The Health Service Executive (HSE) has warned Tallaght hospital that unless it moves quickly to implement measures to eliminate lengthy waiting times for patients on trolleys in its A&E department, it will face having to pay the private sector to provide the treatment required.
In a strong criticism of management at the hospital sent last week, the HSE said that the targets for waiting times in emergency departments, which were set by the recent A&E taskforce, were being breached "almost on a daily basis at Tallaght".
The HSE said that while there were some extenuating circumstances, such as the vomiting bug and high influenza rates, it appeared that key recommendations put forward by consultants last September to deal with problems at Tallaght were not being implemented "with the rigour and urgency that the situation at the hospital now requires".
The HSE's national director for the winter initiative John O'Brien said that the action plan proposed changes, to be implemented over a six-month period, which would free up 64 beds on a cost-neutral basis and eliminate the practice of patients in A&E having to wait on trolleys for admission.
"There is now serious concern that with just 10 weeks remaining to the end of March the clinical decision unit and the short-stay unit, which are essential to freeing up the beds indicated and streamlining the passage of patients who present at the emergency department, have still not been set up.
"The setting up of these two units, which I emphasise do not need any additional resources, would bring senior decision- making to the 'front door' and eliminate the need for patients to 'jump through several hoops' before a decision is made on their treatment needs," he said.
The HSE said that it was not prepared to support a situation where on one hand there were patients waiting on trolleys, while on the other there were delays in implementing measures recommended that would reduce such waits. It said that there were other hospitals in the country with fewer beds which saw similar numbers of patients in their A&Es and managed to treat them without excessive trolley waits.
"For example, Waterford Regional Hospital with 429 beds sees about 1,300 patients each week in the emergency department and has about 325 admissions without any significant trolley waits, while Tallaght with 460 beds sees about 1,000 patients each week and admits 250 patients with on-going trolley waits," it said.
Mr O'Brien said that the HSE now required Tallaght hospital management to implement the consultants' findings by the deadline of the end of March.
"Failing this, the HSE will be left with no option other than to put alternative arrangements in place, most likely with the private sector, to treat patients who are waiting over the 12-hour deadline."
Tallaght Hospital management could not be contacted last night.
