Patients face worse trolley crisis this winter, consultant warns

Patients are facing an even more severe crisis in hospital emergency departments this year compared to last winter, the head of the Irish Hospital Consultants Association (IHCA) has said.

Speaking at his organisation's annual conference in Tullamore, Co Offaly, president Dr Gerard Crotty said hospitals were dangerously overcrowded and action must be taken immediately.

“Make no mistake about it - we are walking into an even greater crisis than last winter. We cannot deliver high quality, safe care to our patients unless immediate and properly resourced action is taken.”

“We need the resources to reduce the number of patients on trolleys, reduce the grossly excessive time people wait for a consultant opinion in an out-patient clinic and reduce the number of people waiting far too long for essential surgery.”

Dr Crotty said the Government’s official response to the trolley crisis - the establishment of an emergency department task force - had failed to deliver any tangible results to date.

He said given the average length of hospital stay by patients in Irish hospitals was already short by international standards, in light of ongoing capacity constraints, “there is little room for further increased efficiency within the acute hospital sector”.

Dr Crotty said recent comments by Minister for Health Leo Varadkar that he wanted to see work practice changes on the part of consultants, had angered many of his colleagues.

“Individual consultants are already hugely overstretched. They are working well-over the agreed number of hours, while often covering for consultant posts that have not been filled. They are not being paid for all the work they do, especially weekend work.”

“We are providing 24/7 cover which includes treating and discharging patients at weekends when on call. We cannot continue to do more with diminishing resources and insufficient numbers of colleagues. At the moment, in acute hospitals, there are over 230 permanent consultant posts unfilled.”

Dr Crotty strongly criticised the number of administrators and managers in the publicly-funded health system which, he maintained, “made no sense at all”.

"At the moment we have about 7,500 people in the Irish Army, we have just 13,000 gardaí and yet we have over 15,700 managers and administrators."

“We need to invert this bureaucratic pyramid and put more valuable resources into the frontline. There should be fewer staff spending their days sitting at desks and more people actively treating and curing our patients - that is what our health system is supposed to be about.”

Dr Crotty said the mixed public/private health system in Ireland was facing a "double whammy".

He said just at the time when public hospital could not recruit consultants, the viability of several specialties in private hospitals is threatened by the clinical indemnity crisis.

He said the cost of clinical indemnity for doctors was spiralling out of control and that the increase in premium levels had made private practice in some specialties completely unsustainable.

Dr Crotty said there was an urgent need for the Government to change legislation in this area.