Saturday 24 February 2018

'I really am sorry for Irish patients and staff' - Health Minister's words before 'kick ass' HSE meeting

*Ambulances waiting outside overcrowded A&Es
*Health system needs 'significant investment' - HSE chief
*Thursday trolley count is at least 578
*Nurses en route to 'burnout'

Inset: Health Minister Simon Harris
Inset: Health Minister Simon Harris

Eoghan MacConnell, Denise Calnan and Laura Larkin

Health Minister Simon Harris said he is sorry for patients and staff enduring the “extraordinarily difficult” situation at Irish hospitals.

Speaking at the official opening of the newly refurbished Scott Building on the grounds of the Midland Regional Hospital, Tullamore, Co Offaly, Mr Harris outlined a range of temporary measures aimed at tackling the overcrowding.

At least 602 patients remained on trolleys yesterday, while Tuesday saw a record-breaking 612 patients on the trolley count.

A total of 578 patients remain on trolleys today, according to the latest figures from the Irish Nurses and Midwives Organisation.

University Hospital Limerick is the worst-hit today with a total of 60 patients on trolleys.

Cork University Hospital have clocked an extra eight patients on trolleys today, resulting in a total number of 40.

In the wider Dublin area, Tallaght hospital is worst-hit with 45 patients on the trolley count.

“Our hospitals are going through an extraordinarily challenging period of time at the present," the minister said.

Tony O’Brien, director general of the HSE. Photo: Philip Leonard
Tony O’Brien, director general of the HSE. Photo: Philip Leonard

"I really am sorry for Irish patients and indeed for the staff working in our hospitals experiencing the conditions that they are having to put up with at the moment.

"It isn’t acceptable, the health service must do better,” he said.

Mr Harris insisted the HSE must “redouble its efforts and I expect the health service to do more than outlined in the Winter Initiative.” He was due to meet with the HSE Director General this afternoon where he will be seeking a range of “temporary and immediate” measures.

Mr Harris said these measures include “temporary capacity, where it is possible to put modular builds in place.”

He told the press he also wants to extend “the opening hours of diagnostics so people can get in and out of the hospital environment quicker" to allow GPs make direct referrals to consultants rather than sending patients through the emergency departments.

The HSE will also examine how it can work with nursing homes and residential units to allow older people be cared for in those environments.

Minister Harris said fundamental shifts have to be taken to break the “vicious cycle” of overcrowding in the Irish health system. Central to this is bed capacity, recruitment of nurses and a new GP contract to support and resource care in the community, he stated. 

“All three of those issues I have been working on in the eight months I have been in office,” he explained. 

“I am determined to try and break that vicious cycle,” he added.

While flu affects hospitals every year, Mr Harris said,  “What is different though is the flu season has come much earlier, but the strain of flu is different to the strain of flu we had last year. It is a strain of flu that is particularly challenging our older people.”

“The flu is an additional compounding factor and what is already an extraordinarily historically busy time for our hospitals,” he remarked.

“I hear people saying, 'well isn’t this the same every year'.

"Well actually, it is not having the same impact on attendance as every year because attendance for people over the ages of 75 is up 17pc, the number of calls to the doctors out of hours is up 50pc, the strain of flu is different to last year,” he pointed out.

Mr Harris acknowledged that the pressure being experienced in the hospitals was also occurring in primary care. 

He noted the comments of SIPTU’s Paul Bell in relation to queuing ambulances and said he has requested, and was expecting, a report from the HSE on the matter this afternoon. Mr Harris said he will be meeting with the Emergency Department Taskforce on Friday morning.

Meanwhile, Transport Minister Shane Ross said his cabinet colleague Minister Harris plans to "kick ass" when speaking with the HSE.

"I think it's up to him and I think he intends to go in and kick ass today when he gets to talk to the HSE," he told Pat Kenny on Newstalk.

"It's unreasonable to expect him as Minister to micromanage, in other words to blame him every time the trolley figures go up or down or to claim credit either way but there obviously is a big problem there," he added.


Director-General of the HSE today said the health system will need an investment of "hundreds of millions of euro" to stop the trolley crisis cycle.

Tony O'Brien described the current health system as "well-designed for a previous era" and said it needs an effective redesign.

The HSE chief spoke as it was revealed today that ambulance staff are holding patients outside Accident and Emergency departments for up to six hours as there is no space inside Irish hospitals.

Speaking to RTE Radio One's Today with Sean O'Rourke, Mr O'Brien said the HSE is seeing "significant changes in the needs of the population".

"We're facing a reality that we're operating a system that was well-designed for a previous era," he said.

"We're seeing very significant changes in the needs of the population.

"We require a redesign of the healthcare system if we are to get out of this cycle.

"If we are to make fundamental changes, we need a transitional investment, I think we're talking about hundreds of millions," he continued.

"In New York, they have a programme in place over a 3-5 year period and they are strategically building up services to keep people out of hospital.

"It will take significant transitional investment and a number of years."


A senior consultant has warned that staff in emergency departments are burning out as the over-crowding crisis continues.

Gerry Lane, of the Irish Association of Emergency Medicine ,told RTE’s Sean O’Rourke that he “literally had nurses crying on me” this week.

Dr Lane who works in Letterkenny General Hospital said one nurse was “brought to her knees” by a man’s complaint due to a four hour wait at around 4am in the morning.

“The nurses here are among the most sterling people with whom I’ve ever worked with and these people are beaten down,” he said.

He said the HSE is losing staff and he is seeing people unable or unwilling to take on more extra duties.

Senior nurses are working up to two and half extra hours a day.

“That kind of superhuman effort is only sustainable for a certain period of time before you have burn out,” he said.

Ambulance queues

The HSE issued a statement saying the Christmas/New Year period has been exceptionally busy with many frail elderly patients presenting and requiring admission to hospital.

But medical professionals have slammed the Health Minister for his reaction to the crisis and said the influenza season has yet to reach its peak, meaning the trolley crisis could still worsen.

Now, queues of up to 16 ambulances have been pictured outside hospitals as ambulance staff are under pressure to find space for patients.

SIPTU Health Division Organiser Paul Bell said the current average wait outside a hospital is between one and three hours, but some ambulances have been recorded waits as long as five and six hours.

There were five ambulances on call in the wider Drogheda area yesterday, but there was only one available as four were forced to wait outside the A&E department.

Speaking to RTE Radio One's Morning Ireland, Mr Bell said; "When they arrive at hospital, they are unable to safely transfer the patient to A&E.

"This means that ambulances are being held on hospital sites around the country, and this means they are unavailable for emergency calls and they are unavailable to leave the hospital. The ambulance is now caught at the A&E department."

Mr Bell said the major issue for ambulance staff is they cannot safely transfer the patient from the stretcher to the care of the hospital.

"There's no space in the hospitals and, once there's no spaces, that's the position you're in," he continued.

"Cork University Hospital, University Hospital Kerry and Our Lady of Lourdes Hospital in Drogheda are the most difficult at the moment for drivers.

"This is an issue for us representing ambulance professionals. We were told there was an anticipation this was going to happen.

"There was no planning put in place for how emergency ambulance drivers could do their duties.

"We believe this could have been sorted before Christmas."

Mr Bell called on the Health Minister Simon Harris to have a conversation about the current trolley crisis with ambulance management.

"It's great to talk about bed openings, but what's forgotten is the people who need critical care arriving by ambulance.

"I can say that ambulance professionals fear they are not giving the patient the best opportunity to get the best outcome because they are being prohibited.

"The minister will have to have a conversation with the ambulance management.

"This conversation is taking place every single year at this time and it's getting worse. There is no forward planning, it seems."

HSE National Director for National Ambulance Service told the programme they are currently working to try and improve the situation.

Damien McCallion said that the HSE have recorded a 5pc increase in the number of patients presenting themselves at A&E departments nationwide over the last 12 months.

"Certainly at the moment, we're facing into a difficult period in relation to the demand on our services," he said.

"We're trying to manage the risk in terms of safety in all of the settings.

"The stories out there are clearly not acceptable to us.

"We're working to improve the situation. We've made progress and the ambulance situation has improved massively in the last year."

Mr McCallion described the healthcare sector as a "high risk business" and said he is "satisfied" that the "protocols and resources" are in place to support the situation.

"We don't see 602 [patients on trolleys] as an acceptable figure," he added.


The Irish Medical Organisation 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.”

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