Doctors and Donnelly clash over call for senior medics to work weekends to ease overcrowding crisis

Senior doctors clashed with Minister for Health Stephen Donnelly yesterday after he asked them to work weekends over coming weeks to help deal with the crisis in hospital emergency units.

Mr Donnelly and health officials want hospital consultants to work outside their normally rostered hours in order to speed up discharges and make space for patients to be admitted in order to ease overcrowding in the units, which has hit record levels this week.

“There is an ask of consultants and appropriate medical staff to come in just for the next few weeks, to come in at the weekends,” Mr Donnelly told RTÉ.

However, the Irish Hospital Consultants Association (IHCA) hit back at his remarks, saying that “public hospital staff are working tirelessly attempting to provide appropriate levels of care to patients”.

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“Consultants are on call 24/7, often practising over and above recommended levels, but the reality is there simply isn’t enough of us to meet increased demand,” the representative group said in a statement.

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The consultants warned that the crisis in emergency wards could soon see more than 1,000 patients a day being treated on trolleys, rather than in hospital wards, and criticised the Government for not providing adequate resources and capacity in the State’s hospitals and wider health service.

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A total of 838 patients admitted to hospitals were waiting for a bed on trolleys in emergency departments or on wards on Wednesday morning, according to the Irish Nurses and Midwives Organisation. This was down from Tuesday’s record of 931, but was the second-highest total ever recorded by the union’s trolley watch count.

There is no point in putting in another 200 beds if the same practices are going to prevail

—  Nurse

Mr Donnelly told Cabinet colleagues yesterday that the crisis in hospital emergency units is expected to continue over the coming days as the surge of people sick with respiratory infections shows no sign of ending.

The Minister’s plea to consultants to work out-of-hours comes as health officials say that delays in discharging patients are clogging up the system, leading to growing waits for patients attending emergency units. Senior health sources say that work practices at many hospitals mean not enough patients are being discharged, as consultants are not on-site throughout the week.

Staff at University Hospital Limerick, where the highest number of patients awaiting admission to a bed, 76, was recorded yesterday, told The Irish Times that while more beds are needed there, staffing and patient flow were also significant issues.

“There is no point in putting in another 200 beds if the same practices are going to prevail,” said one nurse, who spoke privately out of fear of being disciplined by the HSE if they were identified. ”The beds will be filled very quickly, but you’ve got to be moving people in and out of the system. Senior people have to see patients. It certainly is an issue.”

Another said overcrowding was being exacerbated by people “going to the ED when they don’t need to”.

“Working, fit, well people are coming in,” they said.

Speaking to political correspondents in Government Buildings after yesterday’s Cabinet meeting, a spokesman for Taoiseach Leo Varadkar acknowledged that there was a “need to improve patient flow” in hospitals. He said the Taoiseach had reiterated that “all necessary resources would be provided”, but that there was no question of additional money being made available to the health service at this stage.

The Cabinet heard that hospital Covid-19 and respiratory syncytial virus (RSV) cases were high, but stable. However, the numbers needing hospital treatment for flu are running at more than twice the level for the equivalent period before the pandemic. Ministers were also told there has been a significant increase in older patients presenting to emergency departments.

Many European countries are experiencing difficult conditions in hospitals due the wave of Covid-19, flu and RSV currently sweeping the Continent. The situation is especially acute in the UK.