The health service is facing a fresh crisis with the stark warning that some of Northern Ireland’s busiest A&Es are reaching breaking point.
The situation has become so bad that a leading nursing union has held formal talks with bosses at the Belfast and Northern Health & Social Care Trusts amid claims that patient safety is being put at risk.
Last night Health Minister Edwin Poots apologised as A&Es at the Royal Victoria, Ulster and Antrim Area hospitals struggle to cope with the additional demand on services following the closure of the casualty unit at Belfast City Hospital.
At the weekend an 86-year-old woman spent 34 hours on a trolley in the Royal Victoria A&E after suffering a suspected stroke — and patients treated there yesterday described the unit as “chaotic”.
Garrett Martin, deputy director of the Royal College of Nursing (RCN) in Northern Ireland, said: “Once again we are hearing about the state of our A&E departments and the difficulties facing patients and staff in trying to cope with a high level of demand on the system.
“The RCN is seriously concerned about the impact pressures being experienced in A&E departments in Northern Ireland are having on frontline nursing staff and patients.
“Stories regarding patients waiting on trolleys and lack of dignity, coupled with staff who are at breaking point, are totally unacceptable.
“We have had formal talks with two health care trusts recently to raise our concerns and we will be approaching the trusts again to see what further measures can be put in place to ensure these problems are tackled.”
Mr Garrett said the RCN is particularly concerned at the use of the emergency department as the point of entry to inpatient services.
He continued: “Emergency departments are not designed to provide facilities to enable dignified care for patients such as personal care, toileting, eating and drinking. Such a high number of patients also makes it difficult to maintain infection control standards.
“All of these issues are having a detrimental effect on public confidence and staff morale and further measures need to be put in place to ensure this situation does not continue.”
The Stormont health committee has demanded full details of waiting times in A&Es across Northern Ireland after claims last week that the Ulster Hospital is struggling to cope with demand.
The problem there has arisen as a result of the closure of the A&E at Belfast City Hospital, which means that more patients are turning up at Dundonald looking for treatment.
The problem has been exacerbated by the overnight closure of the A&E at Lagan Valley Hospital in Lisburn.
Meanwhile, the casualty unit at Antrim Area Hospital has experienced extreme difficulties since the closure of the A&Es at Mid Ulster and Whiteabbey hospitals in 2010.
Health bosses maintain the changes in emergency services were necessary to ensure patient safety.
However, health unions have become increasingly concerned over conditions in the remaining A&Es.
Last year the Belfast Telegraph revealed that a prominent Northern Ireland GP believed the A&E at Antrim Area Hospital was worse than a Belfast city centre hospital during the height of the Troubles.
Responding to the current situation, Mr Poots said: “I want to apologise at the outset to those people who have experienced long delays. It is important to be clear that it was because of patient safety and quality reasons that it became imperative to put in place temporary changes to the provision of accident and emergency services in the Belfast Trust.
“The decision to close the emergency department unit at the City Hospital was not based on achieving efficiencies or cuts, but was driven by human resource issues relating to recruitment, retention and adequacy of training and supervision of junior staff.”
Mr Poots also urged members of the public to only go to A&Es in an emergency and use alternative services, such as GP out-of-hours instead to relieve pressure on emergency departments.
‘It’s a war zone, people were crying in pain’
An 86-year-old former serviceman broke down and sobbed as he described his experience at the emergency department at the Royal Victoria Hospital. Lawrence Harland, from east Belfast, has been to the hospital’s A&E twice in recent days after suffering agonising pains. He said:
“It’s like a war zone there. It was a nightmare. There was one man there who was bleeding from the mouth and he had been lying on a trolley for 12 hours.
“I waited about 10 hours and in the end the doctor said there was nothing more he could do for me and sent me home.
“There were people everywhere in pain. I am a religious man and I looked up to God and I asked him to make it a better place for all the sick and people who were in pain.
“I’m an ex-serviceman and I don’t want to be like this. I was badly injured serving my country and I live on liquids now. Even as I am talking now I am in agony.
“I was taken back to the Royal by ambulance on Monday but I didn’t want to go because of what had happened on Sunday.
“The second time I was there six hours and eventually the doctor came out and told me there was nothing they could do. My GP has given me very strong painkillers now.
“Something needs to be done. The people in charge need to get down there and see the plight of the people. It’s not just for me, it’s for all the other people who were there, crying in pain.”
‘I saw a nurse just standing there in tears’
An 86-year-old woman with a suspected stroke spent 34 hours on a trolley without food or water at the Royal Victoria Hospital A&E. Brent Herdman said his mother Muriel was distressed and frightened during her ordeal, which started on Saturday after she was taken to the unit by ambulance. He said:
“At one stage an elderly woman sitting in a wheelchair next to my mother had to relieve herself while she sat there because she couldn’t get anyone’s attention to take her to the toilet. I saw a nurse just standing there in tears. She could have been upset about a personal problem but I believe it is more likely because of the conditions in which the staff are working.
“When I told one of the nurses I wanted to complain, she told me to because it is the only way anything will ever be done about what is happening there.
“My mother got no food or drink while she was there. She only had a thin blanket over her and no pillow. Eventually they rolled up a blanket and put that under her head.
“There were a lot of drunks there, it was like a war zone.
“I would suggest Edwin Poots goes down to the A&E at the Royal and lies on a trolley for 24 hours without water. Let him go down there so he gets an idea of what patients are going through.”