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Here's the summer of hell you can expect in our A&Es

With our cash-strapped health service facing meltdown, this is the type of thing many of us can expect in the months ahead:

  • If you end up in A&E you may face even longer waits, with trolley numbers still around the 300 mark and likely to get worse. Even when you get admitted, your bed could be one of a number of extra beds crammed into a busy ward.

  • If you arrive at an A&E, you might not get in, as it may have been closed at 8pm due to a doctor shortage. If you are very ill, you may have to be transferred to another A&E miles away.

  • If you need an operation, growing cuts in bed numbers are pushing up waiting lists and cancelled procedures.

  • If you're having a baby, services may be reduced due to cutbacks and doctor shortages. Your local maternity unit may even be temporarily closed.

  • If you need a hospital outpatient appointment, you will have to join the thousands of patients on waiting lists. Some have been waiting three years or more.

  • If you have had a baby, you may face a delay in getting a developmental check-up.

  • If your family is caring for a loved one with an intellectual disability, you may be facing the loss of vital respite care.

  • If you need cancer care, the HSE has admitted that vital extra posts for these services may not materialise.

Most people would accept some health cutbacks were inevitable and that waste-cutting was needed.


However, much of what is happening at the coalface of healthcare right now is far removed from the rosy picture of transformation painted by the HSE in its annual report this week.

HSE funding has now been squeezed until the pips squeak. Surely the HSE cannot guarantee a safe health service for much longer if spending is restricted any further.

A shortage of resources was one of the key factors in the fetal scanning scandal.

The HSE has admitted that services are struggling as a result of the massive €1.2bn cut in its budget this year, and predicts more harsh medicine.

We were told by the Government the savings needed would come from pay cuts, retirements and income, with frontline services left largely unscathed.

However, the axe has been wielded on frontline care since early in the year, and measures such as pay cuts haven't achieved the savings they were supposed to.

With less than half the year gone, the HSE has a deficit of more than €100m. It says "enormous focus" is needed to stay within hospital budgets -- code for more cutbacks.

And if this wasn't bad enough, a planning blunder has led to the threat of hospitals having around 600 fewer junior doctors from July 1. This could cripple services.

Fewer doctors are applying for hospital posts, mainly because the HSE, for reasons that remain unclear, deemed many junior doctor posts were no longer recognised for training purposes.

Last-minute attempts to fix this may fail to avert a doctor shortage on July 1.

Doctors who take up non-training jobs may not be supervised properly, adding to safety concerns.


The doctor shortage crisis is typical of a chaotic approach to planning services.

Our health service may have taken all it can take at this stage.

A doomsday scenario is emerging whereby we may have unprecedented cutbacks to patient services. It could be back to the 1980s, only worse.

Mary Harney needs to sit down with the HSE and sort out this health service mess.

Niall Hunter is editor of irishhealth.com