A RECORD number of patients were on trolleys in hospital A&E departments yesterday.
Five hundred patients endured the overcrowded conditions -- breaching the 495 high of nearly four years ago when Health Minister Mary Harney declared it "a national crisis".
The worst-hit hospitals were Beaumont and Tallaght in Dublin, while Wexford General and Limerick Regional were also under extreme pressure.
While 500 people were in need of a bed, 845 beds were occupied by patients who no longer needed acute care but could not be moved because there was nowhere to go.
Another 896 beds are closed in acute hospitals and public nursing homes, including 77 in Tullamore Hospital and 72 in Sligo General.
The high level of beds that are out of bounds means patients who need to be admitted are left clogging up emergency departments .
The Irish Nurses and Midwives Organisation, which compiles a 'trolley watch' survey every day, said yesterday's figure was the highest ever.
Asked how many "bed blockers" there were in hospitals, a spokesman for the Health Service Executive (HSE) said: "There are currently 845 patients in this category across the hospital system in early January 2010."
He said a number of patients continued to be hospitalised when their care and treatment could be provided somewhere other than hospitals.
"A number of significant developments have taken place recently, which will have a positive impact on delayed discharges, including the development of step-down care facilities and community nursing units as part of the HSE's transformation programme, reflecting the shift to community based care which will continue in 2010," he said.
The spokesman said progress was being made in reducing the numbers and access to nursing home care was being facilitated under the Fair Deal Scheme, to provide financial support for people needing a public or private nursing home place.
"As would have been expected in any new scheme, there was a surge in applications in the initial stages of the scheme.
"The HSE is currently processing 5,400 applications," he added.
Commenting on the overcrowding, Dave Hughes, the nursing union official who is joint chair of the A&E Forum, said a number of factors were compounding the problem, including a lack of beds, a shortage of doctors and cold weather.
"Hospitals are now facing excessively long trolley waits, which have not featured on our statistics for a long time," he added.
"The situation is some hospitals is intolerable and patients and staff are enduring misery."