As many as one in three cases listed for admission to the intensive care unit at Crumlin Hospital, Dublin, have to be refused, according to the surgeon at the centre of the case of a young girl, scheduled for heart surgery, who died on Tuesday after the procedure was postponed.
The hospital has 21 intensive care spaces, but only 13 to 14 of these are functional daily, according to Dr Freddie Wood. The number of nurses available dictates how many are used.
Dr Wood, the senior cardio-thoracic surgeon attached to Our Lady's Hospital, Crumlin, who had to postpone elective heart surgery for the two-year-old, said he was "absolutely devastated" by what had happened.
Speaking on RTÉ's Morning Ireland, he told how he and the consultant anaesthetist had to make a choice on what child should be operated on, adding that similar scenarios to Monday's were potentially occurring on a daily basis.
A shortage of 30 vacancies for nurses, required for the 21 intensive care beds, was identified in August 2000, and approval was given to fill these. But despite the availability of funding in 2001 and 2002 for a recruitment campaign, the hospitals had been unable to get the numbers.
Dr Wood said that today in Crumlin there were 45 vacancies out of a nursing complement of 115. He said intensive care nursing was probably the most demanding area to work in the hospital structure, but that nurses got paid very little extra for this.
The issue of specialised nursing shortages had to be addressed quickly and efficiently and must not be affected by the current financial situation. "I think it's down to money in the end," he added.
This year, a limit on the number of nurses to be taken on at the hospital meant they would have to let go nurses in other areas to recruit. He warned of "massive" cuts in intensive care spaces if more nurses were let go.