Hospital bed shortages: In search of a cure

New figures from the Irish Nurses and Midwives Organisation’s (INMO) trolley watch confirm that demand for emergency hospital admissions continues to grow, with hospitals unable to provide the necessary capacity. On the first three days of last week there were 1,718 patients waiting for an in-patient bed. For the same three days last year there were a total of 1,173 awaiting a bed.

And so the inexorable upward trend in waiting times for acute public hospital care continues. This, despite a fall in the number of influenza cases as we exit an especially busy winter period. It signals a year-round stasis due to an inadequate number of hospital beds which makes the management of patient flow a severe challenge.

Building primary care capacity is an essential first step; existing infrastructure is crumbling

There is a risk of “headline fatigue” with a problem as long-standing as the trolley crisis. But last week’s numbers are the equivalent of three entire hospitals full of patients for whom there are no beds. Many of these people are the most deprived in society, with no recourse to the private sector.

Meanwhile, Health Service Executive director general Tony O'Brien has said the country faces "an existential crisis" in its capacity to provide healthcare for its citizens if system reforms are not expedited. The Sláintecare report presents an opportunity to implement change because of its cross-party authorship and independence of the electoral cycle, O'Brien said. But Sláintecare requires a time-tabled implementation plan if cherry-picking its more palatable points is to be avoided.

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The lack of urgency around the issue threatens the very foundations upon which healthcare reform will be built. Building primary care capacity is an essential first step; existing infrastructure is crumbling, as evidenced by the closure of out-of-hours GP services in Birr and Edenderry last week.

And although National Treatment Purchase Fund funding aimed at those waiting for nine months or longer for planned surgery is welcome, it represents symptomatic treatment rather than cure for our healthcare crisis.