The Irish Times view on the intensive care crisis: A critical issue

There is no excuse for ignoring the crisis in ICU care for over a decade. Urgent remedial action is required

There is no excuse for ignoring the crisis in ICU care. Photograph: Alan Betson / The Irish Times

There is no excuse for ignoring the crisis in ICU care. Photograph: Alan Betson / The Irish Times

 

Most patients admitted to hospital in the Republic will not require treatment in an intensive care unit (ICU). But for those who do, the professional care provided can mean the difference between life and death. Whatever the reason for admission, a fully resourced ICU is an essential part of every acute hospital.

Which makes the ongoing shortage of ICU beds a serious concern. A 2019 HSE report on the number of ICU beds found that there are currently only 249 beds in hospitals here. This places Ireland below most other European countries in the provision of critical care beds.

At present, almost one in four patients requiring cancer surgery do not have their procedure within the designated timeframe for such surgery

A separate audit of ICU services, undertaken by the National Office of Clinical Audit concluded that the shortage of ICU beds meant a level of bed occupancy which was “above the recommended levels for safe patient care.”With patient safety pared to a minimum, both staff recruitment and retention have been affected. According to the Irish Hospital Consultants Association (IHCA), Ireland has fewer than half of the consultant intensivists needed to provide high quality care for patients. The latest figures show there are 35 whole-time equivalent consultant posts, when there is a need for 82. Over the last decade, the Government has failed to increase consultant staffing of ICUs, despite the findings of a HSE-sponsored report in 2009.

This report also recognised the need for additional ICU beds. The problem has still not been addressed. In fact, the country now has 40 fewer ICU beds than it did when the report was published. The shortage of ICU beds and specialists also means that cancer patients are having to wait longer for essential surgery. Most major operations require at least a short stay in ICU; however if there is no ICU bed available on the morning of a planned procedure, then the surgery must be cancelled. At present, almost one in four patients requiring cancer surgery do not have their procedure within the designated timeframe for such surgery.

There is no excuse for ignoring the crisis in ICU care for over a decade. Urgent remedial action is required.

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