Ireland has been lucky so far to have avoided a major healthcare calamity during surges in activity in hospitals in winter, the president of the Irish Hospital Consultants Association has said.
In an address to his organisation's annual conference in Kilkenny Dr Thomas Ryan warned that while the country had been fortunate to date, that luck might not hold out. He called for a massive expansion in the number of hospital beds and a significant increase in the number of consultants.
“The longer the current model of healthcare continues, the more likely we are to encounter a major winter-time calamity.”
Dr Ryan said the number of additional acute hospital beds that were required to provide an internationally acceptable health service in Ireland is equivalent to six large hospitals such as the Mater University Hospital or Cork University Hospital or Galway University Hospital.
He said because of existing capacity deficits, “the public is being forced to accept healthcare rationing as hospitals continue to prioritise balancing inadequate budgets, with the provision of safe and timely care for patients being relegated to a secondary consideration”.
Dr Ryan said there were too few acute beds open in Irish hospitals and that of those that were available, as many as 500 - 600 were occupied by patients who had completed the clinical phase of their treatment and who were ready for discharge.
He said the shortage of accessible acute hospital beds was “the root cause of the trolley crisis in emergency departments countrywide.”
He forecast that the trolley crisis would worsen this winter as it had for well over a decade.
He said it was a reflection of a failing hospital system.
“As many as five per cent of our acute hospital beds are not accessible to treat acute patients awaiting admission and care. These clinically-discharged patients reside in acute hospitals as a direct consequence of the lack of funding for home care packages, nursing home beds and specialist rehab beds.”
Dr Ryan also said there were insufficient consultants working in Irish hospitals.
“We are short consultants in practically all specialties with about two-thirds the number of consultants recommended in the Hanly report in 2003.”
“However since the Hanly report, the Irish population has increased at a faster pace than anticipated and the demand for care has grown significantly.”
“The public has become immune to never-ending stories on the ‘crisis’ in our acute hospitals. However the many unresolved problems in our hospitals are now at such a critical level that patient safety is compromised on a daily basis. Many of our hospitals are running at an internationally unacceptable occupancy rate of more than 95per cent which has an adverse impact on patient safety.”
“We have a failing hospital system which is rationing healthcare to patients. The reductions in acute hospital and ICU beds and the cumulative cuts in investment for equipment and infrastructure have resulted in a stark mismatch between patient needs for care and the means to deliver it. When the first priority of a hospital is to be ‘within budget’, then the result is longer waiting lists, the trolley crises, overcrowding, cancellation of essential surgery and poor patient safety and care.”
Dr Ryan said there was an urgent neeed to strengthen healthcare governance.
“There is an urgent need to strengthen healthcare governance in Ireland. Patient safety should be the first priority in all our hospitals and therefore each hospital and Community Healthcare Organisation should have a board, which includes patient representatives, GPs and practising consultants to which the management is accountable. This is not the case at the moment”, said Dr Ryan.
