HUNDREDS will die needlessly due to trolley crisis, warns top medic
Impending overcrowding in hospital emergency departments to surpass last year’s record f igures
HUNDREDS of patients will die needlessly this winter as a result of being forced to wait too long in overcrowded hospital emergency departments, the leader of the country’s A&E consultants has warned.
Professor Conor Deasy, the president of the Irish Association for Emergency Medicine, predicted this year’s overcrowding crisis will surpass last year’s record trolley figures.
And he warned health spending cuts are already impacting on hospitals, with more than 500 patients left waiting for a hospital bed on some days this week, weeks before Covid-19, respiratory and flu infections peak over Christmas and the New Year.
At the height of the Covid-19 and flu season last winter, a record 931 patients were left languishing on hospital trollies on one day, prompting Health Service Executive (HSE) board members to consider declaring a national emergency.
However, Prof Deasy, who is also Clinical Director of Unscheduled Clinical Care at Cork University Hospital (CUH), said this winter is already looking ‘very bleak’.
He told the Irish Mail on Sunday: ‘I see January as being more difficult than any previous January and more difficult than the January during Covid.
‘In our hospital in October, the number of people we saw aged over 75 was up by 34%.
‘People are dying in A&Es for the want of a hospital bed, and it will end up [being] an inquiry into why we allowed this to happen.’
Prof Deasy criticised controversial Government spending cuts which resulted in a freeze in hiring junior doctors and administration staff, which he said is already impacting on overstretched emergency departments.
He told the MoS: ‘We have the largest population since the Famine, and in light of the freeze on recruiting non-clinical staff… these non-clinical jobs are fundamentally important to how we run the service.’
Prof Deasy dismissed claims that there are too many admin staff working in hospitals as ‘utterly untrue’.
‘If you do not have this administrative support then it has to be done by doctors and nurses, and we are not necessarily gifted as managers.
‘It takes away from the job we are trained to do and the job we are good at.’
Last month the MoS revealed how Health Minister Stephen Donnelly clashed with Public Expenditure Minister Paschal Donohoe over health spending ahead of the Budget. Despite seeking an extra €2bn to keep the health service running, Minister Donnelly was only allocated an extra €700m.
Earlier this week the Cabinet agreed to provide an extra €960m bailout for health as part of €4bn in supplementary estimates. But the Department of Public Expenditure confirmed to the MoS that the €960m is for increased costs incurred in 2023 and will pay for pensions and compensation so won’t alleviate the pressures in emergency departments.
According to a recent study by the prestigious Sorbonne University in Paris, there is one avoidable death for every 21 older patients kept overnight in a hospital emergency department.
This follows a previous study carried out by NHS in the UK, which found that there was one avoidable death for every 82 patients who had to wait more than six hours in an A&E for a hospital bed.
According to Prof Deasy, every year more people die unnecessarily because they were languishing on trolleys waiting for a hospital bed than those killed on our roads.
He gave a distressing insight into the conditions already unfolding in emergency departments ahead of the annual spike in flu and Covid infections.
‘We are seeing elderly people becoming delirious in front of our eyes,’ he said.
‘It is common to see elderly people becoming delirious, and that is distressing for them and their families. It is frightening for them and their families.
‘A&Es are the only part of a hospital that never closes... there is a lot of noise and bright lights and the combination of sleep deprivation and underlying conditions triggers delirium in elderly people.
‘We see them deteriorating at a faster rate. Delirium is not like dementia. It is transient, but there is an increased risk of death.
‘When elderly people become delirious, their recovery takes longer, and this leads to longer hospital stays.
‘Every year there are in excess of 200 avoidable deaths and people are dying for the want of a bed.’
CUH has 1,000 beds, and on Wednesday there were 35 sick patients left waiting on trolleys in the hospital’s busy emergency department. A further 10 patients were on trolleys in wards awaiting a hospital bed.
Yet at the same time, according to
‘People are dying in A&Es for the want of a bed’
‘We are seeing elderly becoming delirious’
‘Pressures are no longer just experienced in winter’
Prof Deasy, there were 60 patients in beds at his hospital who were well enough to be discharged but have to remain at CUH because there are not enough suitable places available in rehab centres or nursing homes.
Meanwhile, some other families are unable to bring their frail relatives home because they cannot get the home help packages they need.
Professor Deasy added: ‘Acute hospitals are being used as nursing homes, rehab for people who need long term care and as a replacement for home care packages.
‘Some of these people could be waiting for days or for weeks to be discharged but they can’t because there aren’t home care packages or rehab places for them.’
In response to queries from the MoS, a Department of Health spokesperson said: ‘As the Minister, HSE CEO and An Taoiseach have made clear there will be a considerable challenge in delivering health services given the ongoing inflationary pressures and our growing and aging population.
‘Equally, those pressures may ease next year, and the post-Covid surge in demand we have seen in particular may dissipate. The Minister for Health has acknowledged the role of all those working in our health service in coping with that extra demand and in ensuring that we continue to maximise productivity in the delivery of those services.’
The spokesperson added: ‘Pressures on emergency departments (EDs) are no longer just experienced during winter periods and prolonged levels of high daily presentations and congestion are now being experienced throughout the year.’