Managers at trolley-crisis hospital told January leave is now banned
University Hospital Limerick has highest levels of overcrowding
Managers in the region with the worst trolley crisis have had leave banned during the festive period - but only for January and not December.
The two-week ban for health executives and operational management teams has been imposed in the University Hospital Limerick group in the mid-west, which suffers the highest levels of overcrowding in winter and summer.
A spokesman said senior management were informed leave would not be sanctioned for them between January 2 and 16 as trolley numbers traditionally spike.
University Hospital Limerick had between 57 and 60 patients waiting for a bed on various days last week.
It comes as Taoiseach Leo Varadkar, who wants full round-the-clock rosters to be maintained post-Christmas and in January, has identified good management as key to tackling overcrowding.
As an example, he highlighted Dublin's Beaumont Hospital as benefiting from good management in bringing down its sky-high trolley figures.
"They are the best performer every day on the TrolleyGAR (the HSE's system of recording patients on trolleys), having been the worst, and have record low overcrowding," said the Taoiseach.
"I met them over the summer to hear what they were doing right. The answer is that it's the obvious good management practices. There's no mystery to it.
"I just don't know why best practice is not mainstreamed."
Cork University Hospital, which also suffers from regular severe overcrowding, did not respond to questions on its Christmas and new year rostering.
But a spokesman for the South and South West Hospital Group said: "There is no additional leave given to medical staff other that what is planned and agreed on a yearly basis to ensure that staff can have their statutory entitlements."
It comes as Health Minister Simon Harris and his officials meet the HSE to iron out details in its winter plan.
The plan aims to rely on the same measures as previous winters to improve patient flow, with increased access to step-down beds and transitional beds, as well as additional homecare packages to move more patients from wards into the community.
However, many of the patients who come through emergency departments after Christmas and the new year will be over 75 with several illnesses and they will need a longer hospital stay.
A question mark still hangs over how soon the additional 79 beds promised to ease overcrowding will be ready.
A spokeswoman for the minister said that "consideration will be given in the coming days as part of the HSE's preparations for winter".
The 79 extra beds, which will mostly not be open until 2019, include a 30-bed ward in Our Lady of Lourdes in Drogheda and a 40-bed modular ward block in South Tipperary Hospital.
She said €10m is being allocated to "enable hospitals to get patients home where appropriate before the end of the year with a focus on supporting patients in the over 75 age group".
Meanwhile, the flu remains at low levels so far and is not having an impact on hospitals.
Last week, there were no confirmed patients hospitalised with flu and there were no reports of flu-related deaths.