Access to hospital services in the Republic continues to be problematic. Latest figures from the National Treatment Purchase Fund show almost 415,000 people were waiting for outpatient appointments and 67,000 for inpatient or day care treatment. While the overall rate of increase is slowing, the number of people waiting over 12 months for outpatient appointments in May increased to 85,130, from 83,347 one month previously.
The number of patients waiting on trolleys or in extra ward beds in emergency departments continues to wax and wane. Although not as severe as early in the year, a sudden spike in these numbers occurs in individual hospitals on an ongoing basis.
The plight of the frail elderly patient was highlighted recently by the experience of a 101 — year-old woman who spent more than 26 hours on a trolley in Tallaght hospital’s emergency department. Needing urgent blood transfusion, she had to endure this overnight treatment in a busy and crowded public environment. Despite Minister for Health Leo Varadkar promising a “zero tolerance” policy towards anyone having to wait more than 24 hours in an emergency department, she was not the only centenarian to experience waiting in excess of this target in recent days.
Writing in this newspaper, emergency department (ED) consultant Dr Chris Luke points out that a quarter of the population attend local EDs annually, thereby enduring the grim consequences of front-line congestion. He put forward a 20 point “care in a crisis” plan which he believes “could decongest and renovate our healthcare frontline, and ‘reboot’ the quest for excellence.”
Among his suggestions is a need to provide a range of alternatives to referral to the ED, including medical assessment units and local minor injury units. Issues around staffing are also crucial: valuing and retaining experienced nurses; limiting the percentage of locum staff, recognising the added risk to patient safety they pose; and appointing GPs to a percentage of permanent ED medical posts.
Dr Luke’s considered plan deserves serious consideration by the HSE and the Department of Health.