It has long been established that Ireland is seriously short of acute hospital beds. Equally, too many of these beds are occupied by patients who should be somewhere else, if the appropriate alternative facilities were available or funded. Instead of addressing the root cause of the current worsening of Emergency Department (ED) crowding, the response of the Department of Health and HSE to the matter proves just how dysfunctional Irish Healthcare is. In the face of record numbers on trolleys in Galway University Hospital where gridlock had reached the point where every physical space in the ED (both appropriate and inappropriate, clinical and non-clinical) was in use to warehouse admitted in-patients, the ‘solution’ being proposed was to suggest partitioning parts of the Waiting Room to warehouse even more patients rather than addressing the underlying problem, namely the well-established shortage of acute beds.
Instead of reducing the number of delayed discharges (so called bed blockers) by ensuring that community care packages are appropriately funded, the latest HSE ‘solution’ is seemingly to deem some of these patients as ‘trespassers’ with the expectation that clinical staff will remove them from their beds and the hospital! This is completely bizarre and suggests that those running the HSE have completely lost touch with reality.
When the three Dublin Paediatric EDs were grossly overcrowded last week, the Minister for Health’s only ‘solution’ was to encourage parents to bring their children to their GP, a stance which completely misses the point. Many of the patients who were awaiting hospital admission in the Paediatric EDs had already been seen by a GP and our colleagues in Primary Care have little to offer patients who have conditions that require hospital admission. The suggestion that their deflection to the Primary Care will solve any problem is both disingenuous and, quite frankly, medically naïve.
A decade into ever-worsening ED crowding as a direct result of an absence of available hospital beds, it is high time that the citizens of Ireland and their public representatives asked why our current and most recent Governments have so systematically and deliberately failed to address the underlying problem. At the same time they naively wonder why the situation is getting worse. In an environment in which the demand for acute hospital admission is rising, we have far too few acute and community hospital beds and too many patients whose acute hospital care has finished but who languish in an acute hospital bed. It is no surprise therefore that ED crowding continues to get worse and continues to cost the lives of some of our more medically vulnerable citizens. What is very surprising is that those with political and managerial responsibility for Irish healthcare can continue to obfuscate and avoid dealing with the root cause of the problem and that they are not held accountable by society for their persistent failure to do so.