Hospitals to experience ‘extreme’ pressure for a number of years, says HSE

Hospitals will continue to experience “extreme” pressure over the coming years as they play “catch-up” creating extra beds for a rising population, the head of the Health Service Executive (HSE) has said.

Stephen Mulvany told the Oireachtas health committee there will be patients on trolleys and in surge beds in winter and during the rest of the year for “a number of years”.

Adding more beds will be a long undertaking, he told Labour senator Annie Hoey, but process improvements and other structural issues also have to be addressed.

“The reality is we have a number of years of extra pressure in the system, measured in terms of trolley waits, ahead of us until we get ahead of those things,” he said.

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Mr Mulvany rejected claims the HSE had failed to provide leadership during the trolley crisis in public hospitals, or that its winter plan had been an unmitigated disaster.

He was questioned by members of the Oireachtas health committee about the record levels of overcrowding faced by hospital emergency departments (EDs) since Christmas. Several TDs asked why emergency measures implemented on December 22nd were not put in place earlier.

Sinn Féin health spokesman David Cullinane accused the HSE of a “failure of leadership” in relation to the overcrowding crisis. He said all the warning signs for the crisis were evident last year but the HSE ignored them and put in place an “insufficient” winter plan.

“Everyone was saying we’re in for one hell of a winter, but leadership and urgency didn’t come from the HSE centre.”

Mr Mulvany said he did not accept there had been a failure of leadership. “Yes, we knew we were facing a difficult winter but what occurred was beyond or at the most pessimistic levels of modelling.”

Attendances at EDs across the country have been higher this year than ever before, Mr Mulvany said, and on some days the National Ambulance Service had received more than 2,000 calls a day, a new record.

A similar situation is being experienced by almost all health systems in western Europe, he said.

Referring to Mr Mulvany’s promise of a three-year care improvement plan, Mr Cullinane said this should have been put in place “years ago”.

“We’re long past the point of learning lessons. It’s about delivery and failure to deliver on plans.”

Mr Mulvany apologised for the experience of many patients who spent long periods on trolleys over Christmas and new year, adding that staff did not believe overcrowding was acceptable and neither did the HSE.

Senator Martin Conway described the winter plan as “an absolute unmitigated disaster” and said none of its targets had been met.

This was rejected by Mr Mulvany, though he accepted there were lessons to be learned.

Asked if he could confirm that no patients had lost their lives during the overcrowding crisis, Mr Mulvany said he could not provide certainty on the question. International research indicates there is excess mortality when patients endure long waits for treatment, he said.

Mr Mulvany declined to comment on the resignation of HSE head of digital transformation Martin Curley, who left this week saying the organisation was not fit for purpose and was resistant to change.

He said the HSE didn’t comment on individual staff matters and he had not seen the detail of Mr Curley’s comments. “There are two sides to every story. I’m sure the full story will get told in due course,” he told TDs.

Mr Mulvany told Senator Conway the HSE is using 180 private sector beds for public patients. This is 12 to 13 per cent of overall capacity in the private health sector. He said many private-sector beds are not suitable for use by public hospitals as they are geared to surgical rather than medical patients.

Asked by Fianna Fáil TD Cathal Crowe whether health staff who train in Ireland should have to stay and work here for a period, Mr Mulvany said it was true that the HSE was losing too many staff but his preference was to encourage, rather than force them, to stay.

Senator Conway asked if it was true that University Hospital Limerick, which has had the highest levels of overcrowding, had requisitioned only five of these private-sector beds.

Mr Mulvany said he did not know but he would not be surprised if it was the case as there is no private hospital in Limerick. University Hospital Limerick is actively considering using private beds in Cork, he said.