Madam, - Much recent comment has centred on overcrowding in A&E departments with patients awaiting admission to hospital beds. The Irish Association for Emergency Medicine is concerned that there is a perception that this problem is due to internal difficulties and inefficiencies in these departments.
It is wrong to believe that such overcrowding is due to internal failure within A&E departments. Rather, it is due to a progressive and sustained system-wide collapse of other parts of the health service. It now seems that the overcrowding in A&E departments has become so ingrained in Irish hospital practice that, for those who have no experience of modern properly functioning and funded healthcare systems, it is now considered the norm.
When there are patients waiting in A&E departments for admission, the rest of the health service trundles along without being affected. Within the health service, while many will sympathise, none will act to alleviate the crisis.
The risk of cross-infection with MRSA and winter vomiting virus is similar, if not greater, in an overcrowded emergency department than on any hospital ward. These bugs do not suddenly gain the ability to cross-infect when they leave A&E.
Why should ward patients need to be separated by 2.5 meters (for infection control purposes) while it is deemed suitable for A&E department patients to be jammed together within centimetres of each other? The same standard of infection control needs to apply to all patient areas.
The members of the Irish Association for Emergency Medicine realise that the problem of difficulty in accommodating patients that require admission will not have a permanent solution in the near future. However it is not acceptable that only the A&E departments and their staff should shoulder this intolerable health and moral inequality.
Patients for admission should be moved on from the A&E departments to other more appropriate areas in the hospital, regardless of the challenge to hospital capacity, whether this be one or two patients per ward or else a holding area.
At least the dignity of the patients could be preserved and proper infection control be implemented.
There is now, however, some light at the end of the tunnel with our new Minister for Health making a firm commitment to dealing effectively with this problem. The realisation that the solutions to this crisis are to be found outside the A&E departments must be understood by all, and the pervading attitude of "it's not my problem" will have to change.
All politicians, managers, doctors and nurses allied to hospitals have to accept collective responsibility for the crisis in the health service if the current crisis is to be solved. - Yours, etc.,
ANTHONY J. MARTIN, FRCSI, FFAEM, President, Irish Association for Emergency Medicine, Royal College of Surgeons, Dublin 2.