Walking wounded: thousands leave A&E without being seen

Shocking MoS f igures show that 120k patients got so fed up waiting for treatment they risked their health and went home

ALMOST one-in-five patients who went to the emergency department in Dublin’s Mater Hospital left without being treated, an analysis of figures by the Irish Mail on Sunday reveals.

The Mater’s performance was the worst among A&E departments around the country for people leaving without receiving treatment.

In total, more than 120,000 people left without receiving treatment over a 17-month period.

Government TD Kate O’Connell experienced the harsh reality of life at the coalface of Ireland’s A&E departments last weekend.

During the week, the Fine Gael deputy told the Oireachtas Health Committee that she was embarrassed about the ‘unacceptable’ conditions she discovered when she attended the Crumlin Children’s Hospital – which she likened to ‘something out of a South American country’ – with her child.

‘It’s wholly unacceptable to my mind that a waiting room would have vomiting babies, breastfeeding mothers, head injury children, broken arm children, all in the one mix,’ she said. ‘I think we really have to get the message out there from this committee that it is unsustainable. In terms of provision of healthcare it’s really not acceptable in a country like this,’ she told the committee.

Analysis of hospital data by the MoS shows the Children’s Hospital in Crumlin is one of the better performing A&Es in the country.

The MoS has analysed data from all 30 A&E departments nationwide over a 17-month period between January 2018 and May 2019. The data relates to the instances in which an individual arrived at the hospital seeking treatment but left before receiving treatment, which is indicative of long delays causing patients to leave in frustration rather than continue to wait.

In total, across all our emergency departments, 122,262 people left without receiving treatment over the 17-month period.

Crumlin – which treats children only – ranks sixth out of 30 with an average of 2.7% of those presenting at the hospital’s A&E department walking out the door without receiving treatment. That equates to 89 children each month.

However, the winter months are typically when hospitals across the country are stretched to their limits. For example, in November last year the average number of patients leaving without treatment at the Children’s Hospital in Crumlin rose to 4.2% and peaked the following month in December at 4.4%.

All of the country’s children’s hospitals perform well in the table in comparison to the adult A&Es.

In other parts of the capital the situation has been much worse. Almost one-in-five patients who went to A&E in Dublin’s Mater Hospital left without receiving treatment, the worst rate of any in the country during the period examined. On average, 1,326 people a month (19.2%) arrived but opted to leave without receiving treatment.

St James’s Hospital (17.5%) and Tallaght University Hospital (14.3%), both also located in Dublin, also performed poorly, ranking second and third poorest respectively.

The three hospitals are by far the worst in the country, with the national average being 6.5%.

St Luke’s General Hospital in Kilkenny (1.2%) and the Children’s Hospital in Tallaght (1.7%) topped the table for patients attending and receiving treatment.

Mrs O’Connell said that as a TD she feared someone would recognise her. However, her comments have led to calls for more politicians to visit A&E departments to realise the magnitude of the problems.

This week a spokeswoman for the TD told the MoS that, while she previously had positive experiences at the hospital, it was ‘out of control now’ and that ‘staff were at breaking point’.

Although Mrs O’Connell is reporting a worsening of conditions at the hospital, the Health Service Executive said the situation had been improving nationwide in recent months. ‘The percentage of emergency department patients who leave before completion of treatment has reduced month on month since July, and has continued to improve in October, with a national figure of 6.3%,’ a spokesperson said. ‘The Mater Hospital reports an improvement in October at 13.1% compared to 15% in August.

‘All emergency departments operate a triage system based on clinical priority, so those who present with more clinically urgent symptoms are prioritised for assessment and treatment.’

Irish Patients’ Association spokesman Stephen McMahon said he wished more TDs would visit A&E departments, so that the ‘penny would drop’ about the crisis.

‘Politicians could learn a lot if they went and spent a night in A&E and just sit there and quietly watch what’s going on in the place. Sometimes you need to be at the frontline to know what goes on, get into the coalface and see what patients and staff are trying to deal with. Maybe then when they go back into Leinster House they would put the patient at the centre of their plans.

‘In a way, I’m not overly surprised that it shocked Deputy O’Connell in the way it operates… when they see someone belonging to them in there, and they have to go down and see what it’s all about.’

‘It’s out of control. Staff are at breaking point’

‘Politicians could learn a lot from one night in A&E’