Dublin hospitals 'clogged up' by outsiders

Patients from outside Dublin requiring non-specialist procedures are "clogging up" Dublin hospitals, the head of the Health Service Executive, Prof Brendan Drumm, has said.

Overstretched Dublin hospitals were coming under additional pressure because of "unjustifiable" admissions from outside the county, Prof Drumm told an Oireachtas Health Committee yesterday.

"This practice is putting unnecessary pressure on our Dublin hospitals and, as I am referring specifically to non-specialist procedures, this practice is unjustifiable and unsustainable when facilities and clinicians are available locally."

The public also had to stop seeing hospitals as the best form of care, if the overcrowding problems at A&E were to be addressed, he said.

"At the moment I believe that there is a perception that if you are not treated in a hospital you will not get the best care. This is not the case."

The acute hospital system was based on junior doctors many of whom had very little experience. "I am going to be pleading more and more with people to stop seeing the hospital as the best provider of acute care."

Greater emphasis needed to be put on the primary and community care system, which needed to become more integrated with each other and with the hospital system. However the management of the hospitals themselves needed massive improvement.

Patents were rarely discharged on Saturdays or Sundays, yet the majority of elective procedures were scheduled for Mondays rather than during the week, creating a "bottleneck demand" for beds on Mondays.

Better patients were discharged, planning was also needed, allowing for step-down care for patients no longer requiring an acute bed.