ICU capacity – a chronic problem


Sir, – While Michael McDowell (“The Government is gambling with public health when it comes to ICU capacity”, Opinion & Analysis, September 16th) is right to ask about the progress made since March on intensive-care unit bed capacity in Ireland, it is important to emphasise that this is a longstanding problem and one which has been knowingly neglected for over a decade.

Thus it predates Covid-19, and while the pandemic has brought it to the forefront of public consciousness, it really represents an exacerbation of a chronic problem.

It is ironic and instructive to reflect on a report commissioned by the then-government in 2008 from management consultants Prospectus.

Completed in 2009, it defined existing and anticipated ICU bed capacity in Ireland. Guided by some of Ireland and Europe’s foremost authorities on critical care, it described a system which had badly configured ICU beds, and a seriously insufficient capacity.

The report was completed in 2009, but not made available to the public for some years after that. It is by now easily available online.

Many of us who are now intensive-care consultants were trainee doctors at that time, and worked voluntarily to collate the raw data. It outlined a plan to boost national ICU capacity from its then total of 289 to 579, along with the closure of a number of facilities to allow centralisation of their resources to medium and large centres.

The irony in this comes from the fact that the remit of the Prospectus report on critical-care capacity is defined as “to identify the future requirements up to the year 2020”.

By the time this year started, national ICU bed capacity was essentially the same as in 2008. – Yours, etc,



Co Cork.