Country ‘cannot sustain’ 29 hospital emergency departments

There are too many hospital emergency departments in the country and it is not possible to run them all adequately, the Irish Association for Emergency Medicine (IAEM) has said.

The association was commenting after a Health Information and Quality Authority report on Portlaoise Hospital, published last week, found that all levels in the HSE were aware of patient safety risks at the hospital but failed to act on them.

It was commissioned following the deaths of five babies in the hospital’s maternity unit and is critical of the Government for failing to properly fund the level of services provided in the hospital, including 24-hour emergency care.

The IAEM said there were too many so-called emergency departments in the country that, like Portlaoise, had major deficiencies and were a cause for concern.

The risks of such departments were often well known to senior HSE management, it claimed, but there was no concerted effort by the HSE to properly address them.

It said the need to keep open such services for political reasons “seemed to take precedence over all other matters, particularly patient safety concerns.”

Dr Fergal Hickey, spokesperson for the IAEM, said emergency departments need to be reconfigured.

"Our difficulty is that we have 29 emergency departments in the country which we simply cannot sustain. And there's no point in us continuing to claim that we have this service when the reality is different" he told RTÉ radio.

He said that, in his view, it was not sustainable to provide a 24-hour emergency department at Portlaoise hospital.

“Given where Portlaoise is and that it is surrounded by other hospitals there is certainly no requirement for there to be a 24-hour emergency department there,” he said.

“The reality is a decision needs to be made at the most fundamental level whether you resource Portlaoise to provide a full 24-hour emergency department service or whether you say this is a service that should be provided between 8am in the morning until 8pm at night with alternative arrangements after 8pm.

“This is the bit that takes a period of time to develop…that has implications for the ambulance service, implications for the surrounding hospitals and they need to be resourced to deal with the consequences,” he said.