Trolley crisis: Waterford hospital ‘shows solution in plain sight’

Hospital has avoided patients on trolleys by purchasing more bed capacity locally, says Dr Rob Landers

University Hospital Waterford has been held up as the exception to the current pressure on emergency departments

University Hospital Waterford demonstrates the solution to the trolley crisis is “hiding in plain sight,” a hospital consultant who works said.

Surgical pathologist Rob Landers, who is also the president of the Irish Hospital Consultants Association, said the hospital has avoided patients on trolleys by purchasing more bed capacity locally.

The hospital has been held up as the exception to the current situation where there is severe pressure on emergency departments and patients have to wait in corridors often for 24 hours before being given a bed.

Dr Landers said Waterford had purchased hospital beds from the UPMC Whitfield Hospital and also step-down beds from local nursing homes to deal with its capacity issues.


There is a culture of prioritising patients who enter through the emergency department and they are treated as quickly as possible, even if that means cancelling elective surgery in some cases, he said.

“Any patient presenting to UHW is prioritised for a bed. There is whole staff engagement on this from the management team to the consultants to the junior doctors and nurses,” he added.

Dr Landers told RTÉ' Radio’s Saturday with Colm Ó Mongáin programme the hospital’s consultants work weekends and are providing “24/7 care, 365 days a year”, but he denied that it was any different from other hospitals in relation to that issue.

“There is local decision making – there is good effective local decision-making, authority has been devolved to the hospital,” he explained.

“That was accelerated during the Covid-19 pandemic by moving closer to the frontline down to the local management team and the consultants on the ground.

Hospital overcrowding: Is adding more beds really the solution?Opens in new window ]

“That allows changes. You can’t govern or run a hospital from several hundred miles away. They need to be talking to the staff and resolve problems on an hour-by-hour basis.”

Speaking in his role as the IHCA president, Dr Landers said his association are in a “deep phase of consultation” with its members over the new consultants’ contract that is on the table.

The Irish Times has reported the Government is to press ahead with the new contract for hospital consultants, which will see extended hours in the evenings and at weekends, despite not having yet the agreement of the doctors’ organisations.

Minister for Health Stephen Donnelly intends to signal the start of the new contract in early to mid-February, he has told colleagues.

From then on, it will be the only contract offered to new consultants, while existing consultants will have the choice of switching to the new contract if they wish.

In response Dr Landers said Mr Donnelly had terminated discussions on the new contract on December 7th.

He said he hoped agreement with the Government could be reached so consultants’ contracts would not be forced through without consultation.

“We are in a very detailed consultation with our members. We are at the 11th hour. There are things that need clarification. We will then be in a position to make a recommendation in relation to the contract after that,” he said.

Ronan McGreevy

Ronan McGreevy

Ronan McGreevy is a news reporter with The Irish Times