
Disease-carrying ticks are coming for us and they're likely to hang around longer too
Tick-borne disease risks are on the rise globally, according to the European Commission's environment directorate. Their increase is one of the many ways in which
climate change
is altering our world.
Changes to temperature, rain, and sunlight, particularly in winter, can make a big difference to a tick's ability to thrive. Extra sunlight in January is one of the most influential factors in its ability to flourish.
Changes to land use and human-animal interactions are also contributing to why more of these tiny creatures are on the way, says the Chinese research cited by the European Commission this month.
READ MORE
These researchers have modelled where harmful disease-carrying ticks are likely to thrive in the future as climate changes.
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Ticks, respiratory illnesses, skin cancer and poorer mental health 'all on the rise due to climate change'
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The highest-risk regions for future expanding tick colonisation in Europe include France, Spain, Ukraine, Germany, Italy, Poland, Romania and the UK, according to the research.
Indeed, about 50 per cent of land in the UK and 95 per cent of land in Spain offers habitat classed as being of medium-high suitability for ticks, the research says.
A rise in disease-carrying ticks will have health implications for all of us. If tick ranges continue to expand, so too will the risk of tick-borne diseases.
Ticks feed on the blood of humans, animals and birds. Like some sort of vampire game show, they go through four life stages, each requiring a blood meal from a host to graduate to the next level. Between hosts, ticks can spread some pretty serious diseases - so more of them isn't good news.
A bacterial infection called Lyme disease is probably the one most familiar to us in Ireland. About 5 per cent of ticks in Ireland are thought to carry the disease. Up to 400 people a year are estimated to be infected with Lyme disease in Ireland from ticks, according to the
HSE
.
Lyme disease can be hard to diagnose - not everyone spots it when they have been bitten by a tiny tick. The disease is no picnic - if left untreated, symptoms can include tiredness, aches, loss of energy, arthritis, neurological conditions such as facial paralysis and heart problems.
Climate change has already extended the peak season for ticks in Ireland, increasing the risk of Lyme disease and other diseases, according to research published by the Irish Medical Journal in 2022.
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How to spot if your child has a tick bite and what to do
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You'll find ticks anywhere in Ireland, including in both urban and rural areas. They are more numerous and active from April to September.
'Anyone who spends time outdoors should protect themselves against tick bites,' Dr Paul McKeown, a public health consultant with the National Health Protection unit has said.
Ticks love an arm or leg, but any warm and sweaty parts not covered by clothing will do.
In children ticks are most likely to bite around the head and neck.
You can limit your risk of a bite by sticking to paths where possible, covering up with long sleeves and long trousers, especially when walking in wooded areas and using insect repellent with DEET, says the HSE.
'Preventing tick bites prevents Lyme disease,' says Dr McKeown.
Human behaviour is at the root of climate breakdown. Burning fossil fuels, deforestation, and intensive agriculture are significantly increasing greenhouse gas emissions.
The greenhouse effect is trapping more heat and causing global warming. Overconsumption and unsustainable practices are contributing to the problem by increasing demand for energy, goods and resources.
We are already seeing the consequences of climate change starting to bite in our lives - more powerful storms are creating damage and knocking out power, heatwaves and wildfires are putting favoured package holiday destinations off limits, there is more flooding, less frost, more water shortages and more erosion.
Soon the consequences of climate change may actually be biting us in the form of more ticks.
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Irish Times
6 hours ago
- Irish Times
Doctor who ‘repeated mantra-like claims in court of Garda surveillance' is suspended
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The Irish Sun
11 hours ago
- The Irish Sun
Our actress daughter, 30, died days after twice being misdiagnosed by ‘substitute doctor'
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Both PAs failed to recognise the blood clot, instead prescribing the musical theatre performer, from Greater Manchester, paracetamol and medication for anxiety. She collapsed and died hours after her second appointment, with the undiagnosed clot in her leg triggering a pulmonary embolism - which occurs when one of the arteries in the lung is blocked. Today, a Marion and Brendan Chesterton welcomed the recommendations, which they claimed would have prevented Emily's death if they had been in place when she became ill. But they also called for further action to be taken to stop PAs prescribing drugs to patients. Marion told Most read in Health "But we feel it's a missed opportunity. It could have gone all the way there and cleared things up totally. "Our daughter died. She was prescribed a drug that she should not have been prescribed. "And it had absolutely catastrophic circumstances. She died for goodness sake." The Leng Review pointed to the fact that PAs - of which there are more than 3,500 working in the NHS - were being misused as substitutes for doctors. Junior Doctors Announce Five-Day Strike in July Amid Ongoing Pay Dispute Emily first visited her local surgery on October 31 complaining about pain in her calf and shortness of breath. She was advised to take On November 7, a second PA diagnosed her with a calf sprain, After discussing the fact she was struggling to walk more than a few steps and her leg was swollen and hot, Emily was prescribed propranolol - a beta blocker for heart problems and anxiety. She reassured her concerned parents that she had been seen because neither PA had made it clear they were not doctors. Mr Chesterton added: "She never knew. "If she come out and said I've seen someone called the physician's associate I'm sure we would have insisted that, you know, let's go back and insist that you see a doctor." The Leng Review recommended that PAs are renamed to "physician assistants" to identify them "as a supportive, complementary member of the medical team". Presnting her findings, Professor Leng said: "Relatives feel strongly that confusion between the PA role and that of the doctor was an important contributory factor in their relatives' deaths. "They were clear that, had they known a doctor had not been consulted, they would have responded differently and sought further help. 5 Emily mistakenly reassured her concerned parents that she had been seen by a doctor Credit: Not known, clear with picture desk What is a physician associate? A PHYSICIAN associate works alongside doctors in GP surgeries or hospitals to diagnose or treat patients. Unlike doctors, people in these jobs do not hold a medical degree. However, PAs do have to undergo two years of intense training for the role. They are usually science graduates or can be allied health professionals, such as nurses or midwives. PAs can: Take medical histories from patients Ask patients about their symptoms Perform physical examinations Diagnose illnesses See patients with long-term chronic conditions Perform diagnostic and therapeutic procedures Analyse test results Discuss treatment plans Develop management plans Provide health promotion and disease prevention advice for patients But they should always be supervised by doctors. PAs are not currently regulated by a medical body, like many other healthcare professionals are. They can, however, join a voluntary register with the Royal College of Physicians. With no obligatory register, any who malpractice cannot formally be struck off, for example. However, under a planned new law, PAs will be regulated by the General Medical Council (GMC). Not everyone is happy about this, though. The British Medical Association (BMA) believes this could lead to patients confusing the different roles, which could have "tragic consequences". There are about 3,200 PAs working in GP surgeries and hospitals in England, with 10,000 more planned in the next decade or so. "Sadly, no one can turn back the clock, but I have listened to their experiences to help make improvements for the future . "The NHS now has more types of role than any other healthcare system in the world, and care must be taken to ensure that these roles are understood by the public and by staff." According to the NHS careers website, PAs "support doctors in the diagnosis and management of patients". They usually complete a bioscience-related degree before undertaking a two-year integrated master's course. Registered healthcare workers, like nurses or Most PAs work at GP surgeries and in A&E, and are supposed to be "under the supervision of a doctor". While they carry out similar roles, they don't have the same medical training so are not direct substitutes. To become a GP, you complete four to six years of medical school before a two-year foundation training programme. Read more on the Irish Sun You can then apply to GP speciality training, which takes a minimum of three years, and pass several assessments. The Faculty of Physician Associates makes it clear that PAs "are not doctors" and "do not replace medical roles". 5 The Leng Review has called for large scale changes to the role of physician assistants Credit: Getty 5 Emily Chesterton (right) died from a pulmonary embolism after being misdiagnosed Credit: PA


Irish Times
18 hours ago
- Irish Times
Inside the insourcing industry: The multimillion euro business within our public hospitals
In a presentation to a conference on the future of healthcare a couple of years ago, an anaesthetist from Cork urged that 'innovative thinking' was needed to tackle the perennial problem of patients waiting long periods for hospital treatment. This involved 'thinking up something new or to think about something old in a new way'. Ken Walsh told the Health Summit conference that in the regular health system there were roadblocks to progress on dealing with the waiting list, such as staff availability, sick leave, absenteeism, pay and funding issues, as well as restrictions under the European Working Time directive. READ MORE However, he suggested there was an alternative that would incentivise staff to work additional hours within the limits of European employment laws. The overall concept was relatively straightforward. With a growing and ageing population, demand for care was likely to surge and the ability of the public system to cope was limited. The State had been outsourcing patients on long waiting lists to private hospitals for years. But what about spare capacity in public hospitals? These had highly trained staff and expensive equipment, largely funded by the exchequer. But routine or non-urgent care was primarily a Monday-Friday, regular working hours operation. Unlocking unused capacity at night-time and weekends could allow tens of thousands more patients to be treated. Hospitals already offered regular overtime to staff. But this new 'third party' insourcing would mean private companies putting together teams of doctors and staff who would be paid premium rates to work in their public hospitals, outside of core hours. This 'third party insourcing' may have proved effective in getting more patients treated but it was also highly lucrative for those involved. And behind the scenes, it generated strong concerns about potential conflicts of interest, perverse incentives and governance and oversight shortcomings. [ Waiting list initiative suspended at Naas after concerns consultants paid directly Opens in new window ] Around teatime on Friday of last week, the Health Service Executive sent a report to an Oireachtas committee on how much such insourcing companies had been paid. Over 27 months to March 2025 three had, between them, received more than €70 million. One, EHF 29 Limited, received €54.636 million. Official filings showed it was largely owned by two doctors, Ken Walsh and Clodagh Ryan. Accounts for 2023 show that EHF 29 Limited had recorded an annual profit of €2.39 million. The company declined to comment this week but its website sets out the scale of its operations. It had carried out more than 70 waiting list projects in 22 acute public hospitals. From a small start in 2020 it assisted in the provision of treatment for 5,500 patients in 2021, 46,000 in 2022 and approximately 79,000 in 2023. Its accounts for 2023 say that the average monthly number of people employed, including directors, was 576. Among projects on which it has worked are day case surgery at St James's in Dublin, vascular surgery at Cork University Hospital, plastic surgery in Galway, breast clinics in Galway and Letterkenny, endoscopies in Ennis, Limerick and Wexford, and a pathology initiative in Waterford. It is understood as part of its operations, it recruits 'suitably qualified staff' from the HSE. Another company, Rosata Recruitment, received €10.3 million in the 27 months to March. This company's accounts list Ronan Corrigan as director and its report for 2023 said it had a monthly average of 29 doctors employed. It reported profits close to €500,000 for that year. The company says it has been 'providing a wide range of insourced surgical/outpatient/diagnostic/endoscopy waiting list initiatives since 2020″. The HSE said another firm, Totally Healthcare, received €5.9 million in the 27 months for insourcing projects. The company says it works with hospitals across the United Kingdom and Ireland. Last year, it announced a 12-month insourcing contract for oral and maxillofacial outpatient and day surgery cases with HSE hospitals in the west of Ireland. [ HSE paid one firm €54m over 27 months for services to tackle waiting lists in public hospitals Opens in new window ] 'All procedures will be delivered during weekends when hospital facilities are not otherwise in use', it said. Sinn Féin health spokesman David Cullinane described the HSE funding report as 'staggering' and warned that insourcing presented risks. However, it was official policy. And while supporters of the idea, such as Dr Walsh in Cork, may have had a vision, it could not have been implemented without political backing. Governments for years had struggled with waiting lists. Taoiseach Micheál Martin as minister for health 20 years ago had established the National Treatment Purchase Fund to buy care for those waiting longest. But after the Covid-19 pandemic there were serious problems. In February 2022 the then minister for health Stephen Donnelly said months of disruption during the pandemic had left more than 730,000 queuing for treatment. The year before, Donnelly had introduced a short-term plan from September to December, which, he said, had provided care to an additional 40,000 people. After Covid, Donnelly now had more money at his disposal than any of his predecessors and he now effectively turbocharged the drive on waiting lists. Initially, in 2022, he launched a €350 million plan, which became a permanent feature in subsequent years. Overall, the sums involved in tackling waiting lists were vast. Over four years, about €1.6 billion was provided. Some of this allowed the HSE to directly hire more staff, more went to the National Treatment Purchase Fund to buy treatment in private hospitals. But significant amounts went on insourcing arrangements. Although regular overtime continued, third-party insourcing became increasingly common. The framework on which this worked was a dynamic purchasing system introduced by the HSE. This allowed hospitals operating a non-recurring initiative to conduct a mini-competition open to providers on the dynamic purchasing system. A multimillion-euro private industry was about to develop inside the country's public hospital system. [ The Irish Times view on hospital waiting lists: Straining to stand still Opens in new window ] There were concerns about insourcing from early on. But they were mainly behind the scenes. Officially, the initiatives were working, particularly in bringing down the length of time people had to wait. Donnelly told the Cabinet last November that since September 2021, there had been a 58.5 per cent reduction in the number of patients waiting over 12 months, equating to over 169,000 people. But in the background, there were concerns. In recent weeks, The Irish Times received documents which suggested that within Children's Health Ireland (CHI), the group that runs children's hospitals in Dublin, there had been particular unease about insourcing. CHI paid €5.66 million to EHF 29 between 2023 and March 2025. It ceased insourcing initiatives in June. However, some in the health system maintain that concerns existed more widely and the documents represented attempts to rehabilitate the image of CHI in the wake of recent controversies. But nonetheless, CHI seems to have pursued its concerns about insourcing, albeit in private, including a meeting with the Health Service Executive in June 2023. Children's Health Ireland said in a statement that its board 'raised concerns regarding the concept of insourcing and the potential conflict of interest for staff, with HSE colleagues on several occasions'. [ Almost €100m spent on companies that use HSE facilities and staff to cut waiting lists after hours Opens in new window ] The HSE said that in 2023, a meeting was convened between it and Children's Health Ireland representatives, including members of the CHI board, to discuss the provision and use of insourcing. 'CHI expressed concerns at the meeting, which were shared by the HSE. It was agreed that insourcing was necessary as a short-term measure to address waiting list backlogs,' the HSE said in a statement. Children's Health Ireland said it reiterated its concerns on foot of a HSE memorandum (on insourcing) issued in February 2024 but agreed to continue with the initiative 'in view of the challenges to patient waiting times and with HSE assurance'. The HSE did not say whether it had alerted its board or the Department of Health to the concerns raised by Children's Health Ireland. However, within the HSE internal auditors began looking at insourcing arrangements in 2023 and early 2024. In September 2024 The Irish Times reported auditors had found that two companies which received more than €1.5 million between them at University Hospital Limerick without a competitive procurement process were owned or part-owned by employees. Over recent weeks more controversies emerged involving CHI, Beaumont Hospital and Naas in Kildare. [ Beaumont Hospital has NTPF waiting list funding suspended Opens in new window ] At the end of June HSE chief Bernard Gloster urged Minister for Health Jennifer Carroll MacNeill to phase out insourcing within a year. He said 83 serving or former health staff were acting as directors in 148 companies providing insourcing and outsourcing arrangements. Carroll MacNeill is expected to decide on the future of the multimillion-euro insourcing industry within the next few weeks.