Emergency doctors call for HSE to provide 24-hour social work cover

EMERGENCY doctors have backed calls for the Health Service Executive (HSE) to provide 24-hour social work cover, claiming they are being used as a catch-all for social problems that should be handled elsewhere.

The Irish Association of Emergency Medicine (IAEM) — which represents doctors in A&E departments — say they are regularly left dealing with out-of-hours crises involving at-risk children, domestic violence victims, the homeless, the elderly and other vulnerable people whose problems are only partly medical or not medical at all.

“Emergency medicine serves as a healthcare safety net for a broad range of medical, psychological and social problems in adults and children alike,” it said. “It is inappropriate that such problems, which could be more appropriately managed in alternative care settings, are foisted on already overstretched emergency departments because of deficiencies elsewhere in the healthcare system.”

Children in particular were failed by this practice as they often ended up being placed in wards for patients with acute medical problems simply because there was nowhere else for them, thus “adding to the psychological distress the child experiences”.

Doctors dealing with such emergencies were also left in the dark about any previous dealings the child or family may have had with social services as there was no access to social workers until normal Monday-Friday office hours resumed.

“This represents an increased risk to the child and may result in an inappropriate assessment being made and the correct intervention not being undertaken,” the IAEM said.

Association secretary Dr James Binchy said: “There will always be cases where it makes sense that an emergency department is the first port of call but once any medical issues are dealt with, it should be possible to discharge a person into the care of social services. That’s not happening because the services don’t exist out of hours.”

The group’s call backs the “24 Hour Child” campaign launched by the Irish Society for the Prevention of Cruelty to Children which urges the provision of round-the-clock social work cover, highlighting the fact that 78% of calls to its Childline service are made at nights and weekends when social workers are off duty.

The HSE said it has no plans to introduce 24-hour cover, planning instead an alternative scheme to begin in June where children in need of crisis care are placed with emergency foster parents until office hours resume.