The scenes at the accident and emergency unit at Belfast's Royal Victoria Hospital on Wednesday night were shocking, but even more disturbing was the claim by a nurse that the unit is operating to almost the same level of demand on a regular basis.
Trust managers and the Health Minister claim that an emergency plan to cope with high levels of admission was enacted and worked, but by what criteria are they judging that success? There was an obvious spike in admissions, although there was no defined reason to explain it. That suggests that the unit is operating at near capacity on a routine basis since the closure of the Belfast City Hospital A&E unit. It does not take a genius to work out the impact caused by that closure, as it is clear the Royal has not been given the resources, nor does it have the total facilities, to cope with the added influx of patients.
To say that staff – who, it has to be clearly stressed, perform heroic work in very difficult circumstances – cleared the backlog in three hours is a fairly meaningless statement. That is purely a measurement of the time it took to ensure patients were either discharged or prepared for admission to the hospital. It is not a measurement of the quality of care. That some had to spend 14 hours on a trolley awaiting further treatment is a clearer indication of the strain in the health service here.
The public needs a lot of convincing that the health service here is either properly structured or resourced. While there is a process of transformation being undertaken, people want to be reassured that there is a clear vision of where the service is headed and that it is on the right path. Those who work on the frontline – never mind the patients – seem to have very different views on this from the Health Minister and those at a managerial level within trusts. To have one of our leading A&E units described as failing by a member of staff should cause us all concern.