‘There will be deaths’
As a perfect storm hits the health service, one frontline veteran gives a chilling warning about the consequences of the current health chaos
CONDITIONS in the country’s emergency departments are worse than they have ever been and will lead to patient deaths, a leading A&E consultant has said.
And hospitals are now being hit with a ‘perfect storm’ of soaring Covid infections and emergency room attendances, with 5,200 staff on sick leave and a lack of bed capacity in hospitals, according to Dr Fergal Hickey of the Irish Association for Emergency Medicine (IAEM).
The senior emergency consultant at Sligo Regional Hospital also revealed patients are being left in ambulances outside crowded hospitals because there is nowhere for them to be treated.
He told the Irish Mail on Sunday: ‘The rubber band that was stretched to its limit has now snapped.
‘At the moment, we have long delays to see healthcare professionals, we’ve ambulance delays, we’ve people who have been detained on ambulances because there isn’t a space to bring them to, so there are delays then in the ambulance service responding to calls.
‘It’s completely circular arguments, all for the want of having enough bed capacity in the hospitals to be able to admit those patients who require admission. It’s never reached this point before where there physically isn’t a place to put them in the hospital because your emergency department is completely full of patients.’
As hospitals come under unprecedented pressure from rising Covid cases, trolley numbers and a lack of beds, it is impossible for patients to be seen promptly, he said.
Referring to a straw poll carried out by the IAEM this week, Dr Hickey said: ‘When people looked at the number of patients they had in their department and the number of cubicles they had, there were four or five patients waiting for every single cubicle.
‘And that’s assuming the cubicle spaces would be free, but of course they wouldn’t be because patients who have received their emerdepartments gency care and are waiting for their bed can’t get one and stay in the cubicle.’
Patients in some hospitals are waiting up to 24 hours to be seen by a clinician and anywhere up to 48 hours for a bed, with some spending their entire hospital stay in the emergency department.
Asked if the current chaotic conditions could result in patient fatalities, Dr Hickey said: ‘We know two things for a fact: we know that overcrowded emergency are dangerous and there is additional mortality as a result of that.
‘So there are people who die who wouldn’t otherwise die. So I am worried about that, yes.
‘We also know, and there’s a big study that was published last month from the UK which shows that, if you wait for five hours for a hospital bed from the time of arrival, then an additional one patient in every 82 will die as a direct result.
‘And if you wait for six to eight hours for a hospital bed, then two patients in 82 will die as a direct result of that.
‘That’s the situation we’re in all day, every day. So yes, I am concerned. This is a risk to patients.
‘This is not about, you know, privacy or dignity or inconvenience, although they’re very important, and patient dignity. But this is a matter of clinical risk. This hurts patients.
‘This has the risk of resulting in death of patients and the evidence supports that. But I don’t have a sense that anybody in the Department of Health or HSE central is doing anything about it.’
Dr Hickey said the key to easing the pressure on our hospitals is increased capacity.
He pointed out that family doctors need better access to diagnostics which they are finding hard to get for their patients.
And he said patients who have completed their acute hospital care and who need nursing home or community care need swift access
‘The rubber band has now snapped’
‘It’s never reached this point before’
‘People die who would not otherwise die’
to these to free up hospital beds.
He added: ‘We have a situation where there’s a never-ending number of patients coming in the front door. But we can’t get them out the other end. And therefore, as a result, there is back pressure in the emergency department.’
On Thursday, the HSE’s chief operations officer, Anne O’Connor, acknowledged the severity of the situation and said hospitals have no option but to cancel elective care.
She said the entire health service is being affected due to the recent surge in Covid cases, with care facilities, mental health services and disability services all being put under ‘serious pressure’.
Ms O’Connor said the resurgence in Covid infections is the main reason for staff absences.
‘It is clear to us that our hospitals cannot continue to do a lot of planned elective work, and we are seeing cancellations already, and we’ll be writing to hospitals to say that we support them in doing that,’ she said.