Consultants to blame for bed shortages, say nurses

NURSES representatives have pointed the finger of blame at consultants for the latest A&E crisis to grip the country's major hospitals.

The Irish Nurses Organisation (INO) said a lack of non-acute beds and failure by consultants to carry out extra rounds and speed up discharges were the only possible explanations.

The claim was rejected out-of-hand by the Irish Hospital Consultants Association (IHCA).

However, INO general secretary Liam Doran said hospitals would have to be asked what caused the latest problems given that significant improvements had occurred in most A&Es under a deal to settle an A&E nurses strike last spring.

"What happened at the weekend is the $64m question. Is it that consultants didn't engage when the overcrowding started? Under a hospital's escalation policy, a consultant can be asked to do extra rounds if there is a backup in A&E to see if anymore discharges can be made. We will be asking questions as to how that was implemented at the weekend," Mr Doran said.

The INO will raise the issue at a meeting with the Health Service Employers Agency under the auspices of the Labour Relation Commission tomorrow. The meeting takes place under threat of a nursing strike prompted by the A&E situation.

However, IHCA secretary general Finbarr Fitzpatrick rejected out-of-hand the INO's suggestion that consultants contributed in any way to the A&E crisis.

"The idea that a consultant has a magic wand and can do ward rounds late in the evening and discharge patients willy-nilly is way off the mark. You can't discharge a patient before he is fit to go home Mr Fitzpatrick said a patient's condition rarely improved so dramatically that someone who was clearly unfit to go home in the morning would suddenly be fit enough to go home in the evening - so extra rounds by consultants would not solve the A&E crisis.

He said using the 250 vacant non-acute beds in nursing homes in the greater Dublin area was a more likely solution.

Major hospitals around the country reported significant improvements in A&E units since last year's strike. In the eastern region, where 450,000 patients are expected to attend A&E this year, 269 acute hospital beds have been added with a further 35 in the pipeline.

Minor Injury Units have been opened in all the acute hospitals to ensure rapid treatment of people coming to A&E with minor injuries. Specialist clinics including chest pain, deep vein thrombosis and respiratory problem clinics have been opened in a number of the A&E hospitals to fast-track patients coming to A&E with specific conditions.

Outreach teams, like the Chronic Pulmonary Outreach Team at Beaumont, are helping patients recover from chest infections at home. Ten extra A&E consultants have been approved.