A €40m plan to deal with the anticipated surge in hospital activities over the winter has been described as a “drop in the ocean” by doctors at a time when operations are already being cancelled and daily trolley figures frequently exceed 400.
The Winter Initiative Plan, published yesterday by the Health Service Executive (HSE), commits to providing just 55 additional acute beds nationwide — too few to meet demand in Cork University Hospital (CUH) alone, where an additional 70 are needed, according to emergency medicine consultant Stephen Cusack.
Since the end of August CUH has had to cancel 40 surgeries, with another 40 cancelled at the Mercy University Hospital (MUH).
University Hospital Galway also began cancelling scheduled non-urgent surgery this week. MUH will gain 18 step-down beds under the winter plan.
The HSE plan also promises 58 additional transitional care beds and 950 additional home care packages — although just last month the HSE conceded that in the south east, new clients could only get access to home care packages when existing clients no longer required them.
The home care packages will target 10 specific hospitals including CUH, University Hospital Waterford, University Hospital Limerick, and St James’s Hospital in Dublin.
Efforts to prepare for the traditional winter hospital chaos include pumping money into community initiatives with the expansion of community intervention teams which the HSE says will benefit 6,643 additional patients.
These are nurse-led teams that operate in the community and are designed to keep patients out of hospital.
The HSE has also promised a targeted waiting list programme for orthopaedics, spinal, and scoliosis to be implemented in designated sites by year end.
The HSE said the plan will take effect from late October/early November, with director general Tony O’Brien describing the measures as “carefully considered” and “targeted”.
Hospital groups and community healthcare organisations must produce their own winter plans for validation by the end of September and the special delivery unit will monitor implementation.
Health Minister Simon Harris said he would be “closely monitoring progress to ensure that the expected improvements will be achieved”. He said he had requested a weekly update report.
Both the Irish Medical Organisation (IMO) and the Irish Association of Emergency Medicine (IAEM) described the plan as “a drop in the ocean”.
IMO president Peader Gilligan said 55 extra beds went nowhere near addressing lack of capacity in a system which lost 1,600 beds during the recession. He described the winter initiative as “more about PR than reality”.
IAEM spokesman Fergal Hickey said lack of capacity was “a 12-months of the year problem”, eg trolley figures hit record highs in July.
The Irish Nurses and Midwives Organisation, whose secretary general, Liam Doran, is joint chair of the ED Task Force Implementation Group, welcomed the initiative but said many of the 300 beds opened under last year’s winter initiative are now closed due to staff shortages.
The INMO said success of this plan will depend on the ability of the HSE to recruit sufficient staff to open all available beds.
The INMO said the plan also included a target of no more than 236 patients on trolleys each morning.
Mr Hickey said: “That’s just unacceptable. The only acceptable figure is zero.”
Fianna Fáil health spokesman Billy Kelleher said the initiative would not make “a meaningful difference” and Sinn Féin health spokeswoman Louise O’Reilly said it was doomed to failure.
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