Emergency department like ‘cattle mart’

The Health Service Executive (HSE) has come under renewed pressure to restore 24-hour emergency services in Ennis and Nenagh Hospitals in an effort to address the overcrowding crisis at the emergency department in the Mid-Western Regional Hospital, Limerick.

 

County councillors have also expressed their frustration with the HSE appeal for Clare patients to stay away from Limerick hospital unless they have a genuine emergency, following claims the department was akin to a “cattle mart”.

The request was criticised by Clare councillors at a HSE West Forum meeting in Galway on Tuesday. They asked where patients with acute illnesses were supposed to go when Limerick hospital couldn’t cope with its admissions and Ennis hospital didn’t have the resources to treat them.

While every available bed is being deployed in Limerick hospital, the number of patients on trolleys reached a high of 48 last Friday. Although it dropped to 38 on Tuesday and Wednesday morning, this was still the highest figure in the country. It fell to 31 on Wednesday afternoon.

A large number of patients over 70 years of age, who are acutely unwell and require admission, are presenting at Limerick hospital.

Councillor Brian Meaney proposed the HSE should consider re-opening 24-hour emergency services in Ennis in a bid to ease the overcrowding.

Before emergency services were removed from Ennis hospital in April 2009, Councillor Meaney recalled people were assured a “world class” emergency department would be provided in Dooradoyle.

Councillor Tom McNamara, who stressed seriously ill patients are entitled to get a service in Ennis if Limerick couldn’t cope, supported Mr Meaney’s position.

Describing the emergency department in Limerick as like a “cattle mart”, North Tipperary County Councillor John Carroll claimed people were misled about the planned improvements in Dooradoyle before services were withdrawn from Ennis and Nenagh.

His colleague, John Kennedy, asked what emergency measures were being put in place to deal with the overcrowding while Limerick City councillor Ger Fahy claimed an additional €5m needed to implement the reconfiguration process properly was not sanctioned by the previous government.

Councillor Kevin Sheahan asked where Mid-West acute patients were supposed to go if Limerick hospital couldn’t deal with them and wondered what advice would he given to constituents.

Primary continuing and community care manager, Bernard Gloster, who was deputising for regional director of operations John Hennessy, pledged to raise all of the councillors’ concerns with hospital management.

Mr Gloster, who is not responsible for acute hospital services, told councillors at the end of the meeting that the hospital group chief executive officer was prepared to meet members.

He said other acute hospitals throughout the country were also experiencing high admissions and noted that Ennis or Nenagh don’t have the required surgical or medical capabilities to be re-instated as 24-hour emergency departments.

Ms Doherty subsequently told Councillors Meaney, McNamara, Fahy and Sheahan, at a meeting on Wednesday that there were plans to open 20 beds in St John’s Hospital over the coming days and new beds on the Dooradoyle site, once the new Critical Care Block is fully occupied.

The Mid-West HSE has confirmed it has not seen evidence of a flu bug to which it can ascribe the high numbers of patients awaiting admission.

“Limerick hospital has had a succession of acutely unwell patients presenting at the emergency department. The majority have required admission to a bed. All patients in in-patient beds are reviewed three times a day to assess their fitness for discharge. However, the reality is that every bed in the hospital is occupied by a sick person.

“There are no delays due to people waiting for Fair Deal home care packages or because of inappropriate stays.

“Despite local emergency centres being available at Ennis and Nenagh, the evidence is that the local population are not availing of these services. Instead, they are travelling directly to Dooradoyle.

“The hospital is very much aware of the inadequacies of the present emergency department and construction has commenced on a new department which is expected to be operational in two years,” the HSE stated.