University College Hospital Galway’s emergency department is consistently breaching international guidelines on ensuring patients receive medical attention due to lack of space and “inhumane” working conditions, the Irish Nurses’ and Midwives’ Organisation (INMO) has said.
It claimed the emergency department at the west’s largest hospital had already lost a quarter of its experienced staff this year for this reason, with 10 nurses leaving the unit since January.
It said patients were waiting an average 10-12 hours just to see a doctor after triage or initial assessment of urgency by nursing staff.
"This waiting time is way outside Manchester Triage System guidelines," said INMO western area industrial relations officer Clare Treacy.
The union has called on Taoiseach Enda Kenny to intervene over the omission of a proposed new emergency department from the Government’s capital spending plans after he said in the Dáil this week that it was “one of the most inadequate facilities in the country, and needs to be replaced”.
During Leaders' Questions, Fianna Fáil leader Micheál Martin described as "incredible" that the project was not in the health capital programme. The hospital's plan had been "rebuffed"and had been sent back to management with an instruction to "scale it down and engage in another cost-benefit analysis".
In an interview with The Irish Times yesterday Mr Martin said: "I was told by hospital and clinical managers that they had proposed a project which was sent back and they were told to scale it down. It has to be the worst accident and emergency department in the country at this stage, and I got the sense when I met management that everyone was at the end of their tether.
“Apart from the national children’s hospital, the health projects in the capital plan seem to be all Dublin-based.”
As the second-busiest emergency department in the State, UHG’s unit is dealing with more than 250 cases a day in a unit provided on an interim basis in the late 1990s to cater for 100 daily.
The hospital's categorisation makes it a "magnet" for referrals from north Donegal as far as the Limerick-Kerry border.
A large proportion of the 1,000 missions undertaken by the Emergency Aeromedical Support Service, provided by the National Ambulance Service and the Air Corps since 2012, also land in Galway.
The hospital recorded 302 helipad landings last year, including cardiac and trauma cases and Irish Coast Guard transfers from the islands.
The closure of Roscommon hospital’s emergency department has also contributed to pressure, although patients are spread between Galway, Portiunucula in Ballinasloe and Mayo General
Staff who did not wish to be identified said yesterday the situation was extremely stressful and “risky”.
“We have had people collapsing in the waiting room before they have even been triaged,”a staff member said.
“On average 20 to 30 people leave without seeing anyone as they are waiting so long,” another staff member said. “These are people who should really be seen by a doctor.”
Three of 10 staff who have left since January were transferred to other departments due to stress, the INMO said, while seven resigned – five of whom have gone to work in private hospitals in Galway.
Mr Martin described as “shocking” his visit to the paediatric bays within the department. “There were two bays in the corner of a room, children were on the ground crying, parents cramped together and there was no capacity to deal with infection control,” he said.
Saolta hospital group chief operating officer Ann Cosgrove said management had been working on a brief and feasibility study for the new emergency department for four years and had completed a cost-benefit analysis, which it was "updating" for submission by February 2016. "It is disappointing that approval to go to design stage is not in the capital plan."
Saolta group chief clinical director Dr Pat Nash denied the existing department was "unsafe", but said its replacement was the "key priority" for management.
The hospital has acquired space from existing departments, including physiotherapy, to provide an extra 30 beds, and a 70-bed wing which is under construction. Dr Nash said while these developments would ease pressure on beds the emergency department still needed to be replaced.
The INMO has repeatedly highlighted the issue, and Minister for Health Leo Varadkar and Minister for Public Expenditure Brendan Howlin both visited the hospital this summer.
Fianna Fáil councillor Mary Hoade recalled that Mr Varadkar had acknowledged during his visit that the unit was not sufficient. She said he should "stop giving a running commentary on the crisis and take action".