HSE chiefs looked at declaring winter A&E trolley crisis a ‘major emergency’
Explosive FOI dossier released to the MoS reveals boardroom bedlam as 900 people languished on trolleys
SENIOR Health Service Executive (HSE) officials became so concerned about patient safety in overcrowded hospitals last winter they considered declaring a National Public Health Emergency, similar to that introduced to cope with the Covid pandemic.
The chair of the HSE board hinted the Army may have to be deployed to deal with the crisis, according to Freedom of Information (FOI) documents obtained by the Irish Mail on Sunday.
It has also emerged HSE board members believed
‘Numbers unprecedented in the history of HSE’ ’
they were kept in the dark about the crisis and only learned the National Crisis Management Team (NCMT) had been called in to deal with events from the media.
In a week when Minister for Health Stephen Donnelly said private hospitals ‘need to do the right thing’ and work with the HSE on its winter overcrowding plan for the coming winter, we reveal shocking documents which show how close the health system came to collapsing.
A record high of 900 seriously sick people waiting on trolleys for hospital beds is exposed by the MoS today just as Minister Donnelly seeks the biggest ever financial bailout to cover the cost of running the health service.
An email sent by HSE board member Dr Yvonne Traynor to HSE chairman Ciarán Devane and other board members on January 3 this year reveals a health system teetering on the edge of collapse.
It reads: ‘Currently we have more than 900 people on trolleys, which is unprecedented in the history of the HSE. We have serious concerns about patient safety. I am a little surprised that we have not already declared a major emergency.
‘Three years ago we took extreme measures to strengthen the staffing of the service by calling up retired nurses and doctors, as well as calling for people to return from other countries. I am not asking we necessarily do this (clinical leaders need to make this call) but should we be thinking along these lines for the next month or so while the respiratory viruses are prevalent?’
The health authority was so concerned about what was unfolding its Crisis Management Team held a meeting – yet it seems the
HSE board was kept in the dark. A day after Dr Traynor emailed her colleagues about her A&E patient safety concerns, board member Brendan Lenihan replied to her and the rest of the board, disagreeing there had been no delay in board members learning about the crisis management team.
‘It may not have been a significant delay... but we should be straightforward enough to admit a delay overall in information reaching the board. We learned of the NCMT [National Crisis Management Team] from the media reports.’
‘Before I left my office on Dec 22nd, I wrote to the CEO on a matter of relatively low priority. If I had known two things (information that was days old at that point ie the convening of the National Crisis Management team plus the letter from the Minister directing changes to the National Service Plan) I would not have done so.
‘I can’t see any reason with modern communications why we weren’t told in a timely fashion... not days later. On the NSP (National Service Plan) letter, this was a letter responding to our collective decision and this letter is hugely significant. The NCMT is also a significant decision.
‘Not for the first time, can I now request we review the arrangements we have in place (particularly within the board) for keeping the board members up to date in a timely fashion please?’
It took board chairman Ciarán Devane two days to reply but he declined to organise a board meeting.
In an email sent on January 5, Mr Devane stated: ‘As planned by the end of the week, the CEO will send us a further update on the current state of the significant pressures on the health system. We will also have an opportunity to hear from him and the EMT (Executive Management Team) colleagues at our additional Board re the National Service Plan once it is set up and again at our regular meeting on the 27th. I am not calling a meeting prior as I don’t want to take the Executive away from their work but updates will be shared.’
He said a decision on whether to declare a ‘major emergency event’ could only be made by HSE CEO Bernard Gloster, adding: ‘As of today, the CEO has not declared a major emergency. He has however requested that a briefing on the pros and cons of this option be prepared for consideration by the NCMT due to meet this week. I will keep the Board updated.’
A day after sending this email to all board members, the HSE chairman wrote to one board member hinting the Army could be asked to help relieve the crisis.
In an email about the possibility of a National Emergency being declared sent only to board member Michelle O’Sullivan, who is a Human Resources expert, Mr Devane wrote: ‘Some red tape goes especially around things like procurement which might make buying private capacity easier. If the government called it a national emergency then some other resources eg Defence Forces might be available. There is a messaging angle but that goes both ways ie helpful and also not.’
Yesterday, a HSE spokesman said: ‘The decision to declare a major emergency event/serious incident is one for the CEO, who informs the Chair of the HSE Board, along with the Minister of Health and Secretary General of the Department of Health. The HSE’s National Crisis Management Team (NCMT) was convened by the then Interim CEO and met regularly to oversee the health service response to pressures during winter 2022/2023.
‘The NCMT oversaw actions to increase care and capacity options during a period of high pressure, including securing an agreement with the Irish Medical Organisation supporting GPs to run additional clinics. Hospitals also partnered with private hospitals to access additional beds to those available nationally for urgent or emergency admissions. There was ongoing engagement throughout the winter period with private hospitals to maximise availability and use of private bed capacity.’
‘We learned of the crisis team in media reports’