The Irish Times view on the HSE’s winter plan: Christmas crowding

The late announcement of the detailed plan has, not unreasonably, led to questions about its effectiveness

The Health Service Executive’s winter plan to reduce hospital overcrowding sets out a number of actions to free up hospital capacity, with a particular focus on Christmas. The late announcement of the detailed plan has, not unreasonably, led to questions about its effectiveness.

Outpatient appointments, planned inpatient and day case procedures will be curtailed. Additional diagnostic capacity is promised. On the community front, a community representative, on site in acute hospitals will assist in helping with the timely discharge of patients. Some 550 home support packages are to be made available under the plan to help free up capacity to meet the expected increased demand for beds.

However, a number of potential holes in the plan are evident. The plan is targeted at just nine acute hospital sites. Aiming to increase diagnostic access for GPs for acute cases is a non sequitur: people who present to their family doctor with a significant acute event by and large require urgent assessment in an emergency department. And publishing a plan less than two weeks before its implementation must severely handicap its chance of success. Still, a belated plan is better than no plan at all.

Minister for Health Simon Harris predicted that the number of inpatient beds in the acute hospital system will rise above 11,000 in 2019. Welcome as this increase is, the fact that it takes our national public bed complement to a threshold last seen in 2009 is a reminder of how far we must still travel to reach international norms. We have the highest hospital bed occupancy rates in the developed world, at 94 per cent, well ahead of the OECD average of 77 per cent. With high occupancy rates and low numbers of beds the system will continue to struggle.


It is estimated that over 100,000 patients have been affected by hospital overcrowding this year. A true measure of the winter plan will be whether the figure for the highest number of patients waiting for admission on a single day(714) is breached in 2019.