Sir, – Our hospitals are in crisis with short-term and longer-term causes. Crisis management needs good leadership and good leaders in crisis are seen to lead.
Wouldn’t it be great to see the Minister for Health, the secretary general of the Department of Health, and the HSE chief executive each produce a three-minute daily update video on actions and results, with numbers? – Yours, etc,
FRANK DEVITT,
Maynooth,
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Co Kildare.
Sir, – The current crisis in our acute hospitals is not a new problem.
Sadly, this overcrowding crisis is a long-term problem which seems to just rumble on through the decades without any effective solutions.
I first became aware of the winter overcrowding crisis and bed shortage in the early 2000s when I was a sole full-time carer for my elderly mother after she had a stroke and other serious illness.
The “Celtic Tiger” years proved money was not the sole cause of the problem as winter after winter I listened to RTÉ's then economics correspondent George Lee report on Ireland’s unprecedented budget surpluses in the run-up to the December budgets, while in the same news bulletin the Irish Nurses and Midwives Organisation commented on dangerous levels of overcrowding in acute hospitals due to seasonal winter infections. There were not enough beds to admit patients who required admission and patients were being treated on trolleys, chairs and in corridors.
The money was there. The coffers were heaving during the boom years, but nothing changed in our health services.
The problems just rumbled on year after year, decade after decade.
My mother received superb care in the nine-bed ICU in Tallaght University Hospital in 2001.
Despite the increase in population and demand on the hospital since then, TUH ICU still had just nine beds until a long-awaited expansion was finally completed and 12 additional beds were added in 2022, 21 years later.
I found myself in desperate situations as my mother’s condition deteriorated and she developed Alzheimer’s and vascular dementia.
With no local GP services available in the evenings and out-of-hours GP services meant waiting hours for help and advice, there simply was no choice but to resort to bringing her to an emergency department. I am sure many people attending EDs at the moment are in the same situation.
There is nothing else they can do. There is nowhere else to go for help.
Primary care units in our acute hospitals and in our communities which are staffed 24/7, 365 days of the year, may help to relieve the pressure on our acute hospitals. Until such time as people who are sick and in urgent need of help and advice have safe and reliable options, they will rely on acute hospital services for help. They have no other choice.
There is also a huge shortage of nursing home beds to meet the demands of our older people.
It is harder for many older people to be discharged from hospital than be admitted to it as there is nowhere for them to go to receive the ongoing care they may need. This further compounds the acute hospital bed crisis.
Something is drastically wrong. Nothing ever changes. It is terrifying to think how this situation is going to develop in the coming years.
How many more decades must we wait for solutions? – Yours, etc,
BERNADETTE BRADY,
Rathfarnham,
Dublin 16.
Sir, – I note the “major internal incident” announced in University Hospital Limerick (News, January 2nd).
Acute illness at Christmas and the new year creates major pressure on all hospitals.
Limerick, however, is especially exposed as acute facilities have been closed in Nenagh and Ennis, without the necessary resources being put in place to compensate.
St John’s Hospital in Limerick city centre could increase its contribution to acute and elective care to patients with only a moderate amount of extra resources and staffing.
Over-concentration of resources in the one location at University Hospital Limerick while downgrading other hospitals in the midwest has not worked and extra targeted capacity needs to be put in place in University Hospital Limerick and in the other midwestern hospitals to address the continuing acute medical problems in the Limerick, Clare and North Tipperary areas. – Yours, etc,
J BERNARD WALSH,
Blackrock,
Co Dublin.
Sir, – I note that our beloved “A&E” acronym is being gradually transformed into an “ED” and I worry, as we all should, that this is just remission until it becomes a fully blown “ER”. – Yours, etc,
SIMON BLAKE,
Munich,
Germany.
Sir, – The health service is complex. However, the explanation for at least some of its current difficulties appears very simple. In any setting, when peak demand exceeds peak capacity, there will be a service deficit.
You cannot put a pint and a half into a pint bottle. – Yours, etc,
MICHAEL McDERMOTT,
Rathgar,
Dublin 6.
Sir, – Reading the issues that the Taoiseach has declared as national emergencies – Ukraine, homelessness, the climate, the cost of living and child poverty – I was amazed that the situation in our emergency departments didn’t feature.
But then I remembered this had already been declared a national emergency in 2006, by Mary Harney as health minister.
That’s a relief. – Yours, etc,
BRIAN O’BRIEN,
Kinsale,
Co Cork.