Overcrowding in many hospital emergency departments has worsened over the past year with the imperative to continue doing something about the problem lessening since the general election, it was claimed yesterday.
Dr James Binchy, secretary of the Irish Association of Emergency Medicine, said now there was not the same focus by the Health Service Executive (HSE) on addressing the issue. There had been a 50 per cent increase, at 2,751, in the number of people on trolleys overnight in the emergency department of Galway's University College Hospital where he worked in 2007, compared to 2006, he said.
"There was some improvement in the last quarter of 2006 when there was a lot of political pressure . . . but this hasn't been maintained and the situation has got worse," he said. "There isn't the same imperative . . . maybe it's because the election is over."
Significant numbers of patients were also still having to wait overnight on trolleys at other hospitals such as the Mater and Beaumont in Dublin, he said.
Dr Binchy said little or nothing had changed since the publication last year of an A&E taskforce report, which said seven emergency departments were "unfit for purpose" and which recommended a time frame be set by the HSE to reduce waiting times in A&E to a maximum of six hours.
The HSE had set a 12-hour target for A&E waits and even this hadn't been met in all cases, he said. "There is no doubt that this is adversely affecting patient outcome. Two independently published papers from Australia suggested that emergency department overcrowding, due to lack of hospital capacity, was associated with a significantly increased hospital mortality.
"Applying these figures to Ireland suggests that there are in excess of 360 deaths a year, ie one a day, directly attributable to emergency department and hospital overcrowding." These deaths were resulting from delays in patients being seen and treated.
Dr Binchy said more investment was required in acute hospital beds, community beds and diagnostic services to alleviate the overcrowding. A number of A&E units also needed to be rebuilt.
Furthermore, he said, patients attending the A&E units found to be unfit for purpose - at the Mater, Beaumont, Drogheda, Cavan, Wexford and Letterkenny - should not have to pay the €66 A&E charge.
Meanwhile, Dr Pat Plunkett, a consultant in emergency medicine at Dublin's St James's Hospital, also claimed things were worse in A&E at the end of 2007 than at the end of 2006. He said there were insufficient beds and insufficient funds to discharge people to other facilities.
Labour's health spokeswoman Jan O'Sullivan has urged the HSE to acknowledge the A&E problem was getting worse. She said the recommendations of the A&E taskforce must be implemented.
The HSE denied the problem was getting worse, saying such claims were not supported by facts. "In the last two years, great improvements have been achieved and more will follow," it said. It was working with hospitals which had problems meeting the target of having no A&E patient waiting more than 12 hours.