THE numbers of patients enduring "trolley misery" in overcrowded hospital emergency departments surged last month.
Figures show 4,648 were languishing on trolleys in August - compared to 3,913 in the same month last year.
The rise of 19pc, highlighted in a report from the Irish Nurses and Midwives Organisation (INMO), shows the increasing pressure on hospitals as more patients look for treatment even before the autumn and winter influx.
The figures show some hospitals suffered a particularly sharp rise in patients with the numbers on trolleys in Dublin's Mater Hospital up to 285, compared to 82 in August last year.
Other hospitals where there was an increase include Naas General, where numbers went up from 40 to 230. University Hospital Galway's emergency department had to cope with a jump from 146 to 319.
Connolly Hospital in Blanchardstown, which is in the constituency of Health Minister Leo Varadkar, saw its trolley numbers fall from 464 in August 2013 to 271 last month.
There was also some respite in Waterford and Cavan hospitals.
However, the union pointed out the negative trend was continuing and follows another rise in July. It called for closed beds to be opened and more long-stay patients to be transferred to appropriate accommodation.
General secretary Liam Doran said: "The figures are a clear warning that our health service has already cut back too deeply."
Meanwhile, the number of discretionary medical cards or GP visit cards that have been returned is still at around 11,400.
This is despite the original estimate that 15,000 people would be due the cards back.
A spokeswoman said that all cards due back to people who lost them between July 2011 and June last have now been returned. She said the files "have been reviewed in recent weeks it has become clear that there are a variety of reasons that some medical cards are not renewed such as some individuals' health status having improved such as not to warrant a medical card.
"Some cards are restored to one member of the family as opposed to the entire family and some card-holders having passed away or emigrated during the intervening period."
Anyone who feels that they may meet the criteria but have not had their card returned should contact PCRS on 1890 252 919.