The stress of simply getting to and from an appointment can be an insidious burden, adding to the patient’s already compromised state, writes Sheilagh Foley
I recently attended a patient meeting that had a ‘virtual lot’ where people were asked to ‘park’ their ideas. This is very inclusive and lovely and all (although, I did wonder if the ‘lot’ was a euphemism for the trash folder), but it got me thinking, should we actually address the real-world car-parking crisis facing patients at our hospitals?
The stress of simply getting to and from an appointment can be an insidious burden, adding to the patient’s already compromised state, and weighing heavily on caregivers, who are often under pressure to deliver the patients on time. I attend a hospital in the UK that has a rule – if you are 10 minutes late, your appointment is cancelled!
Although I am fortunate to be able to cycle to most of my hospital appointments, this is not a viable option for most patients. Due to our inclement weather I have also had the displeasure of driving to all of the hospitals in Dublin as a patient and/or visitor.
One city-centre Dublin hospital seems to constantly have its carpark full sign aglow. If you do happen to win the lotto and gain entry to this underground chamber (after at least a 20-minute wait in a queue that snakes out of the hospital grounds) that is just the beginning of your stress.
The parking spots were designed to fit sardines, packing us all in on top of each other. A modern car can barely squeeze in between the lines. Once in the spot, if you manage to open your door a sliver, you run the risk of denting the next car, or most certainly receiving a scrape in return. You must then hold your breath and shimmy along, surfing the side of your motor vehicle, to escape the clenches of the metal sandwich. If you happen to have an elderly, infirm person, or child with you, forget it, aside from a roof extraction, there’s no way to get them out cleanly.
The disabled spots with roomy turning circles and locations right by the lifts are few and far between. It feels like they get snapped up early and are inhabited all day long.
While my father was alive, taking him to a hospital appointment was panic-fuelled. At times I would have to park illegally close to the entrance while I pulled out a rollator from the boot of the car (which is not light). Then I would have to lever my six-foot frail father out of the front seat, which probably looked more like an awkward rugby tackle to a passerby. We would then walk at a glacially slow speed into the building, my eyes frantically searching for some sort of seat I could deposit him on while I prayed my car hadn’t been clamped or towed.
Once he was deposited safely (somewhere) I still had to find a parking spot and get back to my Dad before he got fed up and tried to exit the hospital by himself, one shuffle at a time.
If there was no room in the underground hellscape I would be forced off the property trying to park on residential streets. This understandably is infuriating for the local community.
Get a bus! I hear you cry. There is no bus that would bring me directly to any of the hospitals, all would involve a change, in fact, I’d likely have to go in a different direction and double back on myself. This is great if I am by myself and have a million hours of spare time. This is a non-starter with an elderly person, sick child, or if I myself am feeling unwell.
A great number of people, especially the older generation, rely on lifts or taxis. I often see incredibly kind taxi drivers helping people in and out of their cars outside hospitals. Whether you are paying privately or linked in with a charity, this option does seem to work well, but should we make it more official? Could there be a government program for hospital lifts?
Perhaps people could sign up to the program and pay a couple of euros each for a shared journey. This would be cheaper than the escalating parking fees, and the constant reliance on costly taxis or volunteers from charities. Not to mention the unquantifiable economic impact of caregivers taking unpaid leave, all contributing to a system that disproportionately burdens the ill and their support networks.
The Caring Cabs program (just throwing out a moniker) could ease the pressure on the healthcare system, who no doubt feel the ripple effect of parking challenges and limited public transport options through missed appointments, delayed diagnoses, and longer waiting lists.
If we look at it from an environmental slant, the countless cars idling and circling, contributes to urban pollution and exacerbates air quality issues in areas already under strain.
If a government run program is a no-go, charities and volunteer drivers are vital and could widen their offerings with more support and collaboration from the government.
Perhaps the new HSE app that is gaining traction could be co-opted in as a facilitator. Maybe there is an Uber Care element to the app (again, just banging out the name options). You sign up via the app, perhaps you have to qualify for the program with a doctor’s letter to weed out the unscrupulous just looking for a cheap ride to work. If we were very clever and data privacy was not an issue, you could share your location with the hospital secretary and they could see when you were due to arrive. Although, they are the doctor’s secretary, not your secretary, and they don’t work for Traffic Control.
While in the digital space, another option is to increase the amount of virtual appointments offered. However, many patients, particularly the elderly or those with complex conditions, still require or prefer in-person visits, and this demographic often struggles the most with digital interfaces.
Hospitals themselves could offer a shuttle service or they could provide a car valet parking service. I would happily tip someone to park my car in the inevitable car-crash that is multi-story parking.
Arguably this transport conundrum is a legacy issue, many existing city-centre hospitals, designed in a different era, struggle with their geographical constraints, making expansion of parking or integration with public transport hubs an uphill battle. Therefore, future hospital planning must prioritize accessibility from the outset, not as an afterthought. I wonder how that’s working out for the new children’s hospital.
Perhaps the ultimate answer will be driverless cars assigned to each hospital. Maybe you could be virtually triaged or start your (digital) paperwork during the car ride. Although, you might need a robot to get you in and out of the car, take your walking stick and raincoat, have a bit of general chitchat, and come in afterwards for a cuppa.
It might be easier to stay home and bring back house calls. 
