'Nobody would believe it. Patients lying on trolleys in corridors in the 21st century in one of the richest countries in the world.' Angry and bewildered A&E patients and their families talk to Róisín Ingle.
It's 10.45 p.m. on Wednesday night and 75-year-old Joseph McManus is trying to get some sleep. There are 17 people on trolleys here, some of them crammed along the small accident and emergency corridor, others dotted around the outpatients and X-ray departments of Cavan General Hospital.
Joseph, who was brought in suffering from a stiff neck and suspected pneumonia, doesn't seem the complaining type and he understands that the nurses and doctors are "trying their best under difficult circumstances". But he is tired. "I'll surely not get any sleep here," he says softly as staff hurry past and the sound of small boys being flogged in the movie Song For A Raggy Boy blares out from a television in the nearby patient waiting area. "Mary Harney would want to waken up," he sighs, closing his eyes.
He was just one of hundreds of sick people lying on trolleys in hospitals around the country in a week when the spotlight fell, yet again, on the seemingly incurable health care crisis. What was different about this week's coverage of the crisis was the emergence of a new brand of "patient power", as relatives spoke up louder than ever about how their loved ones were being treated, their stories making headlines and, in some cases, improving the plight of patients.
On another trolley in Cavan, 56-year-old publican Michael McKenna has only one word to describe the situation: "unreal". "It's unreal," he repeats. This is his second day on the trolley after he was brought in suffering from severe chest pains and high blood pressure.
"Nobody would believe it," he says. "Patients lying on trolleys in corridors in the 21st century in one of the richest countries in the world. Being lifted in and out of our beds in full view of the public. It's humiliating. My family don't want to come in because they can't have a private conversation with me."
He has been a Fianna Fáil voter all his life but blames the party for the current health crisis. "They have been in government for the majority of time since the foundation of the State so there is nobody else to blame," he says. "Next time I am voting Sinn Féin."
Shielded from the public area by a thin blue curtain, 85-year-old Annie Moffatt lies with her head pointing in a different direction from the other trolley patients, a nod to the fact that she is the only female in the corridor.
"It's not that nice, not that comfortable," she says, her breath coming in short gasps as she keeps cool with a colourful paper fan bearing the words Jesus Loves You. "I was in one of the X-ray rooms before and I was sorry to leave it. What can you do, though, except lie here? I hope I am not on the trolley a couple of nights."
She wasn't, as it turned out. By the following morning in Cavan, where the A&E crisis had been compounded by an outbreak of the winter vomiting bug which led to staff shortages and ward closures, the 17 people waiting for beds had been reduced to seven. And by yesterday morning the 200-plus patients on trolleys waiting for proper hospital beds around the country had been reduced to just more than 100.
While the general pattern in hospitals these days is a build-up of trolley patients over the weekend, overcrowding earlier in the week and slight relief towards the end of the week, those in the sector have no doubt that this week's problem was halved thanks to "patient power".
People such as Janette Byrne from Finglas in Dublin have emerged this week as key figures in the "patient power" movement, grabbing headlines with stories that have been impossible for politicians and the public to ignore. Byrne has been telling anyone who will listen - and when it comes to heartbreaking health stories the nation is all ears - about her mother, Kathleen, who went into Dublin's Mater Hospital last Saturday and lay on a trolley until Wednesday, both contracting the vomiting bug and getting bedsores as she lay waiting for a bed.
"She had a series of mini-strokes and a consultant told us she could not be treated until she was in casualty," says Janette Byrne. "We couldn't leave her side for two minutes. We knew she had to have monitors attached to her, we knew she needed treatment but she wasn't going to get that treatment without a proper bed".
As the Byrne family grew increasingly worried for her mother, they decided to take action. Three years ago Janette had successfully campaigned through the courts to be given a bed so that her cancer care could be continued and she knew her voice could make a difference.
A group of relatives collected 200 signatures and presented a letter to the Minister for Health and Children, Mary Harney. Meanwhile, Janette and her brother Gerard warned that they would consider legal action if their mother was not given a bed.
To the family's relief she, along with many other patients whose stories had been broadcast and told in newspapers during the week, was eventually given a bed five days after she was admitted to hospital.
"It's disgusting that this should be happening. We were supposed to be focusing on our loved ones, getting our parents well and instead we have had to be out fighting and campaigning for their rights which adds to the stress they are already under. Well, we are urging everyone to keep on fighting. This will not stop here," says Janette, who now has a notebook filled with the telephone numbers of people who want to be involved in the new pressure group, Patients Together, which was formed yesterday in the Mansion House.
According to Tony Fitzpatrick, industrial relations officer with the Irish Nurses' Organisation, the relatives of patients and the patients themselves deserve to be applauded.
"We are delighted that people are finally speaking out about the issues. We have always encouraged patients and relatives to complain in an effort to get things done, but in the past people have been afraid the nurses might get blamed," he says.
"This week people have just had enough, and because they have complained the issue has been brought to the top of the political and media agenda. It's not just nurses talking about it any more and that means the people who matter are sitting up and hopefully taking notice."
In Cork University Hospital, as in the rest of the country this week, the A&E department was filled with anxious patients and relatives concerned about the level of care they could expect.
Stephen Cusack, an A&E consultant, is candid about the scale of the problem of people having to wait on trolleys at the casualty unit, but he is quick to point out that the A&E crisis is symptomatic of a wider problem within the hospital and the entire health sector.
The trolley-waiting, he says, "has gone from being a winter event to a year-round event, and over the last five years it has really begun to bite," he says, adding that the department has gone from having seven people on trolleys each morning to an average of 18.
Cusack adds that the issue of having patients on trolleys is partly caused by the fact that the number of consultants at the hospital has increased and therefore more procedures are being carried out by specialists, more beds in the main hospital are being taken up and fewer beds are available for people admitted through A&E. The A&E departments, he says, are like "pressure valves" in hospitals and are affected by shortcomings in every other department.
Whether these shortcomings can be substantially improved by patients and their relatives taking a more vocal stance remains to be seen. But this was the week when those worst affected woke up to the fact that as health consumers with horror stories to tell, they can have a positive influence on the hospital crisis in the months ahead.
Meanwhile, Joseph McManus spent most of yesterday - his 76th birthday - on a trolley in Cavan General Hospital. He has since been discharged.
- Additional reporting by Barry Roche