Minister for Health says ‘combination of solutions’ needed to resolve A&E crisis

If the provision of more hospital beds and more staff was the solution to overcrowding in emergency departments the problem would have resolved many years ago, Minister for Health Leo Varadkar has said.

He said over-crowding was a choronic problem in about seven of the country’s 26 emergency departments which had people on trolleys all year round.

He said on occasions in the past when more beds and staff had been put in place “the number of (non-urgent) elective cases increase and the same number of people end up on trolleys”.

Mr Varadkar said the problem of emergency department over-crowding had emerged first 15 years ago when the current Fianna Fáil leader Micheál Martin was minister for health.

The Minister said that comparing like with like, time of year with time of year and using the calculation system of the Irish Nurses and Midwives Organisation (INMO), the number of patients on trolleys in emergency departments on Wednesday was the lowest in seven years.

However he later indicated that if patients on additional beds in wards were included, the figures may be different.

General secretary of the INMO Liam Doran, who has been appointed co-chair of the new emergency department task force, said additional beds and nurses were needed, not high-level strategies.

The INMO, which held a rally outside Leinster House to highlight the problem of over-crowding, said 77,091 people last year had spent time on trolleys, chairs or in additional accommodation in wards while awaiting a hospital bed.

It said this represented a 14 per cent increase on the figures for the previous year.

The INMO said nurses in several hospitals, including Beaumont, Naas, University College Hospital in Galway and Limerick, Ennis , Croom and Nenagh in the mid west, were scheduled to commence industrial action in prostest at overcrowding within the next few weeks.

Mr Doran warned that the planned industrial action by nurses could escalate, if the problem was not solved.

Mr Varadkar said: “When it comes to industrial action and work to rule, my experience from my time in the health service is that it does not particularly impact on patients but does make life harder for other front line staff particularly junior doctors so it is certainly not a solution to this problem.”

However he said he understood that nurses were frustrated and sick to death at dealing with a chronic problem that had afflicted one third of the country’s emergency departments for 15 years.

“I totally understand where they are coming from,” he said.

In relation to emergency departments where industrial action was scheduled, the Minster said what was required was “a combination of local solutions worked out on the ground in those hospitals assisted by measures swe can take at a national level”.

“There is nobody who wants to resolve this 15 year chronic problem more than me.”

Asked about Mr Doran’s call for additional beds and nursing staff, the Minster said: “If more beds and staff were the solution, the problem would have been found 15 years ago when the problem first emerged. It is about more than that. If resources were the solution it would have been solved a long time ago.”

Mr Doran said he would be proposing to the task force that the role of triage nurses in emergency departments be expand.

He said they should be able to order diagnostics and fast track patients through system.

He said there was no problem with nurses approaching work practice changes but there was a difficulty “with management not being able to understand the benefits that will flow from it”.