There is a group of people in the country who are shocked but not surprised by the treatment received by the late Savita Halappanavar, whose inquest concluded last week with a verdict of misadventure, and by her husband. Praveen Halappanavar has the sympathy of the country, not only because of the tragedy of losing his wife, but because of what he himself endured in watching her avoidable death.
The group of people who are shocked but not surprised by the suffering of Praveen Halappanavar are the relatives of hospital patients all over the country. This is the group of people which not only sympathises with Praveen Halappanavar, but identifies with him.
To be the relative of a patient in the hospital system is to feel at once completely powerless and yet totally responsible. It is to feel that information is being kept from you.
Above all, being the relative of a patient in the Irish hospital system, is to be convinced that no one is supervising the case as closely as you are. A truly terrifying thought, yet a reasonable one in a system that can’t keep or maintain its own records.
“If I had known I would have followed them up myself,” said Praveen Halappanavar of his wife’s blood results. The fact that he has this to say at the end of his ordeal is not only unutterably sad, it is a national scandal.
Yet there are relatives murmuring the same thing in hospital corridors and waiting rooms every day of the week.
At the rate our hospital care is fracturing it will soon be like hospitals in poorer countries, where the family arrives with the patient and stays with them for the duration of their treatment.
In fact, in the treatment of old people in Irish hospitals, we are already at that point, as the adult children of old people travel to be with their parents at hospital meal times, to make sure that they eat.
The truth is that it is needlessly traumatic to be the relative of a patient within the Irish hospital system – and that’s if your loved one emerges from that system alive.
Let us say at the outset that there are parts of the Irish hospital system where staff are compassionate and efficient, communicating freely with both relatives and the patients, where morale is high and outcomes positive.
And then there are the majority of Irish hospitals. As a relative of a patient in an Irish hospital, you feel confused, patronised and above all frightened about what is going to happen to your loved one when you leave their bedside to go home.
It is truly dreadful to get into your car outside a celebrated Dublin teaching hospital, convinced that you might as well be leaving your loved one on the platform of Heuston Station.
Of course, you tell yourself, this could be the normal and natural separation anxiety that will occur when you have a sick relative.
But then you remember the long day you have just had. Looking for the consultant; and never finding him or her. Hearing staff about to administer different doses of the drugs, and sometimes completely different drugs, as their shifts change. Finding dirty adult nappies on the counter top in the bathroom. Lying in wait close to the nurses’ station to pounce on a nurse that might talk to you. Remembering that when you arrived at visiting time you had to help your relative into the second half of their pyjamas. Removing your relative’s bloodstained surgical gown, which had been lying on their bed for some time, and being told by a nurse, who doesn’t raise her eyes from her paperwork: “Just put it in the bin there.”
And these are the minor matters. To complain about these things, it is strongly implied, is to be a stroppy cow. We’ve got people dying in here, is the implication, and there you are making a fuss about pyjamas. We’ve got forms to fill out and here you are asking for a light bulb. The person asking for a light bulb for her bedside lamp was told that it would be replaced in the morning.
The patient pointed out that she was only staying in the hospital – a major hospital, outside Dublin – for one night. A nurse moved her to a closed and empty ward, which had full rubbish bins outside the door. The young woman did not feel safe there. She felt she was being punished for being perceived as cheeky. She had no relatives in the town.
But these are still minor matters. Let us not forget the relatives of the mentally ill in the Irish hospital system, and shudder at their suffering. Chaotic hospital care; psychiatric services run by the doctors as medieval fiefdoms; social workers whose main job seems to be keeping patients out of their hospitals, and away from treatment there; housing officers who do nothing about the bullying of mentally ill people ( frequently by other mentally ill people); no sharing of information about potential treatments elsewhere, and so on.
If minor matters are disdained they can snowball into a lot of pain. Our hospital system has been described as “a conspiracy against the public”.
Praveen Halappanavar’s seemingly endless ordeal reminds the public how true that is.