Why has HSE 'winter initiative' no plans to recruit vital staff?
Published 10/09/2016 | 02:30
Elderly people trapped on trolleys in hospital corridors for hours. Seriously ill patients, who have been on waiting lists for more than a year, turned away and told their surgery is cancelled because there is no bed for them. These could be the stark scenes in hospitals across the country on any winter's day.
However, it was the depressing picture to emerge yesterday as temperatures were at 17 degrees and 318 patients endured gruelling delays for a bed. It underlined how the trolley crisis is now a year-long grim reality.
It also might explain why there was so little fanfare around the HSE's launch of its underwhelming €40m 'Winter Initiative', with its catalogue of pledges to tackle worsening gridlock in the coming months. Worryingly, it will not kick in until late October.
The basic formula is the same as previous years. It is promising 55 additional beds for Tullamore, Beaumont, Naas, Waterford and Mullingar Hospitals.
Another 950 home care packages will be provided to help relieve overcrowded hospitals in Cork, Waterford, Drogheda, Mullingar Galway and Dublin.
There will be 58 more transitional beds, increased funding for aids and appliances to allow people leave hospital, and an expansion of minor injury services in Dublin, including Saturday openings.
Two key targets include not having more than 236 patients on trolleys each morning and keeping the number of delayed discharges - patients who no longer need a hospital bed - below 500.
It comes against a background of the well-documented pressures which will see demand surge over the winter, particularly a sharp rise in older patients who will need a hospital bed and have complex needs.
We might as well brace ourselves now for the worst because despite all the work we are told went into the plan, it is lacking a key measure - how do hospitals overcome staff shortages?
The continuing failure to attract enough nurses and doctors is undermining the service and blocking improvements.
Several of the 300 extra beds provided last year are closed because of lack of nurses.
Waiting lists are growing because key medical specialists are not applying for jobs. There are now growing problems finding staff to provide home help in the community.
Tallaght Hospital consultant Dr James Gray commented: "We have a staffing crisis across the frontline from consultant to junior doctors and across nursing. Beds do not open without staff. This initiative fails completely on addressing this."
He also pointed out that having a 236 maximum for patients on trolleys is fine in theory but asked: "What are the penalties if there are 237 or more? Who will be accountable?"
He predicted more patients will be subjected to "sensory torture with constant light and noise for hours and days on end".
There is also the ongoing issue of GPs being forced to send their patients to emergency departments because they cannot get timely access to a scan in the community.
The focus on emergency overcrowding for most of this year has led to waiting lists soaring to record levels and while Health Minister Simon Harris is promising to outsource thousands to private hospitals, once the €50m special funding comes through. But how much of a dent will it make in the alarming queues of people needing care?
The situation is dismal but that is the price for years of lack of reform, under-investment and political indecision.