Ireland's Emergency Departments are not treating patients properly - leaving some of them at risk of serious injury or even death, the AGM of general practitioners heard yesterday.
It also heard that GPs from around the country have had patients sent home without treatment, even though they had serious life-threatening conditions.
Waterford-based GP Dr David Janes, who worked in West Africa, told the meeting in Limerick that A&E patients in The Gambia were treated quicker than they would be in Ireland.
Dr Janes proposed a motion calling on the Government to urgently address the emergency department crisis and "cease the current practice where patients are being returned to general practice without appropriate investigation and treatment".
He told how he urgently sent one of his patients, who presented with symptoms of a blood clot, to A&E but was sent back because the tests were "inconclusive". The patient was sent back again and ended up going back and forth for over a month before she was ultimately diagnosed with a lung clot - a major life-threatening condition with a high death rate.
Dr Janes also spoke of dangerous under-staffing at the country's A&E departments, and referred to Clonmel Hospital, which he said had lost up to 100 nurses in recent years. He added: "On one occasion, I spoke to the junior doctor in the hospital about my patient. He simply didn't have enough English to understand the basic question I was asking as to whether my patient was in the hospital as an in-patient or an out-patient - in other words, if he had been admitted. That level of English is simply not good enough to be working in medicine in Ireland. You have to have great communication to practice medicine - he hadn't even a basic level."
South Dublin-based Dr Stephen Murphy said he had a verbal contract with some of his elderly patients not to send them to A&E. He said his patients were afraid of being sent to A&E and would "prefer to die at home" rather than suffer the indignities they encountered in hospitals.
Dr Janes said he spent up to four hours a day dealing with cases which had been referred to hospital because they could not be treated in general practice effectively or safely, but had been sent back to him without treatment. "I have to follow-up on all these cases - they get misdiagnosed or don't even get to see a doctor. The system is no longer safe and is certainly below what is acceptable," he said. "It takes up huge amounts of my time, which in turn means I have less time to see the patients who need me."
He cited another case of a woman in her 80s who had been diagnosed with pneumonia who was left in an open area on a trolley with no privacy for days. Although she recovered from her initial bout of pneumonia, she contracted the disease again. This time, however, she refused to go to hospital, despite her serious condition, because of her previous treatment.
Dr Murphy said it was extremely difficult for doctors to agree with patients not to send them to A&E. He said he had an "ethical obligation" to provide the best care to his -elderly patients, but also had to take into account their wishes.
He added: "I have several patients who have made me promise them that I will not send them to A&E if they are very ill. They would prefer to die at home rather than suffer the indignities of lying in a corridor for hours, days or weeks and I understand that. But it is also very difficult for a doctor to not try to get them treatment of any kind."
The National Association of General Practitioners urged the Government to act to relieve the crisis and properly staff the country's A&E departments.