Sir, – Like the majority of doctors and nurses that work in our hospitals, excluding those who work in emergency departments, I am sick to death of hearing about the crisis in our emergency departments. This is the myth that just keeps on giving.
There is no crisis in emergency departments, but there is a shortage of beds. Trying to resolves the effects but not dealing with the cause of a problem is doomed to failure.
To date the Department of Health’s solution has been to redevelop emergency departments, and increase the number of doctors and nurses who work in these units. This has failed abysmally to improve the situation. Only by providing somewhere for patients to be admitted from an emergency department can this problem be resolved; this means more beds, and the more than 400 people on trolleys every day confirms this.
Putting more resources into emergency departments rather then into a solution merely perpetuates the problem and the myth.
The Minister for Health’s recent suggestion that providing more beds would reduce pressure on doctors to discharge patients beggars belief. Surgeons now admit on day of surgery and discharge as soon as possible. Day-case surgery has also become a norm.
Joint replacement surgery now requires only a two-day to four-day hospital stay, but that requires the patient to be admitted in the first place.
Recent industrial action by emergency department staff has resulted in the establishment of escalation protocols dictated by ED staff that effectively cripples local bed management. The consequences of the current policy is that planned surgery cancellations will increase even further, and waiting lists will get bigger.
Ironically hospitals will be criticised for the length of their waiting lists, and the HSE will force surgical treatment to be outsourced to private hospitals. This means that funding that could be used to increase bed numbers will be dissipated into the private sector in a self-fulfilling prophecy.
In order to expand our bed numbers, nurses need to be valued and paid more as they are the backbone of our hospitals, but not just those who work in our emergency departments.
So rather then listening to the emergency department staff, perhaps the solution should be sought from those who do not work in emergency departments. Otherwise we will end up with hospitals attached to emergency departments, rather the emergency departments attached to hospitals. I write this letter today out of frustration as four out of five patients on my operating list today have been cancelled, and I question whether it was really necessary! – Yours, etc,
PETER O’ROURKE, MCh,
FRCS (Orth),
Consultant Orthopaedic
Surgeon,
Letterkenny University
Hospital, Co Donegal.