Hospital overcrowding a ‘national emergency’

HEALTH Minister, Leo Varadkar is coming under increasing pressure to tackle the chronic overcrowding in the emergency department at University Hospital Limerick (UHL).

Deputy Timmy Dooley said the HSE has stated the new emergency department (ED) in Limerick will not be fully operational until next year, due to its requirement to comply with national value-for-money procurement procedures.

However, he believes the declaration of a national emergency would allow the HSE to set aside procurement procedures for a short period of time, in the interest of patient safety.

“Overcrowding should be treated as a national emergency. If people are going to die as a result of the crisis that has emerged, it is obvious the mechanisms delaying the investment benefiting patients need to be set aside.

“Work needs to be advanced to open the new ED as quickly as possible. The HSE has stated it will be 2016 before the new fit will be completed, due to procurement procedures, which is ludicrous,” the Clare Fianna Fáil deputy said.

Sharing concerns expressed by hospital consultants, Deputy Pat Breen admitted Clare patients could lose their lives due to the “chaotic situation” in the ED at UHL, unless radical action is implemented.

The Fine Gael TD believes a package of measures needs to be considered, including the provision of a new temporary prefab to relieve overcrowding in the existing ED, more funding for the Fair Deal nursing home scheme, more step-down beds and the provision of another 24-hour ED in the region.

The number of patients on trolleys and wards waiting for treatment reached 40 in UHL on Wednesday.

The Irish Nurses and Midwives Organisation (INMO), which is balloting for industrial action in the Mid-West, is calling on people to support its public protest outside the Dáil next Wednesday at 12 noon, to highlight the grim reality facing patients and staff.
Asked about the impact of the closure of 24-hour emergency services in Ennis and Nenagh under the previous Fianna Fáil-led government, Deputy Dooley said the level of investment that was required and scheduled in UHL did not happen.

With some Clare families waiting up to 20 weeks before Fair Deal nursing support packages are sanctioned, Deputy Dooley has asked the minister to revert to the previous scenario, where elderly patients were admitted to long-stay residential care, on the basis that Fair Deal would be paid retrospectively.

He said elderly patients could not afford to spend over 15 weeks in a nursing home at their own expense, before the Fair Deal package is officially approved.

As the number of patients waiting for treatment in UHL reached dangerous levels again this week, details of a recent case involving the death of a Cratloe man, who was not seen by a doctor within the recommended timeframe of 10 minutes, came sharply into focus.Darragh Curley, aged 33 of Ballybroughan, Cratloe, died at UHL in the early hours of July 8, 2013, three hours after admission.

Consultant in emergency medicine, Dr Gareth Quin, stated at his inquest that the significant delays in the medical assessment of patients was caused by the level of departmental activity on the night.

The number of patients on trolleys in corridors or wards, nationally, reached a record 601 on Tuesday, prompting the INMO to call for an immediate meeting of the Emergency Department Taskforce, established by the minister before Christmas, to consider, and agree, measures to alleviate the crisis.

On Wednesday evening, the minister announced that he will convene such a meeting next week.

Describing the latest rise as a “national emergency”, the INMO requested the opening of extra beds, the immediate recruitment of extra nursing staff and an injection of resources into the community to support additional homecare packages and community nursing interventions.

Professor Colette Cowan, CEO UL Hospitals, said while waiting times for some patients has reduced, the ED continues to be very busy.

Amongst the key factors contributing to the increase in pressure within the ED is the older age profile of patients presenting and the complexity of issues they have. As a result, the hospital is experiencing delays in discharging these patients home or to other appropriate settings.

“Management has worked with its HSE community colleagues over the last week, who have identified capacity and supported our patient discharges to elderly care units or nursing homes,” Professor Cowan said.

“As part of our escalation plan to address the expected increase, UL Hospitals has opened additional beds across the group and patients who have finished their care are being discharged home or to the community.

“Where possible, patients are being transferred from UHL to Ennis, Nenagh and St John’s for ongoing treatment and elective non-emergency surgery has been deferred. Staff are working very hard to ensure the optimum care and safety of all our patients during this exceptionally busy period,” she continued.

“Patients are reminded to keep the ED for emergencies only and to contact their GP or out-of-hours services in the first instance. Local injury units are open in Ennis and Nenagh hospitals from 8am to 8pm, Monday to Sunday and 8am to 6pm Monday to Friday at St John’s Hospital in Limerick,” she concluded.

By Dan Danaher