Unresolved issues around hospital overcrowding

There is ‘incontrovertible evidence that if patients over 75 are detained on a trolley for in excess of 12 hours they will suffer worse outcomes’

The finding that March was the worst month on record for overcrowding in Irish hospitals is worrying. Of even greater concern is that trends in the numbers of patients lying on trolleys, while waiting for a hospital bed, continue to be upward. Numbers waiting for inpatient, day case and outpatient care are also rising.

The next few weeks should mark the tailing off of the annual surge in influenza and other virus related admissions as the “clinical winter” comes to an end; however there is no indication that trolley numbers will level off, let alone reduce, such is the crisis in the health service.

Perhaps the most sobering statistic is one collated by the Irish Nurses and Midwives Organisation: it found that the 9,381 patients who spent time waiting on trolleys for a bed in a ward during March represented a 100 per cent increase compared with figures from March 2008. Despite the additional money and effort spent dealing with the issue in the latter part of 2015, the numbers represent a five per cent increase on the same month last year.

Irish Association of Emergency Medicine spokesman Dr Fergal Hickey pointed to incontrovertible evidence that if patients aged more than 75 are detained on a trolley for in excess of 12 hours they will suffer worse outcomes.

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And there is mounting evidence that patients themselves know this with family doctors reporting increasing numbers of patients refusing hospital admission because of what they see as the insurmountable hurdle of emergency department chaos.

“The overcrowding problem is only going to be tackled when there is a stable government prepared to do what’s necessary,” Dr Hickey added. He is correct in one respect: investment and strategic decisions are on hold under a caretaker administration.

Without a long term plan to put our health system back on its feet, the haemorrhage of doctors and nurses from all parts of the service will continue. But we have a caretaker Minister for Health who continues to draw a salary. Mr Varadkar must not forget the day job, broader political challenges notwithstanding.