limerick were told that their jobs had ‘migrated’ to Lodz in Poland, where the rate of pay is much less. In Ireland, we have... Read more

The importance of post-graduate research in psychiatry

Dr Mabifa Olasunkanmi | 16 January 2009 | Letters

Dear Editor, Most clinicians will agree that research is an essential part of the training of young physicians. Research training is thought to help develop critical thinking. Some feel that research in psychiatry is vital to the stability and continuing... Read more

Comments 'offensive'

Dr Aislinn Donovan | 16 January 2009 | Letters

Dear Editor, I was absolutely appalled to hear Dr Mark Hamilton discuss a patient he had seen in A&E on the Tubridy Tonight show on 10/01/2009. I found that the comments he made about his patient both offensive and ageist.... Read more

St Vincent's to be commended

Fenton Howell | 16 January 2009 | Letters

Dear Editor, Congratulations to St Vincent’s Hospital in Dublin for being the first of the newly designated cancer centres to make their campus completely smoke free as and from January 1, 2009. Connolly Hospital in Blanchardstown, a leader in the... Read more

Doctors should make views known

Patrick Carr | 16 January 2009 | Letters

Dear Editor, As some of your readers will be aware, the Law Reform Commission (www.lawreform.ie) is conducting a consultation on advance care directives. In an age where patient autonomy has been elevated to the supreme good which trumps all others,... Read more

Just one 24-hour ED for mid-west, says report

Gary Culliton | 16 January 2009 | Guests

Gary Culliton reports on the conclusions and the recommendations of the Teamwork/Howarth Report in relation to the mid-west. The HSE has commissioned a number of reviews in relation to how acute hospital services should be organised, including the Teamwork/Howarth Report... Read more

Time lapse was bar to complaint being considered

Ed Madden | 15 January 2009 | Guests

Ed Madden, BL, looks at a recent UK case in which a psychiatrist objected to a case being taken against him on the basis that too much time had passed for the case to proceed. Between 1996 and 1998, ‘Anna’... Read more

An Bord Machete will slash hospital services

Dr Garrett FitzGerald | 14 January 2009 | Garrett FitzGerald

Dr Garrett FitzGerald writes that the ballooning health budgets of recent years have done little to solve problems in the health service ... what will it be like after these budgets are slashed? Barack Hussein Obama is coming to save... Read more

Observations on a Peugeot I do not own

G.B. | 13 January 2009 | The Inside Back

While driving my girlfriend’s 1994 Peugot 106 from Dublin to Westport, I found myself stuck behind a 2008 Range Rover Sport being driven erratically by a woman who was on her phone. I am about 6’1” — not all that... Read more

Boston – not a big medical town

Dr John Ryan | 13 January 2009 | Letter from America

The night before I flew home for Christmas, I was packing my bags and had the television on in the background. This is… Spinal Tap was on. There is a scene in the movie when the band’s show gets cancelled... Read more

NCHDs squeezed but locums thrive

Mark Hannon | 13 January 2009 | Mark Hannon

Dr Mark Hannon says that although hospitals use every device possible to penny-pinch from NCHDs, they lavish money on their replacements. The New Year has dawned and for once, tales of woe at the health service have slipped somewhat from... Read more

Paramedics are well trained — but scarce

Prof W Arthus Tanner | 13 January 2009 | Letters

Dear Editor, I enjoy reading Illona Duffy’s spirited defence of Monaghan Hospital. However, I cannot let her disparaging remarks about Advanced Paramedics go unchallenged. To qualify for admission to an Advanced Paramedic programme one has to already be an Emergency... Read more

Medical Council Changes under way

Gary Culliton | 13 January 2009 | Guests

Gary Culliton speaks to Prof Kieran Murphy, President of the Medical Council, about the new lay majority, changes under the Medical Practitioners Act 2007 and the fact that hearings of the Council's Fitness to Practice Committee will be held in... Read more

Diabetes guidelines and the use of aspirin

Dr Velma Harkins | 12 January 2009 | Letters

Dear Editor, I wish to reply to Dr Ray O’Connor’s comments, published in the 5/12/’08 issue, regarding diabetes guidelines and the use of aspirin in primary prevention (www.imt.ie/opinion/2008/12/the_use_of_aspirin_in_treating.html). Dr O’Connor rightly points out the emerging evidence from the POPADAD study... Read more

New consultant contract deal — was Minister Harney right?

Sherif Sultan | 12 January 2009 | Guests

Mr Sherif Sultan writes that Minister Harney was sincere and decisive in reversing the unsustainable consultant contract and withdrawing the offer that had been made to medical consultants. Health Service Executive, Irish Medical Organisation and Irish Hospital Consultants Association negotiators... Read more

You ain't seen cutting yet — it's back to 1987

Dr Garrett FitzGerald | 09 January 2009 | Garrett FitzGerald

Dr Garrett FitzGerald predicts that within 20 years the HSE will be able to provide unlimited services at no cost at all based on its current predictions. No need to make resolutions for this New Year. They have already been... Read more

Consent issues and the elderly patient

Elaine Healy | 09 January 2009 | Guests

Elaine Healy of Beauchamps Solicitors writes that, as with all other patients, it is essential that a practitioner has received the appropriate consent when providing care to an elderly person. The informed consent of an elderly patient is a prerequisite... Read more

Medics must speak out on service cuts

F Lennon | 08 January 2009 | Letters

Dear Editor, I refer to the feature article by Dr Illona Duffy on hospital services in the 28/11/’08 issue (www.imt.ie/opinion/2008/11/medics_cannot_stand_by_in_sile.html). Her views are shared by many of her GP, nursing and consultant colleagues in the north east. It is vocational... Read more

If you are this woman, please do us a favour

GB | 08 January 2009 | The Inside Back

One morning in December, a very handsome-looking and well-dressed woman got on the bus and sat in the seat behind me. We were about 45 minutes from my stop on the quays when she boarded – a long way and... Read more

Service Plan cuts will make 2009 a lean year

Mick Molloy | 08 January 2009 | Mick Molloy

Dr Mick Molloy writes that the HSE's new National Service Plan means that 2009 is shaping up to be a pretty bleak year for our health service. The HSE National Service Plan for 2009 has already received a lot of... Read more

Hospital worker claimed for needlestick injury

Ed Madden | 08 January 2009 | Guests

Ed Madden, BL, looks at a case in which a worker who sustained a needlestick injury at work claimed damages in respect of psychiatric injury he allegedly suffered as a result On August 4 2006, Sean Fryers, who was employed... Read more

Legacy of chief demythologiser

Dr Seamus Kilby | 05 January 2009 | Guests

In the few weeks since the demise of Conor Cruise O’Brien, there has been a barrage of obituaries and life reviews. Predictably, these have ranged from gushing hagiography, best typified by the Sindo-nista school of journalism, to the hostility of... Read more