There was a further blow for the HSE on Monday with the resignation of Dr Tony O’Connell, who as director of acute hospitals has direct responsibility for trolley waits.
The resignation comes as the number of patients waiting for a hospital bed came close to record levels on the first effective working day of the New Year.
Dr O’Connell is leaving the post after less than nine months to return to his native Australia.
There are currently 563 patients in hospital emergency departments or on wards waiting for admission, according to the Irish Nurses and Midwives’ Organisation.
The Government promised earlier in its term never to have more than 569 patients on trolleys, so this commitment is in danger of being broken if the surge in New Year presentations is maintained.
Minister for Health Leo Varadkar has promised a number of short-term measures, funded by €25 million in funding in the Budget, to alleviate pressure on emergency departments this winter. Last month, he warned the 569 target was in danger of being breached if additional community beds and extra nursing home places were not provided and planned surgery cancelled.
The INMO, which counts trolley figures every morning, said today's figures were the highest it has recorded. General secretary Liam Doran said he was shocked at the figures and warned there could be over 600 patients waiting for admission by next week unless action was taken.
“I’m genuinely taken aback by the severity of the overcrowding at this time,” he said.
Mr Doran called on the HSE to respond to the crisis by cancelling all elective work for two weeks, open additional beds where possible and increasing community supports. He said a short of qualified staff was a major problem and the Irish health service should be recruiting in the UK to encourage nurses to return to full-time posts here.
There are 50 patients waiting for admission at Our Lady of Lourdes Hospital in Drogheda, 41 at St Vincent's University Hospital in Dublin, 39 at St Lukes in Kilkenny and 30 at Naas General.
Mr Doran said that unless the Department of Health and the HSE act to deal with the issue immediately, there could be over 600 patients waiting by next week.
Overcrowding at the emergency department of the Midland Regional Hospital, Mullingar is the worst in Ireland according to the INMO, where 28 people are on trolleys waiting for a bed.