Overcrowding in A&E units

Madam, - Anyone working in an Irish hospital knows that the principal problem is the shortage of hospital beds

Madam, - Anyone working in an Irish hospital knows that the principal problem is the shortage of hospital beds. Our population is 25 per cent higher than it was 20 years ago but we have 25 per cent fewer hospital beds.

The Government has clearly failed to live up to the requirements of its own health strategy, published four years ago. Instead it has chosen to mislead the public by throwing unfounded and grossly unfair abuse at hospital consultants who are endeavouring to serve the public in inadequate conditions.

The Taoiseach said last Wednesday: "Consultants and others must be encouraged to work more." Has he still no understanding of the reality of hospital life? I have the schedule of a consultant surgeon in front of me as I write.

This surgeon works over 50 hours each week. In addition he can be on call at night and at weekends. When emergencies arise in his speciality, he comes into the hospital and deals with them. Some may be relatively straightforward. Others can be complex and may not be concluded for some hours. Regardless of the complexity, he is expected to be in the hospital at 9 next morning as normal. This workload is typical of many hospital consultants around the country.

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The following day, the Minister for Finance said: "Dealing with the problem involves not simply trying to improve capacity in accident and emergency departments, but also involves co-operation from consultants throughout the hospital particularly regarding elective surgery".

The Minister must be aware that consultants want to co-operate regarding elective surgery. Their problem is that they cannot get patients into hospital to do in-patient elective surgery because emergency patients (or those who have been medically discharged but do not have an appropriate place to go) occupy the acute hospital beds. That of course translates into longer waiting lists.

Both the Taoiseach and the Minister for Finance are members of the Cabinet sub-committee on health. They should be aware of the 121 commitments made in the Government's health strategy. Of those that directly affect patient care, there is one on which significant progress has been made. Action No 83 promises that one-day procedures will be used to the maximum consistent with international best practice. It is one of the very few actions for which consultants have some responsibility and 77 per cent more day-case procedures were carried out in 2003 than had been two years previously, when the strategy was launched. These were mostly elective procedures.

Members of the Government should take the trouble to inform themselves of what is happening in our hospitals. - Yours, etc,

DONAL DUFFY, Assistant Secretary General, Irish Hospital Consultants Association, Dundrum, Dublin 14.