The State has "a very major problem" in its hospital accident and emergency departments, the head of the Health Service Executive (HSE) Prof Brendan Drumm admitted last night as he confessed that measures put in place to try and solve the problem hadn't worked.
Prof Drumm said the problem of patients having to spend hours or days on trolleys in A&E units was unacceptable but it had existed for several years before he took over responsibility for the day-to-day running of the health service. He said that while people before him had treated the problem with urgency he was "left with a problem that seems to be larger than ever".
He said that in places where significant numbers of extra beds had been put in place "we have a worse A&E problem than when they were added three or four years ago, so the solutions that have been put in place haven't delivered anything to the degree that people proposed they would".
He said he now wanted to put in place long-term solutions to solve the crisis, as well as taking short term measures to ease the plight of those who have to spend part of their hospital stay in A&E. But he warned it could not be done within a matter of months.
Over the weekend A&E conditions were heavily criticised, particularly by the actor Brendan Gleeson on the Late Late Show, who said it was "disgusting" the conditions elderly people had to endure. He also suggested a baboon could sort the problem out.
Prof Drumm insisted he was taking the problem seriously. He said a new A&E taskforce was announced by the HSE two weeks ago and even since then the numbers on trolleys had come down. He said there were 195 patients on trolleys yesterday afternoon. The daily trolley count by the Irish Nurses Organisation put the number on trolleys early yesterday at 282.
Prof Drumm said internal processes in some hospitals were partly to blame. He said people had to ask why it was that three of the biggest A&E units in the country, in Waterford, Limerick and Galway, had one-third of the numbers on trolleys as a smaller A&E unit in Dublin yesterday.
A further part of the problem, he claimed, was that X-ray departments were closing early and people had to stay in beds overnight so they could be X-rayed the next day. There was also a lack of out of hours GP cover in parts of Dublin, as well as delayed discharges. These factors went some way to explain "why this country seems to have a very major problem in its A&E departments".
"These are the issues we have to deal with if we're going to solve this problem long term . . . to do otherwise is firefighting," he said.
The HSE chief executive rejected claims that patients were being left to die while waiting on trolleys. "I believe the staff in our A&E departments and indeed in our hospitals would not allow that to happen," he said.
However a recent sitting of Dublin City Coroner's Court heard how a woman died of a brain haemorrhage on a trolley in a nurses' tea station at the Mater hospital in Dublin after waiting for four hours to be seen by a doctor.
Prof Drumm, who was attending Siptu's annual nursing convention in Sligo, also insisted sufficient resources were being devoted to the crisis.
"We have 100 people a day going through A&Es where there are 25 doctors rostered and approximately 45 nurses rostered," he said.
Meanwhile, Miriam McCluskey, Siptu's national nursing official, told delegates additional capacity in hospitals, together with targeted initiatives aimed at delayed discharges, needed to be put in place in order to reduce the numbers waiting in A&E.