Current hospital crisis will seem like picnic if more beds not provided in future - HSE

The current level of hospital overcrowding will “look like a picnic” compared to what will happen in the future unless capacity is increased, the head of the HSE has said.

Tony O’Brien said the population was growing and ageing and people would need more access to healthcare. He said this meant the healthcare system would have to be “differently shaped and differently sized”.

He said he was pleased that there was now a political consensus about the issue.

Speaking on RTÉ’s News at One, Mr O’Brien said if additional bed capacity was not provided, the healthcare system would face “an existential crisis” in the years ahead.

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“We cannot go through the next five years without addressing this issue, because what we’re seeing today will look like a picnic if we don’t,” he said.

“If we continue with the healthcare system in the shape that it is, with only the number of beds that it has, with the population changing and increasing, the level of demand for emergency care will continue to grow with a static bed stock.”

Mr O’Brien made his comments after new figures compiled by nurses revealed there were 551 patients on trolleys in emergency departments or on wards awaiting admission to a hospital bed.

Mr O’Brien said he acknowledged that the experience for many patients in hospitals at present was not good.

He said the trolley figures for Wednesday were much too high but they were also clearly evident of the tremendous work being carried out by staff and the fact that some of the planning put in place over the last year had been effective in part.

Mr O’Brien said the Irish public health system was structured for a different time, as was its level of capacity.

He said bed occupancy in many of the country’s major hospital was running at well over 100 per cent.

“Last week in the UK, because it exceeded 85 per cent (bed occupancy levels) we saw the prime minister apologising for the cancellation of all elective treatment. If we followed that we would not be doing elective treatment at all.”

He said he was pleased that with the forthcoming report of the Government’s bed capacity review and the Slaintecare reforms “we are on the brink of changes which will mean in the future we will not see what we are seeing now”.

Not competitive

The Irish Times reported on Saturday that the review will call for the provision of an additional 2,000 - 2,500 acute hospital beds if planned healthcare reforms were implemented and up to 9,000 additional beds if the changes were not put in place.

Mr O’Brien warned, however, that increasing capacity in hospitals did not involve “going down to Bargaintown and buying a few beds”.

He said providing infrastructure in hospitals was a complex, long and expensive business.

He said additional staff would also have to be found and he acknowledged that Ireland was not internationally competitive in recruiting healthcare personnel.

New figures released by the Irish Nurses and Midwives Organisation (INMO) said there were 43 patients at Letterkenny General Hospital and 42 patients at Galway University Hospital waiting for a bed after being deemed by doctors to require admission .

The INMO figures suggest that the number of people on trolleys is down from the 575 recorded on Tuesday and the record levels of 677 reached last week.

The INMO figures show that in Dublin the largest number of people waiting for a bed was at Tallaght Hospital while 29 people were on trolleys or on wards awaiting admission to a bed.

Capacity

Meanwhile the Irish Medical Organisation (IMO) urged the Government to acknowledge that the health service was experiencing a system-wide problem of lack of capacity and not just an emergency department or trolley crisis.

“ What we are seeing in our emergency departments is only the manifestation of the wider problems - and we are now seeing the same problems in other parts of our services as they struggle to cope with capacity and patient demand.”

“It is not sustainable to have solutions that:

*cancel elective procedures. In many of these cases the patient will simply present back in the emergency department and in all cases will add to the already unmanageable waiting lists.

*transfer patients from hospitals to private facilities. Continuing a policy of investing much needed resources into the private system with no corresponding investment in our public system will simply maintain the status quo - it is the same number of patients requiring treatment but we are putting taxpayers’ monies into a private profit based system.”

The IMO said all the problems being experienced centred around capacity:

“capacity with regards to the number of beds in both acute hospitals and the community setting; capacity with respect to the number of medical staff. We need to attract more consultants and capacity in general practice - we must deliver a wider range of services at GP surgeries .

“The unfortunate truth that Government seems to be avoiding, is that all this requires a seismic shift in the way we deliver and fund our health services and that costs money. It would be truly revolutionary to hear the Government saying not only have they decided on the priorities but they are actually going to fund them. As a society we cannot continue to simply give out about our health services, we need to agree on the solutions and agree that these will have to be paid for.”

Meanwhile the trade union Siptu called on health service watchdog HIQA to investigate the overcrowding being experienced in hospital emergency departments.

HIQA said it did not have the power to regulate acute general hospital services and had no enforcement powers.