A&E task force forbidden to discuss issues of overcrowding

MEMBERS of the Accident & Emergency task force were forbidden from raising the question of using more acute hospital beds to relieve overcrowding in casualty, it has been claimed.

Task force member, Dr Gerard Lane, also warned in a recent email to members of the Irish Association of Emergency Medicine (IAEM) that key decisions were made for the task force by the Health Service Executive (HSE).

He said the task force was forbidden from considering bed capacity or any solutions that could not be implemented before January 2007.

Dr Lane’s email, published in the latest issue of the Irish Medical Times, has also claimed that the bed capacity issue had been removed from the table and taken by the HSE’s director of the national hospital’s office, John O’Brien, for a separate group to report on.

The group’s report, due last June, was not now expected until later this month, he pointed out.

Dr Lane was part of an Irish Hospital Consultants Association (IHCA) delegation that had argued that A&E overcrowding could not be solved without increased acute bed capacity.

A HSE spokesperson said members were told at the inaugural meeting that a national bed capacity review was being carried out.

It was agreed, however, that the task force would have a “strong focus on optimising bed capacity” as a way of delivering improvements in the short term.

The spokesperson also pointed out that the bed capacity issue had been raised during hospital visits and during subsequent meetings. “The issue was therefore very relevant to the task force,” the spokesperson insisted. “It was discussed and these discussions will be reflected in the final report that is due to be published shortly,” she said.

Meanwhile, a meeting of the Irish Association of Directors of Nursing and Midwifery (IADNM) has been told a shortage of beds was not the main reason for long waits on trolleys.

British operational management expert, Paul Walley, told the IADNM conference in Tullamore, Co Offaly, the problem was caused by a mismatch between the variation in demand and the variation in capacity. And while variation in capacity was responsible for 80% of the problem, it could be resolved.

“If we reduce the variability in the system and create a smooth flow through the system ... we can virtually eliminate trolley waits.”

Mr Walley said the British Government had increased expenditure on healthcare to reduce waiting times. “Superficially, this has been successful, but at a tremendous cost,” he stressed.

Another conference speaker warned that younger patients were demanding a bigger say in treatment. Director of the Irish Society for Quality and Safety in Healthcare (ISQSH), Willie Reddy, said a recent survey by the society found that patients under 34 years were far less satisfied with their level of involvement in treatment than those over 50.

The study found that over 40% of the 5,000 patients surveyed did not feel encouraged to voice their opinions about services.

Mr Reddy said it was clear that the patient of the future was not happy to continue with the status quo and if the healthcare system was not ready to meet the challenge they would find other ways to exercise their consumer rights.