One of Ireland’s most respected emergency medicine doctors has described Ireland’s overcrowded hospitals in life-threatening terms. The head of the health system admitted that it was possible for people to die as a result.
Due to the winter surge in respiratory illnesses and a shortage in acute hospital beds, hundreds of patients are waiting every day on trolleys in Ireland’s hospitals. According to the Irish Nurses and Midwives Organisation, 438 patients were on trolleys Friday. This is the worst January figure since 2006.
Sky News was informed by Dr Peadar Gilligan (a consultant in emergency medicine at Dublin’s Beaumont Hospital), that the situation is grave.
He said, “We know this from the fact patients who visit emergency departments that are markedly crowded are more likely than others to die.” It is dangerous and must be addressed.
‘Extremely challenging’
Dr Gilligan stated that Beaumont Hospital conditions are “extremely difficult” and that it is “very difficult to find a space in the ED (emergency section) to treat patients”. He said that staff are stressed and patients and their families are worried about their care.
The Irish Health Service Executive (HSE), says it is taking additional measures to address the crisis. This includes implementing seven-day work for hospital staff, including senior physicians, in order to speed weekend patient discharges.
The HSE says that the operational situation is far better than its most “pessimistic” modelling. Sky News asked Stephen Mulvany, chief executive of HSE, if any patients died because of hospital overcrowding. Mulvany replied that it was difficult for him to answer with certainty but that it was “certainly very real”.
He said, “We know from a NHS study that delayed hospital admissions through an ED are associated with additional mortality.”
Dr Colm Henry, the HSE’s chief medical officer, said that there was a clear association between mortality and delayed admission to the hospital. It’s not clear if this is directly due to it or if it’s related to the fact that these people have already been diagnosed with heart problems, strokes, pneumonia, heart attacks, or other issues.
“But I have no problem saying yes, delays in presenting to the ward were associated, as we know, with higher mortality and, even more, people who come to emergency departments who are delayed seeing is certainly very dangerous.”
“It was only traumatic”
Marie McMahon from County Clare feels the pain of Tommy Wynne’s 2018 death while on a trolley at University Hospital Limerick. After he suffered a stroke, he was admitted to hospital with an apology. He spent 36 hours on a cart and died without being admitted to a ward.
UHL is among the most severely affected hospitals this winter. “Extreme” levels of overcrowding led to an “internal incident” earlier in the month. It is a stark reminder for Ms McMahon that her husband’s final hours were difficult.
Sky News recalls that it was “just traumatic.” “People were lying on their stomachs, from trolley to trolley. People screaming for a bedpan. No privacy, no dignity, no respect.”
Five years later, Ms McMahon claims that she doesn’t blame the staff. She is now a campaigner for better conditions. She says, “Ofcourse it makes me mad.” “But, I must channel that anger into action.”
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Although the major incident at UHL was resolved, serious overcrowding continues throughout the health system.
Like in the UK ambulance turnaround times are being severely affected as paramedics can’t complete patient handovers at overcrowded emergency departments. Private sector volunteers are being requested to help.
Sky News visited Ireland’s largest privately-owned ambulance service, Lifeline at its base in Leixlip County Kildare. Darragh Geoghegan and Tommy Maguire, paramedics, were unloading their fully-equipped EUR200,000 (or PS177,000) emergency ambulance to take them to St Vincent’s Hospital in Dublin.
Lifeline’s 28 ambulances can take patients to hospitals. This allows the National Ambulance Service (NAS), to respond to 999 emergency calls faster and the hospitals to discharge their patients more quickly.
Tommy says, “If patients don’t move out hospitals, freeing up beds, it’s going to get worse.” “It is our responsibility, and it’s vital, that patients be moved as quickly and efficiently possible to make sure there are beds available for those who truly need them.
The surge is not expected to slow down with flu levels that are forecast to continue rising for at least several weeks.
Dr Gilligan sighs, recalling that he used to talk about it every winter for twenty years. He is a former president of the Irish Medical Organisation (IMO) doctor’s union. He says that it will need an additional 5,000 beds in the hospital system to end the overcrowding crisis.
He says, “My message to HSE is simple.” “We need to have the bed capacity made available.”