in government, health

Buns, parking and the modern acute hospital

I feel for the people who run hospitals. Hospitals are mainly judged by trifling aspects of their outward presentation rather than how fundamentally good they are as hospitals. In a recent Facebook discussion I witnessed, participants got very angry about the cost of a bun in the cafe. The issue of car parking also caused consternation.

In reality the prices in the cafe or the availability of car parking has absolutely nothing to do with how good your acute hospital is. The only thing that really matters is that a hospital is good at making your sick relatives or friends (or yourself) well again.

Well, the other thing that matters (though not as much) is how much the hospital costs to run. It turns out that acute hospitals are really expensive to run, by which I mean massively expensive. According to Appendix 5 of the annual plan, acute hospital services in Ireland will cost 4.88 billion euros to run in 2015, around 12 percent of the national tax take.

Let’s think about what an immense amount of money this is. That is 13 million euros a day. If you take the case of just one acute hospital (the 1000-bed St James’s in 2013) the spend is 400 million euros. That is more than a million euros every day, 365 days a year, just to keep one hospital going. Are taxpayers and patients getting good value out of that million-euro-a-day bill? Who knows.

I hope that the people who run hospitals spend a lot of  time thinking about the above two issues, quality of care and value for money, and not too much time thinking about the car park or the price of buns (which will bring in less than a million euros to the hospital in a great year).

That said, car parks and buns do matter. Maybe they shouldn’t get as much attention as other aspects of hospitals, but the reality is that they do, because they are a key part of the experience of visiting a hospital for most people. Hospitals have to be better at presenting a friendly and welcoming face to hospitals. The underlying issue, I think, is that people don’t feel welcome in, or respected by hospitals and that has to be addressed. This is something hospitals should address. A doctor’s bedside manner may not make her patients better, but it does matter, and the everyday facilities and courtesies a hospital provides for its patients and visitors matter too.

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