Eilish O'Regan: 'Rammed A&Es in winter mode - and with no flu to blame'
It's the height of summer but our overcrowded hospital A&Es still appear to be locked in a permanent state of winter.
Across the country yesterday, 451 patients on trolleys were enduring another long-haul wait for a bed - not far off the 495 in 2006 when former health minister Mary Harney declared a national emergency.
There's no flu to blame for the ongoing crisis, which has left crammed hospitals with little respite and no downtime.
University Hospital Limerick reported 78 patients on trolleys while the HSE's own figures - which only count those in need of a bed in A&E - were 75pc up on the same day last year.
So why are A&Es constantly at boiling point all year round?
Doctors and nurses blame understaffing and lack of beds and clearly these are adding to the queues.
But there are other outside pressures which are now causing this lack of reprieve.
Although the HSE says there are no cuts in its homecare budget, it seems there has been a slowdown in allocating home helps, leaving more patients occupying beds who could be discharged.
University Hospital Limerick yesterday said that as of yesterday, the hospital group had a total of 22 patients with a delayed discharge, twice the normal level.
A spokesman said there were "multiple reasons for delayed discharges, including patients with complex medical and social care needs. We are currently working with the community to arrange appropriate care".
This is also the week when junior doctors in training change hospitals and begin another six-month stint.
They have to get used to working in unfamiliar surroundings with a new team.
If there are fewer senior doctors around, this slows up the process of induction - and patients are caught in the middle.
The training doctor has to explore the new territory while the patients keep coming.
There are other reasons why there is no summer let-up and it has to do with the kind of illnesses patients are presenting with.
A study led by Dr Jacinta Mulroe, of the HSE's Health Intelligence Unit, found the majority of patients admitted with respiratory conditions in winter and summer are over 65.
The most common causes of emergency respiratory patient admissions are the same in winter and summer.
While there are an additional 379 respiratory admissions during winter compared to summer, the good weather does not create much breathing space.
In summer, the number of patients attending A&E and needing a bed while suffering from cancer, injury, poisoning or gastrointestinal conditions can be higher than in winter.
Health Minister Simon Harris must wonder what impact the additional beds coming on stream will have.
University Hospital Limerick, which was worst hit by the trolley crisis over the winter, has 450 inpatient beds.
Over the past 12 months its bed capacity has increased by just five.
Construction has started on a new 60-bed block but it won't open until the end of next year.