Why are the hospital emergency departments in crisis?
Q.Why are emergency departments so overcrowded?
It's groundhog day again in hospital emergency departments. Overcrowding happens every year at this time due to a combination of pressures, including more colds and flu and winter illness suffered by people with bad hearts and chests.
Many people do not feel well over Christmas and New Year but put off going to hospital until the festivities are over.
Why were there record numbers of trolleys this year?
The usual overcrowding is worsened this year by the higher numbers suffering swine flu. But other factors are also at play which mean patients who should be moved to a ward are having to stay in the emergency unit or even a corridor
There were more than 1,000 beds closed at the end of the year due to hospital funding problems. Isolation wards are taken up by swine flu patients and there could be around 600 "bed blockers", patients who are ready for discharge but are still waiting for a home care package or nursing home place. Staff shortages in some units mean that care is being delayed.
Were we not promised this problem would be solved?
It has led to a multitude of plans, winter initiatives, strategies and a major taskforce report. It's not that progress has not been made; there have been measures such as medical assessment units, admission lounges, discharge lounges, target waiting times and even some new A&E departments built. More patients now undergo surgery on a day basis with no overnight stay. But while there have been sporadic improvements, the underlying problem remains. There are insufficient beds available to cope with people on trolleys who need to be admitted.
What is the Health Service Executive doing about it?
It has come up with a new plan and will spend around €8m this year diverting patients -- many of the elderly -- to more appropriate facilities where they can be seen and discharged earlier.