Health service: Enough of the hand-wringing

Which comes first: a crisis or an emergency? It is a relevant question as the annual surge in the number of people waiting for urgent hospital admission surpasses already very high levels. Officially declared an emergency by former minister for health, Mary Harney, in 2006, the problem of patients waiting for days on trolleys in the State’s public hospital emergency departments has yet to be effectively addressed.

That we continue to experience some 300 additional deaths annually that occur because patients are forced to wait in unsafe and intolerable conditions is an indictment of our political system. It also reflects a tolerance of underperformance by senior managers in the Health Service Executive (HSE) who continue to preside over a dysfunctional health system that potentially threatens the well-being of every citizen.

For example, the HSE has said its full capacity protocol is in operation nationwide. Yet a quick perusal of the latest Irish Nurses and Midwives Organisation (INMO) Trolley Watch figures (which detail the number of patients on emergency department trolleys as well as those on hospital corridors) indicate that not all acute public hospitals are following a protocol that was designed to tackle the waiting-time crisis.

Politically, it is hard to view waiting for the results of the acute bed capacity review as anything other than an abdication of responsibility. There have been enough high-calibre health service reports, such as Sláintecare, published in the last year to confirm the number of new hospital beds needed. And there is no disagreement that an enlarged and revamped primary care sector will take pressure off our acute hospitals.

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A test of political will

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While part of the solution to the crisis in our health services lies in the long term, avoiding taking decisions now simply guarantees a prolongation of suffering for another generation. The Government must commit now to a specific number of additional hospital beds, as well as some reconfiguration of existing ones, to be implemented under a definite timeline. And it must look at co-locating general practices and acute mental health services next to emergency departments.

Meanwhile, an effective short-term solution that could be implemented is the building of temporary modular beds, as extensions of existing wards, in the hospitals that consistently top waiting time tables - such as the university hospitals at Limerick and Galway. Another option is the temporary redeployment of skilled doctors and nurses not required for scheduled work in inactive operating theatres to emergency departments.

If Minister for Health Simon Harris and his cabinet colleagues truly accept we are facing a meltdown of the health system, it is clear there are firm decisions that can be taken today to protect the citizens of the Republic. Hand-wringing and expressions of sympathy are no longer enough.