Record overcrowding has led to yet another peak in the ongoing Accident and Emergency (A&E) crisis in the hospitals. There are over 400 patients throughout the State waiting for an in-patient bed; unlike hospital waiting lists, the length of which have been partially shortened by transferring patients to the private sector, no such facility exists where acute ill-health is concerned.
When chest pain strikes and breathing becomes difficult or a person is a victim of a road traffic accident, there is no option but to attend the nearest A&E unit.
These departments are now highly dysfunctional. People spend days packed sardine-like as trolleys are pushed one against the other. Blood, urine and faeces mix to form an unpleasant and unhygienic environment. Cleaners cannot complete their job and the risk of infection rises. Doctors and nurses have difficulty providing treatment that ordinarily would be administered in the wards of the hospitals. When a patient's condition deteriorates, vital minutes are lost before resuscitation can begin. During periods such as this, A&E departments, rather than offering a safe refuge, become significantly dangerous places for patients.
There are a number of reasons why this time of year brings with it particular pressure on A&E units. Respiratory infection is at its highest, while planned admissions for elective treatments are boosted following a natural seasonal lull. But the single most important reason has been well-documented: we do not have enough hospital beds for our growing and ageing population.
This week has seen a divergence of opinion between a leading A&E consultant and the leader of the Irish Nurses' Organisation as to the merits of one short-term possible solution. The suggestion has been made that A&E patients be moved to the corridors outside the already-full wards. This offers potential benefits but also risks. Representatives of front-line staff should maintain a united front, especially in the absence of a meaningful response from the health service managers who are primarily responsible for the crisis.
The Tánaiste and Minister for Health, Ms Harney, outlined a ten-point plan to solve the accident and emergency problem last autumn. All of its actions offer medium to long-term relief. Ms Harney has said that she does not wish to be a fire brigade Minister, reacting to every crisis and individual health service problem. However, the A&E crisis is already a long-term one and she cannot hide behind the newly-established Health Service Executive. The Minister must announce a package of short-term measures to deal with the problem.