A week later, my consultant told me to pack an overnight bag. He wanted me admitted to a special haematology ward where I would receive my first chemotherapy as an inpatient.
The doctors like to do this, to keep a close eye on patients during their first treatment and to ensure they don’t have any adverse effects.
But, first of all, they needed an empty bed on the haematology ward and there wasn’t one.
So, I was sent to an ordinary general ward, nominally for respiratory diseases but in fact, there were patients with cancer, broken hips, ulcerative colitis, and kidney infections.
The thinking was, that as long as I was waiting at home, ‘urgent’ cases would appear in A&E and leapfrog my position on the waiting list; but after the PET scan the consultant didn’t want me to wait.
My Hospital Stay
Just like the UK in January, everything was incredibly busy in this Dublin hospital.
The woman in the bed next to me had spent 36 hours in A&E before transferring to the seventh bed in a six-bed ward.
I soon saw how this was done.
An extra bed was wheeled in and tucked behind the door.
There was no space here for a bedside locker or a visitor’s chair, no socket to plug in a phone or a laptop, but at least it was comfortable and under the supervision of the ward staff.
My consultant came to see me, even at the weekend, bringing his registrars and nurses with him.
He started me on steroid tablets, which made me feel a bit better very quickly.
Then, every day, somebody would pop up to keep in touch and tell me there was still no bed on the haematology ward.
Maybe the next day.
Maybe the day after that.
The clinical liaison nurse came up to talk to me about the chemotherapy and the side effects. Yes, I was going to lose my hair.
It took six days to get me transferred, and when I got there, the atmosphere was very different from the general ward.
Here, we all had individual rooms, and never saw the other patients.
The nursing station was just outside my room, and I asked if the door could be kept open some of the time so at least I didn’t feel so isolated, but of course, the reason for the individual rooms is to separate immunocompromised patients so they don’t infect each other.
This was a tough gig for an extravert.
The next day the chemotherapy began.
I have been on a regime for Non-Hodgkin’s Lymphoma called R-CHOP, a mixture of an antibody-based immunotherapy called Rituximab, three ‘classical’ chemo drugs; doxorubicin, vincristine and cyclophosphamide, and a plethora of adjunct drugs designed to eliminate nausea, prevent bad reactions to the main chemotherapy drugs, and guard against ‘tumour lysis syndrome’.
Tumour lysis happens when the therapy is the victim of its own success; if it kills a lot of tumour cells and they all burst open at once, there can be a rush of uric acid and electrolytes into the bloodstream which is damaging to the kidneys.
The drug given for this is allopurinol, a traditional treatment for gout, which is also due to an over-abundance of uric acid in the blood.
It all went well.
No sickness, no fever, no pain, just a certain amount of fatigue, and after 48 hours, I was allowed home.
From the definitive diagnosis to my first chemotherapy was exactly a month, and that was with Christmas in the way.
The Hospital Bills
Not long after that, I received a bill from the hospital for €720.
The Health Service Executive (HSE) has been charging €80 for each night in hospital, not for the treatment but for the accommodation and food (which was excellent, by the way).
Or, that was the case; I paid for my time in hospital because it was in January.
From the 17th of April, those charges have been abolished and the State picks up the bill, as Ireland tries to make its system a little more like the NHS.
Each attendance, as a day patient, to my chemotherapy sessions also cost €80, but I only paid for the first one.
There was a cap to these hospital charges of €800 per year, so unlike the USA, hospital fees never bankrupt anyone.
Nevertheless, it’s good to see them go.
A new Irish system of paying for Healthcare
The Irish government is trying to introduce a system called Sláintecare.
You’ll probably know that when you raise a toast to someone in Ireland by saying ‘Sláinte’, you are wishing them ‘Health’.
There’s been a working party on this subject for years.
One of the key ideas is that Ireland will be split into six health regions which will operate more or less autonomously, with most specialities available in each geographic area.
Right now, things are too dependent on centres of excellence around Dublin, where 29% of the country’s population is based, although there are University Hospitals in several other cities and regions.
But towards the end of 2021 several high-profile committee members resigned from Sláintecare because not much progress was being made.
Rumours are that the civil service or ‘the permanent government’ as they are sometimes known, are unhappy with power being assigned away from Dublin and have been less than forthcoming with progress. Let’s hope they get back on track.
It’s interesting to note how Ireland is paying for these changes.
GDP in the State is high right now, although we all know that it is artificially high because of the activities of around ten large multinationals that have EU headquarters or other significant operations in Ireland.
Tech companies like Twitter, Facebook, Google and Microsoft, financial services companies, and pharmaceutical manufacturing make up this sector.
They’ve been paying minimal tax in order to attract them into the country, but major countries in the OECD have been unhappy at the advantage Ireland was giving itself and insisted that Ireland put up its corporation tax rate from 12.5% to 15%.
With a plethora of caveats and exceptions, Ireland has done so, in the face of dire warnings that the economy would suffer, but it seems that even with the extra tax, there’s enough here to persuade these Foreign Direct Investors to stay.
An ‘up to €16 billion’ increase in tax revenues is now predicted for the Irish government, which allows it some scope for generosity. How better to spend this money than making more of Irish healthcare free at the point of use.
To be continued.
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