Dear Editor,
I am glad to notice the Health Minister’s agitation that the rise in healthcare investment isn’t corresponding to an equal surge in activity (News, April 15th). Often, it feels like public spending is escalating without diligent follow-ups from our representatives to ascertain the received value.
As a practicing doctor in a hospital, I feel compelled to highlight some reasons on why resource-induced activity isn’t on the rise.
Initially, the economic construct of diminishing returns comes into play. This commonly occurs in numerous spheres of life and can be seen as an alternate phrasing of the issue at hand rather than an explanation. Basically, the worth you get from each additional unit spent decreases the more you spend.
Two primary reasons shed light on why this is particularly visible in modern healthcare. One involves minute amounts of time wastage on a large scale daily, while the other concerns larger intervals of time wasted on a lesser scale.
Hospital conditions now tend to involve much more paperwork, red tape, checklists and bureaucracy than before. In current times, a patient awaiting surgery has to go through several pauses and checks regarding their identity, surgical plan, allergies and other concerns, all part of their “care pathway”. While this undeniably aids in reducing risks from miniscule levels to almost zero, it consumes considerable amounts of time when multiple carers perform such checks on every single patient daily.
The second contributing issue is a shift towards less invasive procedures. Previously, surgeries typically involved clear visualisation and crude removal of problem areas via open incisions. However, contemporary healthcare has embraced minimally invasive or “keyhole” surgeries, and is now venturing towards robot-assisted procedures. Given the reduction in patient trauma, complications and incision size, the adoption of this method is inescapable. However, these procedures, especially as medical staff are still learning the techniques, are time-consuming and can double operation durations, although recovery times should reduce. Such transformations are bound to happen in developed healthcare systems.
Despite the longer procedure times and recurrent checks, these changes present greater safety and smoother recovery to the lucky patients. However, they necessitate more time and infrastructural resources like surgical robots, thereby substantially extending related interventions. – Yours sincerely, BRIAN O’BRIEN, Kinsale, Co Cork.