Sir, – Minister for Health James Reilly argues that, "No staffing issue can explain away the lack of basic clinical care that took place in the tragic circumstances surrounding Savita Halappanavar" (Home News, October 11th). The fact is that basic clinical care is being compromised on a daily basis in our health system by staffing issues. Over-stretched nurses, tired doctors, far too few senior decision-makers, are common themes in morbidity and mortality audits countrywide. Missed opportunities as detailed in the Savita Halappanavar report are commonplace and inevitable in the system. Every doctor and nurse working in the acute service will be aware of similar cases.
The standards to which the Health Information and Quality Authority encourages us to aspire are far removed from the standard of care that is possible on a day to day basis with the resources available. The ongoing sub-standard clinical care offered in the form of emergency department overcrowding is a straightforward example of the gulf that exists between the standard of care that Hiqa has outlined (Hiqa’s Tallaght report recommends that “every hospital should cease the use of any inappropriate space, eg a hospital corridor for trolleys, to accommodate patients receiving clinical care”), and what we deliver. Bed closures linked to staffing cutbacks (in particular nursing) are directly linked to emergency department overcrowding.
Emergency department overcrowding causes increased morbidity and mortality for patients. A similar gulf probably exists between the service that Minister for Health Dr James Reilly aspires to for his patients, and what Dr Reilly can deliver with the current political and financial constraints that ultimately determine what sort of a service patients receive. It is disingenuous of Dr Reilly to suggest that lack of basic clinical care and staffing issues are disconnected. – Yours, etc,
BRENDAN McCANN,
Consultant in Emergency Medicine,
Waterford Regional Hospital,
Waterford.