Is there broad support for the current Public Sector strikes?

[Sister Sara]

The number of appointments the service is permitted to offer is dictated by agreements on work practices with the unions

Its not. The number of appointments the services is permitted to offer is dictated by government policy deriving from Dept of Health and in consideration of best practice, or acceptable level practices as advised upon by the medical profession. Determining the policy will encompass available resources of the State.
Unions can of course have their say like any other stakeholder but ultimately it is the policy of Dept of Health with HSE as the organisation tasked with implementation and execution of the policy with the available resources.

If such a policy determines that there is to be a medical unit with the capacity to have 250 appointments a week with say, 5 full-time nurses, then that is the number of appointments determined.
If in fact resources for only 4 full-time nurses are provided it does not take a shop steward logging appointments to determine that resources are being stretched, and that over the long-term this may lead to standards of care that fall below the stated policy.

 

[mathepac]

If such a policy determines that there is to be a medical unit with the capacity to have 250 appointments a week with say, 5 full-time nurses, then that is the number of appointments determined.

I'm puzzled. Surely the capacity/throughput/capability of a medical unit is dictated by the number of medical staff on duty and their qualification level(s). A unit staffed by nurses, even nurse-practitioners, is a nursing/paramedical unit.

 

[Sister Sara]

I'm puzzled. Surely the capacity/throughput/capability of a medical unit is dictated by the number of medical staff on duty and their qualification level(s). A unit staffed by nurses, even nurse-practitioners, is a nursing/paramedical unit.

Correct.

 

[arbitron]

A modeling study from Trinity College Dublin and the National Cancer Registry of Ireland found that Cervical Check prevented an estimated 5,557 lifetime cervical cancers between its inception in 2008 and 2022 (source). That's 397 cases a year or around 1.5 a day based on 5 days a week over 48 weeks a year. The 5 year survival rate for Cervical Cancer in Ireland is 65%. That equates to 1 life saved every day. Even if that's out by a factor of 10, or even a factor of 100 that's still way more than 0.1 excess death within a five year period. I think we need to see your friends calculations.
That's just one of 4 screening programmes.

- Comparing screening with no screening, not the situation here. We're talking about delayed screening, very different thing: it's like not eating for a day versus never eating again. Cervical screening works because it picks up pre-cancerous lesions, which the take ca. 15 years on average to progress to cancer. A delay of weeks/months would have a tiny effect.
-The "life saved every day" calculation is backwards. If 1.5 cancers are prevented per day with 65% is the survival rate, then 35% would have died. So if they are save then that gives ~0.5 deaths prevented per day (1.5 x 0.35) not 1. But that again assumes the choice is screening versus no screening. Which is not the case. And again forgetting that we are talking about excess deaths...
- And those 2008-2022 figures are lifetime estimates, for mainly cancers that would have appeared years/decades later.
- If a delay had the effect described above, suspensing screening for months during Covid would have caused a big rise in late-stage cancers. Which did not happen.
- Only 3 of the 4 screening programmes are relevant here. Diabetic eye screening doesn't prevent death.

If one days screening over all of the screening programmes prevented 0.1 excess deaths over 5 years then in one year 0.02 excess deaths are prevented. If screening is done 5 days a week for 48 weeks of the year then it prevents 4.8 deaths a year (48 x 5 x0.02). Worst case scenario (0.8 deaths over 5 years) 38.4 lives are saved. The National Cancer Strategy has a budget for screening of €105 Million so we are spending over €20 million per life saved (worst case scenario over €2.5 million per life saved).

This is all jumbled up. The 0.1 number here is the putative extra harm, not the total value of screening. It is the extra 0,1 death potentially caused from delaying screening. Not failing to screen. They still get screened. The rest of it is mystery maths.