Wednesday 21 February 2018

Hospital crisis is 'only going to worsen' as at least 602 patients remain on trolleys today

*602 patients on trolleys on Wednesday
*Trolley crisis 'to worsen' - consultant
*Calls for cuts to bed numbers to be reversed
*A&E departments need 'overhaul' - leading doctor

(Stock picture)
(Stock picture)

Denise Calnan and Laura Larkin

A medical consultant has warned that the trolley crisis is "only going to worsen", as it is revealed that at least 602 patients remain on trolleys nationwide today.

Dr Fergal Hickey of Sligo General Hospital said the influenza season has yet to reach its peak and disregarded the Health Minister’s comments that the trolley crisis was “unpredictable”.

On Tuesday the Irish Nurses and Midwives Organisation recorded 612 people on trolleys around the country -- the highest number on record.

Today, the updated number of patients on trolleys is at least 602, as St Vincent's were not in a position to provide a ward figure to the INMO.

University Hospital Limerick is the worst-hit, with 66 patients on trolleys at the moment.

Midland Regional Hospitals in Tullamore, Portlaoise and Mullinagar have 45, 34 and 32 patients on trolleys, respectively.

In the wider area of Dublin, Tallaght Hospital and the Mater are the worst-hit with 23 patients on trolleys each.

Speaking to RTE Radio One’s Morning Ireland programme, Dr Hickey said the current situation is a crisis for the individual patient.

“It certainly is a crisis for the individual patient, even if it’s not a political crisis,” he said.

“I don’t accept unpredictability as a reason [for the number of patients on trolleys], perhaps things happened earlier than planned this year but that is not an excuse.

“There were 612 patients on trolleys yesterday. The minister is being disingenuous.

“The influenza, at a normal background level, is 18 cases per 100,000 people. At the moment, we have 46.7 cases. And this is nowhere near what it’s likely to get to, which is 80.

“To suggest that [influenza season] is someway unpredictable or unprecedented is nonsense,” he continued.

“That’s the nature of an influenza season, the cases increase exponentially over weeks, reach peak and then tail off in a similar fashion. This information is known. The only issue is it occurred two or three weeks earlier than expected.”

Dr Hickey said the fundamental problem was the lack of beds to submit patients into hospital.

“It’s interesting that both Britain and Ireland have the greatest trolley crisis in Europe and we’re outliers when it comes to acute beds. The lack of capacity means we’re going to run into this problem.

“Unless we solve the capacity problem, we’re never going to get out of this mess.

“What the minister talks about is moving deck chairs around the Titanic. We need to deal with the fundamental problem which is the lack of capacity.  A lot of the discussion is around peripheral issues.”

Bed cuts

The Irish Medical Organisation also said the crisis of overcrowding will continue until the cuts to bed numbers in public hospitals are reversed.

They also said Ireland needs to become an attractive location for Irish-trained doctors to want to work in.

"Politicians often complicate what is a very simple explanation for our overcrowding crisis," Dr Peadar Gilligan, Consultant in Emergency Medicine at Beaumont Hospital and Chairman of the IMO Consultant Committee, said.

"It’s not because of seasonal issues or a spike in flu cases. 

"It’s because politicians knowingly and deliberately took 1,600 beds out of our hospitals, introduced policies that were a direct cause of doctors emigrating and failed to invest in General Practice. 

"All this at a time when our population was rising and there are more elderly people than ever before in need of healthcare.  It doesn’t get simpler than this; we’ve reduced the size of the container but we’re still trying to get more and more into it every day.  It just won’t work.”

Overhaul

Meanwhile, another leading doctor said an overhaul of the A and E model in Ireland is needed if overcrowding in hospitals is to be tackled effectively.

A and E's around the country have become "one stop shops" which is adding pressure to a system where there is a lack of capacity Chris Luke, an A and E consultant based in Cork University Hospital warned.

"I really do think that we have to have a very urgent debate about the demand. I don't think, unfortunately, that the model we have of the emergency department function in these islands is working anymore," he told Newstalk Breakfast.

"In a sense it's become kind of a one stop shop... the majority of patients in Emergency Departments are now are not in for [what we would call emergency treatment].

"It's become the main portal of entry into the health service for the elderly, who are declining slowly, in nursing homes for example you can predict their heart or lung function is declining and  admission to hospital could be better planned," he said.

Others are sent to A and E because there is a delay in getting further scans or treatment done he added.

"Unfortunately the emergency department has become kind of an emergency department store," Dr Luke said.

The doctor also warned that in the coming years there will be a shortage of GPs which will also have an impact on the health system.

"Look at number of GPs about to retire in the net five years that's coming down the track too. You have this huge cohort of GPs in their late fifties who are destined to retire in the next three to five years. Not just GPs but you have a lot of consultants in A and E who will go in the next five years.

"Instead of doubling the number of consultants in the emergency department you are going to see a shrinkage in the next two-five years.

"These problems  have been here a long time and they are fundamentally about capacity but also about the model we have of the emergency department," he said.

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