A hospital doctor who hit out at conditions in a dramatic announcement to an overloaded emergency waiting room at Antrim Area Hospital has spoken out in the past about the pressures facing the health service.
Dr Hugo Dowd made headlines last week when he warned patients at the hospital's emergency department (ED) that they may have to wait up to seven hours to be seen.
Addressing the crowded waiting room, Dr Dowd said the backlog of patients waiting for a hospital bed was slowing down the speed at which his staff could treat people arriving at the ED.
And in a controversial claim that angered his colleagues in the community, Dr Dowd criticised GPs for sending patients to hospital when they don't need to be there.
It has now emerged that Dr Dowd made a similar speech about the challenges facing emergency care staff at an inquest into the death of an 80-year-old patient at Cardiff's University Hospital of Wales.
Retired miner Jan Arciszewski died at the hospital in January 2006 after being left in a wheelchair in a corridor for half an hour because there was no bed available.
Giving evidence at the hearing, Dr Dowd, who was a consultant in the emergency unit at the time Mr Arciszewski was a patient, said working at the hospital was akin to dealing with a terrorist attack every day.
He said: "I'm having to run my department as if we're having the London bombings going on every day, because of the level of management put into it, and it's frustrating.
"I like to treat patients, not run around like a headless chicken trying to find beds."
Dr Dowd said the hospital was so full the night Mr Arciszewski died that patients should have been sent elsewhere if possible.
He also explained that on the day Mr Arciszewski died, there was "a minimum" of 13 patients having to wait in the corridor for an "extended" period of time.
The medic said more beds, both in hospitals and care homes, would help the situation. He added: "There are a significant number of patients in a trust bed for more than 30 days waiting to be moved to a different care environment."
Dr Dowd was working in the ED at Antrim Area Hospital at lunchtime last week when he revealed that 10 patients had been waiting on trolleys for more than 12 hours to be admitted to a ward - while a further 100 people were waiting to be seen.
"I don't have 100 doctors, I don't have 50 doctors - I have eight," he told those waiting.
"You will not be seen in the order in which you have arrived, but in the order of priority.
"That means that some people may seem like they are going ahead of you, please be patient, if we are doing that it is to speed up the whole of the time people are in this department.
"Sometimes we order X-rays and bloods early so that when the doctor sees you, she or he can sort you out quicker.
"If any of you are unsure of why you are here, please speak to one of the triage nurses.
"Quite often, GPs kick for touch and send patients up here who don't need to be in an emergency department."
He added: "Everyone who has turned up will get seen but some of you listening to this are going to be here for another six or seven hours. We are an emergency department, we will see everybody who has turned up but not necessarily the order in which you have arrived.
"If I have a cardiac arrest, I have to put three doctors in to that patient and two nurses - it's what you'd want if it was your relative."
Emergency departments across Northern Ireland are struggling to cope with demand, with 18,110 patients spending more than 12 hours on trolleys from April to September.
It is not the first time the ED at Antrim Hospital has encountered difficulties. In two high profile cases, a prominent GP said in 2012 that conditions at the unit reminded him of the A&Es in Belfast during the height of the Troubles, and last year a paramedic revealed the ED had run out of portable oxygen because it was so busy.