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Effectively no blood test service due to cyberattack, says Cork GP

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Doctors’ capacity to offer blood tests and X-rays are among the areas that have been worst affected by the cyberattack on the HSE, according to GPs in Cork city.

Dr Mary Favier, former president of the Irish College of General Practitioners, said the impact of the cyberattack is just about manageable at the moment but she is concerned for the future.

“The biggest impact is on our ability to get blood tests – there is effectively no blood test service at the moment because all those results were given electronically and the IT system has had to be shut down,” she said.

“Similarly, you can’t organise X-rays without electronic communications with the HSE and you can’t send referrals electronically anymore, you have to revert to paper which is adding to the time it takes and is creating a delay.”

To illustrate the point, Dr Favier said that her practice at Parklands Surgery on Cork’s northside could see 100 patients a week requiring blood tests but each patient could require between five and 20 blood tests so the volume of blood tests affected is simply huge.

“If a patient who comes to you feeling unwell, looks pale, describes an altered bowel habit and you would have a high suspicion for a bowel cancer – I had one of those on Tuesday, I’ve slotted him in for bloods next Monday.

“But it now seems highly unlikely we won’t have bloods next Monday and I have to decide what to do – do I send him into the emergency department for a test even though he wouldn’t usually be an emergency department referral?”

Macroom GP, Dr John O’Riordan echoed Dr Favier’s concerns regarding diagnostics such blood tests and X-rays and pointed out that any referral to a specialist for any consultation is affected as it is usually done electronically.

“Most practices do all their referrals electronically so now we’re either storing up referrals that we can do down the line or else generating letters but we’ve been told not to post anything at the moment so everything is on hold.

“You would be hoping that within the next week or so if things can get sorted at least the backlog might be manageable but if this continues indefinitely, the backlog is increasing and doubling up on top of the regular work we do.

“The good thing is that our system is not shut down – if I ring a secretary in a hospital, they have no access to their systems because it’s shut down but I still have all your details on our practice system,” he said.

“At least we are not dealing with blank screens and we know our patients but it’s just that the interface between primary and secondary care, which in the past 10 years has become an electronic interface, is affected.

“We will get through it but the message to the public has to be ‘thanks for your understanding thus far and don’t put off anything if you are worried, ring or come in to see your GP’,” he said.

Meanwhile, Dr Nick Flynn of MyCorkGP said that in addition to the impact the the cyberattack has on patient information systems in hospitals, it could also have an impact on the running of GP practices.

“It’s affecting bloods, it’s affecting smear tests, it’s affecting referrals – we had got very comfortable with e-referrals but simple things like where we did an e-referral in the past we can’t even see that in our system,” he said.

But Dr Flynn also identified another problem – the fact practices are funded on a capitation basis under the General Medical Services scheme where practices are paid a fee per item for certain tests and procedures and if they cannot be done, it may affect cash flow.

“I think it is safe to say that on the short term over a couple of weeks this cyberattack won’t cause a funding issue for general practices but if it goes beyond two or four weeks, general practice could be at risk of cash flow problems.

“Normally, you would perform a task and get paid the next month and that’s fine but if there’s an interruption to the fee per item services and it runs on for four or six or eight weeks, it could have cash flow consequences for practices.”

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Shock in Germany after cashier shot dead in Covid mask row

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The killing on Saturday evening in the western town of Idar-Oberstein, Rhineland-Palatinate, is believed to be the first in Germany linked to the government’s coronavirus rules.

The row started when the cashier, a student, told the customer to put on a face mask, as required in all German shops. After a brief argument, the man left.

The suspect then returned about an hour and a half later, this time wearing a mask. But as he brought his six-pack of beer to the till, he took off the mask and another discussion ensued.

“The perpetrator then pulled out a revolver and shot him straight in the head,” prosecutor Kai Fuhrmann told reporters on Monday.

The suspect, a 49-year-old German man, walked to a police station the following day to turn himself in. He was arrested and has confessed to the murder.

He told police he felt “cornered” by the coronavirus measures, which he perceived as an “ever-growing infringement on his rights” and he had seen “no other way out”, Fuhrmann said.

Idar-Oberstein mayor Frank Fruehauf called it “an unfathomable, terrible act”, and residents have laid flowers and candles outside the petrol station.

The murder comes just days before Germans head to the polls for a general election on September 26 that will see Chancellor Angela Merkel bow out of politics after 16 years.

Katrin Goering-Eckardt, the parliamentary leader of the Green party, tweeted that she was “deeply shaken” by the killing, which she said was “the cruel result of hatred”.

Agriculture Minister Julia Kloeckner from Merkel’s centre-right CDU party, who hails from the region, said the murder was “shocking”.

The Tagesspiegel newspaper said far-right chat groups on Telegram were applauding the murder, with one user writing “Here we go!!!” while others posted thumbs-up emojis.

Germany has seen repeated protests from anti-mask demonstrators throughout the pandemic, some of them attracting tens of thousands of people.

The Querdenker (Lateral Thinkers) movement has emerged as the loudest voice against the government’s coronavirus curbs and regulations. Its marches have drawn a wide mix of people, including vaccine sceptics, neo-Nazis and members of Germany’s far-right AfD party.



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Remains found in Dublin adds intrigue to search for Robert Emmet’s grave

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Skeletal remains have been found at one of the locations identified as a possible last resting place of Robert Emmet who was executed on this day in 1803.

The remains were found during an excavation at the back of St Paul’s Church in Stoneybatter in Dublin.

The disappearance of the body of Robert Emmet is one of the great mysteries of Irish history.

Emmet was tried and then hanged for instigating the ill-fated 1803 rebellion. He became a symbol of Irish martyrdom for his speech from the dock in which he concluded: “Let them and me rest in obscurity and peace, and my name remain uninscribed, until other times and other men can do justice to my character. When my country takes her place among the nations of the earth, then, and not till then, let my epitaph be written.”

After he was publicly hanged outside St Catherine’s Church in Thomas Street on September 20th, 1803, his head was displayed to the crowd by the hangman Thomas Galvin. The remains of Emmet’s body was taken to Bully’s Acre in the grounds of what is now the Royal Hospital Kilmainham and buried there.

When some of his friends went to reintern his remains from Bully’s Acre to St Michan’s Church in Church Street, a church associated with the United Irishmen, they found there was no body there, and so began a search which endures to this day.

Robert Emmet was publicly hanged outside St Catherine’s Church in Thomas Street on September 20th, 1803.
Robert Emmet was publicly hanged outside St Catherine’s Church in Thomas Street on September 20th, 1803.

His great-nephew Dr Thomas Addis Emmet requested an archaeological dig at the family vault in St Peter’s Church in Aungier Street to mark the centenary of Emmet’s death in 1903, but that proved to be unsuccessful.

Speculation

St Paul’s Church is another contender in the saga of Emmet’s remains. It was the parish church of Kilmainham Gaol’s doctor and effective governor Dr Edward Trevor.

In his book In the Footsteps of Robert Emmet, JJ Reynolds speculated that Trevor removed Emmet’s body and put it in an unmarked grave in the grounds of St Paul’s Church. This was to ensure that his grave would not become a shrine for Irish nationalism.

The church, which was the venue for the consecration of the philosopher George Berkeley as Bishop of Cloyne in 1734, has been converted into the Spade Enterprise Centre, a not-for-profit social enterprise unit.

The land where the skeletal remains were found is being turned into a shared kitchen for small business enterprises in the area.

The yard at the the back of St Paul’s Church in Stoneybatter, Dublin where skeletal remains were found.
The yard at the the back of St Paul’s Church in Stoneybatter, Dublin where skeletal remains were found.

Archaeologist Franc Miles said burials in the grounds were from 1702 to the 1860s. A extant set of burial records remain, but Emmet, if he really is buried there, would have no record.

Previous exhumations were carried out when the graveyard was closed in 1860s to make way for a school on the site.

“With all the evacuations, we were left with bits and pieces of body. There weren’t many full skeletons,” he said.

Mr Miles said it all the gravemarkers and stones were removed in the 1860s “so all you are left with really are bones.”

Mr Miles said it would be difficult if not impossible to identify Emmet’s remains even if they are buried in the grounds of St Paul’s Church.

His own “educated guess” is that Emmet’s body is still buried somewhere in Bully’s Acre.

As many of his supporters have said over the last two centuries: “Do not look for him. His grave is Ireland.”

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How the cost of renting an apartment in Copenhagen compares to other cities in Denmark

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With the arguable exception of second city Aarhus, Copenhagen is significantly more expensive to rent housing than anywhere else in Denmark.

But the extra cost in the capital depends on where else in Denmark you compare with, as well as the type of housing you rent.

Private or general housing?

First, it is important to note the difference between the two main types of rental housing in Denmark: private rentals and almene boliger (literally, ‘general housing’), a form of subsidised housing.

For almene boliger, local municipalities put up 10 percent of building costs and in return have the right to decide who is allocated one in four available apartments, enabling them to provide housing to municipal residents who need it. The housing therefore plays a role in the social housing provision.

This type of housing is normally managed by a boligforening or housing association. Rent goes towards costs of running the housing and to pay off the housing association’s loans, which means property owners aren’t profiting from rents and prices are controlled.

Aside from housing assigned by the municipality, almene boliger are open for anyone. However, to get one, you must get to the top of a waiting list, which you join by signing up with associations which operate housing in the city where you live (or want to live).

In Copenhagen or Aarhus, it can take years to get to the top of these lists, while in smaller cities you might get an offer in weeks or even days.

As such, many newcomers to Denmark must turn to the private rental market if they are living in one of the main cities.

READ ALSO: Deposits, complaints and registration: Five key things to know about renting in Denmark

Private housing: Copenhagen clearly pricier 

A study conducted by housing research centre Bolius in November 2020 found the cost of a 56 square-metre apartment in Copenhagen’s Nørrebro district to be 8,536 kroner per month.

The study, which was based on data from 2019 and 2020 from rental platforms boliga.dk and boligportal.dk, shows the average monthly cost of non-limited private apartments on Nørrebro, compared with 16 other locations in Denmark.

The cost takes into account the cost of a deposit (normally three months’ rent) and adds it to the average cost of renting the housing for five years (thereby assuming none of the deposit is returned to the tenant).

In comparison to the price in Nørrebro, the study found rent in Hillerød north of Copenhagen to be slightly less (8,218 kroner) for a slightly larger apartment (65 square metres).

Moving further out from Copenhagen, costs begin to drop even more.

In Kalundborg on the west coast of Zealand, you can rent a 71-square-metre flat for 5,167 kroner per month. Næstved, a commuter town between Copenhagen and the Great Belt Bridge, comes in at 6,039 kroner for an apartment at 72 square metres.

The cheaper rents are consistent further to the west, exemplified in Jutland cities Aalborg (5,544 kroner for 62 square metres), Vejle (6.696 kroner for 84 square metres) and Esbjerg (4,399 kroner for 54 square metres).

Although Aarhus is not included in the study, third-largest city Odense is. Here, there is still a significant saving on Copenhagen, with 8,488 kroner, a similar rent to that in Nørrebro, getting you an apartment over 50 percent bigger at 82 square metres.

General (almene) housing: closer, but still higher in Greater Copenhagen

Rent prices for almene or subsidised housing were most recently analysed in a 2020 report by Landsbyggefonden (National Building Foundation), a support institution for the social housing sector.

According to that report, the rent for family housing (meaning housing not reserved for students or seniors) is “on average, approximately 100-200 kroner per square metre higher [per year, ed.] east of the Great Belt Bridge than west of it”.

Of the five administrative regions, average rent for family subsidised housing is highest in Greater Copenhagen at 906 kroner per square metre for a year’s rent.

The lowest rents can be found in South Denmark, where the yearly cost is 722 kroner per square metre.

Zealand is the region that comes closest to Copenhagen on the costs for this type of regular housing. Here, tenants can expect to pay 859 kroner per square metre in a year. The equivalent costs in Central Jutland and North Jutland and 778 kroner and 747 kroner respectively.

The study also places Greater Copenhagen as the most expensive region when rents are presented as the median monthly rent for family housing.

Here, the median values are split into five categories based on apartment size, with Copenhagen coming out as the most expensive region for each category.

For example, the median monthly rents for apartments between 50-60 square metres are as follows: 5,039 kroner (Greater Copenhagen); 4,913 kroner (Zealand); 4,541 kroner (Central Jutland); 4,388 kroner (North Jutland); 4,236 kroner (South Denmark). The national average is 4,667 kroner.

Sources: Domea, Bolius, Landsbyggefonden



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