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CRISIS: Minister Reilly faces impossible task

It's seven days and counting to D-Day for our hospitals, as they scramble to fill junior doctor posts due to become vacant on that day and avoid a staffing 'tsunami' in emergency departments.

But if you are talking about trouble in A&Es, this probably isn't the particular crisis we should be concentrating on.

In recent days the prospect of a major shortage of trainee doctors in A&Es appears to be easing to some extent.

Health Minister James Reilly said late last week that the number of vacancies had now reduced to around the 250 mark and recruitment was continuing.

He admitted, however, that there still may be doctor shortages.

But let's not kid ourselves that this means an end to the problem.

Because even if James Reilly manages to fill every single one of the remaining vacant junior posts in hospitals over the next week, which admittedly is unlikely, A&E departments will still face a crisis.

The same old crisis they have been mired in for years and will continue to suffer until the day comes when we finally sort out the woes of our health system.

Hospital emergency departments have been in a state of crisis for years -- they simply cannot cope with the pressures put on them.

Getting a patient admitted through A&E can be like the proverbial camel getting through the eye of a needle.

As A&Es fill up and the trolley count mounts, so does the squalor and risk of infection.

Research shows that patients left on trolleys in A&Es are more likely to get sicker or even die than those admitted to wards.

The A&E chaos is due to a tangled mix of poor health service planning; lack of beds and community 'step-down' facilities to move people on from beds and accommodate patients coming through A&E; flawed systems in hospitals for processing patients and chronic funding shortages in key areas.


So what does the average punter face these days when he or she enters many hospital emergency departments?

It's often a question of 'welcome to hell'.

It has got so bad, that the health safety body HIQA has ordered an inquiry into the safety of one of our biggest A&Es, Tallaght Hospital.

Just look at this recent account of a patient's experience in Tallaght, A&E as detailed on RatemyHospital.ie -- and this is probably the experience of people in many A&Es at the moment: "There was a woman oozing some stuff from her foot in the middle of the corridor. She was on her second day. My trolley was shoved out of the way multiple times as I was dumped in front of X-ray.

"I was left with a dirty bedpan at my head the whole time I was in A&E. No wonder there is disease spreading through the hospitals when basic hygiene is ignored."

Now that our health service is facing an unprecedented funding crisis, the minister's task is becoming gargantuan.

And it gets worse. Not only are their safety concerns about Tallaght A&E, but the minister has said emergency departments in many smaller hospitals around the country, including St Colmslie's in Loughlinstown, are inherently unsafe.

This is due to the low volume of patients going through them, their lower numbers of key staff and the difficulties in providing supervised training for doctors who work there.

This means that smaller A&Es such as Loughlinstown will stop providing a 24-hour A&E service sometime later this year, potentially putting pressure on other bigger A&E units that are already struggling.

Over to you Dr Reilly ...