Medics warn of overcrowding deaths
Patients will die unless the overcrowding crisis which saw record numbers on trolleys in the country's hospitals is urgently tackled, senior emergency department doctors have claimed.
After the Irish Nurses and Midwives Organisation (INMO) recorded 601 people waiting for a bed and full admission - including scores in corridors - health chiefs claimed they had reduced the backlog by a third in one day.
The Health Service Executive (HSE) disputed the nurses' figures saying their records showed the number of patients waiting for admission fall from 513 to 354 in the afternoon.
The worst conditions were reported from Our Lady of Lourdes Hospital in Drogheda - 45 people were waiting for proper beds on wards - 39 on trolleys in emergency departments and another six squeezed in elsewhere on corridors and in wards.
Sinn Fein president Gerry Adams claimed the numbers included three children, two under the age of six months.
The Irish Association for Emergency Medicine, with emergency department consultant Mark Doyle as president, issued a grave warning over the crisis.
"Unless steps are urgently taken to decant patients from grossly crowded emergency departments, it is inevitable that patients will die and others will have much worse medical outcomes than they should have, resulting in longer lengths of stay and additional health service costs as well as avoidable grief and suffering," the consultants said.
Beaumont Hospital in north Dublin, which recorded 41 people waiting on trolleys, cancelled operations planned for this week, except for cancer treatments, in a bid to clear corridors and crowded wards.
A spokesman said the hospital acknowledges and regrets the difficult conditions experienced by patients and staff.
Beaumont blamed the overcrowding on delayed discharges - 14 more than its average - combined with an increase in the number of patients due in part to a change in cancer services in the region.
It called for more long-term solutions from health chiefs but also pointed to failed efforts at home and in the UK to fill 50 nursing vacancies in the hospital, including jobs in the emergency department.
The overcrowding is now at levels never seen before and has surpassed crisis points which sparked previous commitments and rapid responses from governments in 2006 and 2011.
Nurses voted 100% for a work-to-rule at Beaumont's emergency unit over the crisis where all patient care will be provided but non-essential or administrative work will not be done.
Lorraine Monaghan, INMO industrial relations officer, said the action was being taken in an attempt to end severe and unsafe overcrowding.
"This situation is beyond tolerable for patients and staff," she said.
HSE bosses claimed overcrowding will fluctuate in the coming weeks but escalation plans adopted by all hospitals, including opening overflow units, stopping non-emergency surgery, extra diagnostics and discharge, were having an impact.
"However, although the HSE anticipates the figures will continue to fluctuate, the collaborative arrangements now in place with the professional bodies and management are having an impact," the health chiefs said in a statement.
"We will continue with these measures."
Nurses at a number of other hospitals are also being balloted by the INMO to highlight the bed shortages including Drogheda, Naas, Mullingar, Galway and the Mid-West (Limerick) Hospital Group.
The HSE responded saying: "Staff working in a busy patient care environment, such as emergency departments, do their very best to provide the highest quality of care to patients despite the challenges, and in situations that can be stressful for both patients and their families."
Health Minister Leo Varadkar, who is overseas, came under fire from Mr Adams who claimed he was missing in the midst of the crisis.
"Overcrowding, the closure of A&E services and record numbers on trolleys are a direct result of the policies of Fine Gael and Labour," Mr Adams said.
"Meanwhile, the Minister for Health appears to be AWOL. This is unacceptable."
The reasons for the record overcrowding are down to a number of factors, medics claim.
Among them are the delayed discharge of patients to outpatient care, nursing homes or their own homes where they receive care in the community. The closure of wards and cuts to community and public health nursing also plays a part and is compounded by the traditional increase in demand for care after Christmas and in mid-winter.
Liam Doran, INMO general secretary, refused to accept that dispersing sick patients one at a time from overcrowded emergency units to wait in wards as a potential solution.
"What they are talking about is an initiative that has been tried in the past and failed in the past," the union leader said.
"It does not deal with the problem, it passes it on."
The previous health minister Dr James Reilly gave a commitment that by the end of 2012 the need for patients to be left waiting on trolleys in corridors would be ended.
Mary Harney, when running the health portfolio, was forced in 2006 to declare the overcrowding crisis a national emergency when figures were below 500.
Fianna Fail health spokesman Billy Kelleher said: "These figures from the INMO are further evidence of the escalating crisis in our Emergency Departments, which shows no signs of abating and is raising serious concerns about patient safety.
"Hundreds of patients, many of them who are elderly and frail, are being left for days on end on trolleys in A&Es, corridors and makeshift wards without privacy or dignity, as frontline staff struggle to cope without the necessary resources or support."
Mr Varadkar convened the emergency department taskforce involving consultants, senior doctors, Health Service Executive directors and the INMO to find solutions to overcrowding before Christmas.
It has met once.
The nursing union repeated its calls for a series of special initiatives which would have an immediate impact, including the opening of additional beds, acute and non-acute; the immediate recruitment of additional nursing staff; and an emergency injection of resources into the community to support additional home care packages and community nursing interventions.