The need for urgent reform of accident and emergency facilities in hospitals has been recognised by this Government for many years.
And yet it has failed to address the problem in a comprehensive and effective fashion, as is evident from the large number of patients who have to wait in appalling conditions on hospital trolleys. Last month, the Tánaiste and incoming Minister for Health, Ms Harney, made the issue one of her priorities. She and the coalition Government will be judged on the progress made when the general election is called.
Overcrowding at accident and emergency services has become endemic. Previously, the situation only became critical when winter illnesses seriously affected older people. But now it is a year-round phenomenon with patients waiting for days on trolleys and chairs for a bed. The factors behind this deterioration include inefficient management of the admittance and discharge systems, a shortage of staff and available beds and inadequate step-down facilities.
Delays and overcrowding in hospital waiting rooms have been exacerbated as a result of an estimated 100,000 low-income individuals losing medical card eligibility. They tend to favour such facilities, rather than attend expensive GPs as private patients. Before the last election, the Government promised to extend medical card cover to an extra 200,000 citizens, but it has allowed the situation to deteriorate.
A shortage of hospital beds and the imposition of a cap on staffing levels has made the task of management extremely difficult. But reform is desperately needed in relation to admission and discharge of patients. While families protested outside the Mater hospital at the weekend because of the manner in which 20 of their relatives were accommodated, some 77 people who were fit for discharge were occupying acute beds because no alternative, long-term care facilities were available.
The Tánaiste has inherited three major reports on health service reform from her predecessor, Mr Martin. All of them have become affected by delays, political controversy and a shortage of funding. In opting to take charge of this high-profile department, however, Ms Harney seems determined to make her mark and to introduce much-needed, contentious reforms. She will have her work cut out. Resolution of the accident and emergency crisis may be one of the easier tasks.
A commitment to implement the Hanly report on the regionalisation of hospital services is now a year old and no nearer implementation. Ireland has the lowest number of hospital beds per capita in the EU and a pledge to add 3,000 more beds remains unfulfilled. There is an urgent need to invest in the ambulance service if hospital reform is to become a reality. Compensation talks with junior hospital doctors drag on. And negotiations with consultants on a common contract have not even started. There is much to be done.