Contingency plans have been drawn up to treat patients in ambulances in the carpark of Dublin's Mater hospital if the accident and emergency unit becomes grossly overcrowded due to recent bed closures. Eithne Donnellan, Health Correspondent, reports.
The plan, which was compiled by the hospital's accident and emergency consultants, was submitted to the Eastern Regional Health Authority in April.
It states that "drastic measures" such as holding and treating patients in ambulances in the hospital car-park will be among the "only logical options available" if A&E becomes overcrowded. This and other options set out in the plan, which include closing the A&E department altogether, would be implemented "in the interest of patient safety", according to the contingency plan, which has been obtained by The Irish Times under the Freedom of Information Act.
The plan states that if ambulances cannot be diverted to another hospital, the only other options would be to immediately invoke the Mater hospital major incident plan or identify "holding areas" elsewhere in the hospital where patients awaiting admission can be transferred for ongoing care.
A spokeswoman for the hospital confirmed yesterday that a number of patients already had to be treated this year in ambulances in the hospital carpark but she emphasised it was not a regular occurrence.
The hospital announced 115 bed closures, the equivalent of one fifth of its beds, in March due to a shortfall in its budget for 2003. It said it was facing an €18 million deficit this year unless it took immediate action.
In a memorandum to the hospital's chief executive, Mr Martin Cowley, setting out details of their contingency plan for A&E while the beds are closed, the A&E consultants wrote: "We have no doubt that the bed closures will increase the exposure of the emergency department to clinical risk beyond acceptable standards. With this in mind we have formulated the contingency plans outlined."
They added: "The view of the emergency department consultants is that these drastic measures are the only logical options available and would be implemented in the interest of patient safety."
When a copy of the contingency plan was submitted to the ERHA in April by Mr Cowley, the ERHA's director of planning and commissioning, Mr Tom Finn, sought a meeting with hospital management and its A&E consultants. He also told Mr Cowley by letter that the holding and treating of patients in the Mater courtyard was "inappropriate and most certainly not necessary". He suggested that in the absence of trolley availability within the A&E department patients arriving by ambulance should be brought into A&E and treated "on the ambulance gurney (trolley)".
He also said the ERHA felt emergency department saturation "does not rise to a level which would require the hospital to invoke a major incident plan".
Furthermore, he said the closing of the unit altogether was "non-workable".