Tom Kelly: Humour might be the only response to the crisis in our hospital A&Es

AS I write this column, I've been frantically making sandwiches for Dad's 86th birthday. It's the end of a very stressful week. On Tuesday, his GP called urgently, telling me to take him to hospital immediately. They'd received some test results indicating a serious health decline. I asked how urgent, and she said within the next half hour. Panic set in: new pyjamas, a wash bag, slippers, and so on. We arrived at Daisy Hill within half an hour and, to our relief, the GP had emailed ahead. The relief was short-lived. We waited and waited, but the accident and emergency department was packed. It was only Tuesday evening, and no doctor was available. We didn't see a doctor until 24 hours later. Dad was given an upright chair to sit on for 22 hours with a drip attached to his arm. Eventually, he was upgraded to a reclining chair. He never closed his eyes once or even complained despite the obvious discomfort. He even joked that everyone in the waiting room would have a square ass the next day. People of his generation are quite stoic about such things, and Dad, having previously had his prostate removed and a serious sarcoma dug out from his skull, is incredibly grateful to the staff at Daisy Hill, Craigavon, and the Ulster Hospital. He has an innate respect for his doctors, nurses, ancillary staff and porters. Hospitals are, in a way, a family. Any ignorant bigots believing there are too many immigrants in the north need to wake up and smell the coffee. A visit to any hospital should cure them of their prejudices. Whether it's the cleaners, the nurses, doctors or consultants, our health service would collapse without immigrants. Good as the care was for my father, it was not good enough or timely enough. There is very little dignity for senior citizens in waiting rooms overnight. This is not the fault of the staff who are labouring under horrendous conditions with limited resources. Drunks and druggies were in and out of Daisy Hill as if it was a drop-in centre. I am fully aware that often these people do not reach this level of addiction without significant trauma in their lives, but an emergency department is not the place to treat them. Others were plainly drunk and stashed bottles in the shrubbery around the hospital. Police arrived with some, and there was constant police presence throughout the 24-hour stay. This is not a proper use of police time, babysitting people who are either drunk or suffering from mental health issues. Obviously, the police are there to ensure hospital staff are not attacked or in danger – and to protect their 'charges' from committing more self-harm to themselves or, worse still, other patients. Daisy Hill was clearly in distress, as are other provincial hospitals. There is no quick fix. People from the hinterland Daisy Hill serves stretch from Culloville to the far side of the Mournes. Roads in south Armagh and south Down to Newry are perfect for leisurely tourists but for not ambulances. In fact, Belfast is more convenient than Craigavon. And even then, as pointed out in this paper last week by fellow commentator Máiría Cahill, A&E in Belfast is a horror story. There is little point shifting serious ill patients from a blaze in Newry to an inferno in Belfast or Craigavon. There's a rot at the heart of the management of casualty departments. Some caused by impatient patients. Obviously, centres of excellence for specialist surgeries are a must – that argument is won. It is too difficult to attract skilled surgeons and consultants to smaller hospitals. And it is also why, by and large, ministers of health and politicians of all hues should follow clinical advice when deciding which services should go where. The Causeway is a case in point. The new health minister, Robbie Butler, has decided to do a new review of healthcare provision across the north. It is baseless – other than the fact there's an election approaching. There are more reports into our health service than there are serving MLAs not contesting the next election. Frankly, it looks like Butler has bottled it under political pressure. This review will be stalled through Purdah next spring and it won't be on any minister's desk this side of Autumn 2027. Even then, it will have to go out to consultation. The big decisions need to be made on health and social care in NI. Start by amalgamating the various health boards – fewer managers and administration and more frontline staff. The waiting times in emergency departments are way too long, because on-call night GPs seem to refer many directly to the nearest hospital. The public can see failure in those waiting rooms. They can see the same failure in GP service provision. Try ringing a surgery for an in-person appointment – there's more chance of the Orange Order getting down the Garvaghy Road. Last week Daisy Hill had scores of people waiting in chairs all night – some could not be discharged because there was no doctor to do the discharge. The irony is Daisy Hill has empty and under-utilised wards. The local demand for beds is there but the staff numbers are not. Despite having devolved government and several health ministers, management of the service is lamentable. This commentator believes now is the time to integrate the Northern Ireland health service with the NHS – anything less fails the tax-paying public and those on waiting lists. As for Dad, he had a great birthday. Telling a joke, he asks 'Why do to you think my generation and bishops have such longevity? Answer: God is in no real hurry to see us and the Devil is not ready for the competition!' Humour is often the best cure.