Winter may be ‘hell on earth’ for hospital patients and staff if projections correct, says Dr Fergal Hickey

This winter could be “hell on earth” for patients and hospital staff if projections for hospital and ICU admissions are correct, Dr Fergal Hickey, president of the Irish Association of Emergency Medicine has warned

It would be an “Armageddon” type situation, he told RTÉ Radio’s Today with Claire Byrne show before an expected rise in admissions from influenza and Covid cases this winter.

Dr Hickey repeated his warning about the state of the healthcare system due to the lack of acute beds, the lack of critical care beds and the difficulty in recruiting staff who were “voting with their feet” and emigrating to work in Australia and Asia where work conditions were better.

Staff did not want to work in a broken system, he said, as a result the system was “haemorrhaging” healthcare workers. The lack of acute beds had been an issue for many years, he said. The issue had not been addressed despite many years of “agitation” on the issue.

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Emergency departments have become “warehouses for admitted patients”, he said. “Our acute beds capacity is 2.8 acute hospital beds per 1,000 of the population, the OECD average is 4.3, so we’re going into this with one hand tied behind our back and the reality is that our emergency departments have been left to become warehouses for admitted inpatients.”

A report for today’s meeting of the Emergency Department Task Force shows that there were 40,398 breaches of waiting times, when patients were left waiting more than 24 hours in the period from January to August this year.

Dr Hickey said that the 40,000 patients waiting over 24 hours for admission were patients who had already been treated in the emergency department and were waiting to be moved to a hospital ward.

“Because they remain in the emergency departments, they completely negate the emergency department’s capacity to act as an emergency department, so we can’t deal with the next group of incoming patients,” he said.

“We can’t cope safely. We have no hope of coping in the winter if these numbers prove to be the case.”

Dr Hickey said the healthcare system problems were an ongoing issue not just in winter. “This is a 12-months-of-the-year, a 365-days-of-the-year problem. The only time that there seems to be either political interest in this, or health service management interest is in the winter, and yet, we set records all through the year.”

The system continued to be short “a few thousands beds”, he said, but nothing was being done. Dr Hickey said that the bed shortage would also have an impact elsewhere in the system as patients could not be released home in the depth of winter to a cold home. This was going to make the situation much worse. People would have to decide between food or heating.

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