‘Unprecedented strain’ on emergency departments not acceptable – minister

‘Unprecedented Strain’ On Emergency Departments Not Acceptable – Minister
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By Cate McCurry, PA

A minister has said that emergency departments (EDs) which are under “unprecedented strain” is not acceptable to the Government nor the HSE, admitting that it needs to do better.

Minister for Public Expenditure Michael McGrath was reacting to a new report from the Health Information and Quality Authority (Hiqa), which revealed that patients in EDs have been forced to wait 80 to 90 hours to get a bed.


The health watchdog warned that overcrowding continues to pose a risk to the health and safety of patients.

It said that patients’ dignity, privacy and right to confidentiality was being compromised.

It was also revealed that one patients had to wait 116 hours on a trolley at Limerick University Hospital.


The report found there are problems around bed capacity, staff shortages and a lack of access to community services.

Mr McGrath told the Dáil on Wednesday that while it does not affect every ED department, the situation is “quite serious” in some.

However, Sinn Féin leader Mary Lou McDonald said the report is a “damning indictment” of Government health policy.

She said that the report echoes concerns of the Irish Nurses and Midwives Organisation, which has warned that hospitals face a “nightmare winter”.


Ms McDonald said last month was the worst November on record for hospital overcrowding, with 12,624 patients left on trolleys.



“Chronic overcrowding creates dangerous situations, and HIQA particularly highlights how patients are often waiting far too long to be triaged for care,” Ms McDonald added.

She accused Minister for Health Stephen Donnelly of failing to address the issues in his two-and-a-half years in office.

“Firstly, patients can’t get admitted because a quarter of the beds promised by Government more than two years ago have not been delivered,” the Dublin TD added.

“Secondly, the minister hasn’t solved the delayed discharge problem.

“There are as many delayed discharges in the system as there are patients on trolleys and patients can’t be discharged from hospital because of the lack of community recovery and step-down beds.

“Thirdly, Minister Donnelly has failed to solve the crisis in home care.


“We now have more than 5,000 older people on homecare waiting lists. This has been brewing for some years now, and it’s these older people pushed into hospitals and nursing homes, when in fact they should be cared for at home.

“There are no carers available to them because the minister has failed to plan a sufficient workforce or to address long-term pay and conditions issues which have harmed recruitment and retention.

“At the same time, people can hardly see your GP anymore. This exerts even more pressure on hospitals and emergency departments.”

Ms McDonald urged the Government to build bed capacity in hospitals, increase community and step-down beds and formulate a plan to address the lack of GPs.

“The Government’s lack of planning and lack of urgency in getting to grips with the bottlenecks in our hospitals most now end,” she added.

Mr McGrath said Mr Donnelly has read the report and will respond to it, adding: “In broad terms, he and the Government accept the Hiqa report and what Hiqa is saying in that report, in particular the points that made around workforce planning, around management, around bed capacity and indeed diagnostics.”

“The type of individual examples that you have highlighted – that your colleagues highlighted – are not acceptable to the Government and are not acceptable to the HSE, so we do need to do better.”

He said demand on hospital services has increase because of Covid-19, RSV, flu and Strep A.

“The difficulties that are evident in our hospitals and some of our ED departments are not unique to Ireland,” he added.

“You’ll be well familiar with the situation in Northern Ireland, in particular, and in England, Scotland and Wales as well. I know that the European Centre for Disease Control warned earlier this week of the impact of Covid, RSV and flu on health services right across Europe.

“Of course we have to do everything we possibly can to address the situation.”

He said the HSE needs to examine where best practices are happening and how that can be replicated around the country.

“Of course some of it will come down to investment. It will come down to capacity, beds and staffing but also comes down to effective management,” the Fianna Fáil minister added.

He said the health budget is 24 per cent higher in core funding compared with 2020, and that Mr Donnelly has delivered more than 900 new acute hospital beds, 73 sub-acute beds and more than 340 community beds during his tenure.

He said critical care capacity is 25 per cent higher than it was in 2020 and a further 608 staff will be recruited as part of the HSE winter plan.


INMO general secretary Phil Ni Sheaghdha, said the report “compounds” its warnings about hospitals under pressure due to capacity issues and unsafe staffing.

“The report is particularly stark when it comes to safe staffing in our hospitals,” she added.

“According to Hiqa, of the seven emergency departments they inspected, only one hospital was properly staffed. This is unacceptable.

“We know that many nurses are leaving emergency departments because of the conditions that they are faced with. This phenomenon cannot continue into 2023.

“Over 70% of the hospitals that Hiqa inspected were over capacity. This is borne out in the INMO trolley watch figures.

“Today alone over 638 patients were without a bed with many patients facing long waits before being admitted to a trolley. We know that excess time spent on a trolley or an inadequate bed has negative health implications for patients.”

She said the INMO has sought an urgent meeting with Mr Donnelly.

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