Over 75s left on trolleys for over 12 hours less likely to live independently – consultant

Patients who are over 75 years of age and on a trolley for more than 12 hours are much less likely to be able to return home to an independent existence, the Irish Association of Emergency Medicines has said.

Fergal Hickey, spokesperson for the association said patients would do "really badly, both in terms of the length of your hospital stay, and the number of medical complications," he said.

Dr Hickey also defended figures that indicated that somewhere between 300 and 350 patients per year die as a result of emergency department overcrowding.

He denied he was scaremongering. “This kills people yet it isn’t considered important enough to solve the problem. The problem is a shortage of beds.

“The Minister has accepted this publicly, the fact that he back pedals periodically is neither here nor there.”

Dr Hickey said that those who work in emergency department have seen many patients die as a result of over crowding and said “the problem is real.”

“Not alone does it cost humanity but it costs money. So not alone are we getting poor medical outcomes we’re also wasting money. We need to stop hoping that the problem isn’t there. Which has been the approach taken to date by successive ministers, this minister included.”

Dr Hickey said there has been little discussion about patients who do badly as a result of being “warehoused” in emergency departments on trolleys.

“ Emergency departments are very good at providing emergency care, what they cannot do is provide both emergency care and also provide in-patient ward care, which is what they are expected to do every day.

"We have huge numbers of patients warehoused on trolleys on a daily basis. In some cases we've had 50 and 60 patients on trolleys in Limerick and Galway in the last few weeks being forced to wait on trolleys.

“The fact that the Minister has been so unambitious in his planning sends out a message to the HSE that this doesn’t matter. The sad reality is that the abnormal has become the normal but that’s of precious little consolation to someone who has lost a loved one as a result of this.”

Dr Hickey said that the Minister for Health Simon Harris has said this is unacceptable and has called on him to fix the problems.

“He says he accepts that there are bad outcomes as a result, if that is the case then let’s go fix the problem and the problem will only be solved by providing enough medical beds so that when we need to admit a patient from the emergency department there is a bed to go to.”

He said that he suspects the delayed discharge figure is far higher than 528 admitted to by the department.

“Colleagues say there are many more delayed discharges. This is entirely in the gift of the HSE. They have the capacity to provide home care packages to support people or nursing home places to support people.

When they talk about this being an unacceptably large number they’re talking as if the solution lies in someone else’s hands.”

Trolley figures

Dr Hickey also said he was not surprised at Tuesday’s figures which recorded 528 on trolleys.

Dr Hickey said the HSE has failed to meet the target of 236 patients on trolleys, describing that target in itself as “fairly paltry”.

"This is a problem that has been going on since 1997. The HSE, the Department of Health have had ample time to prepare for this, winter comes at the same time every year, this is simply a failure to prioritise it."

Dr Hickey predicted that as we come towards the end of the year this problem is going to get worse.

“The winter surge is more significant in December, January, February and into March. If it’s bad now, it’s going to get significantly worse and significant numbers of people are going to die. That’s not scaremongering. That’s simply a prediction of what’s going to happen,” he said.

‘Bed-blockers’

Speaking to RTÉ's Morning Ireland, Dr Hickey said the controversial recent memo on 'bed-blockers' had "missed the point brilliantly but predictably."

Dr Hickey said the majority of patients referred to as “bed-blockers” want to go home or return to a community setting closer to where they live. He said the HSE was obstructing that process, as those “that make financial decisions in the HSE who are not prepared to spend the money it would take to have these patients facilitated in the community.”

“They would rather spend more money accommodating them in acute hospital beds at the same time taking the risk of having large numbers of patients on trolleys rather than fixing the problem.

“Rather than sending around memos suggesting that people should be forcibly removed, the memos should be sent to those who make decisions at community level as to home care packages, home help support. Often these are relatively small costs for going home and yet these decisions are not taken,” he said.