A&Es have ‘woefully inadequate’ staff levels

DOCTORS have claimed vital emergency department units & are being over- stretched because of “woefully inadequate” staff and low locum cover.

The Irish Association for Emergency Medicine (IAEM) has warned that despite an ongoing publicfocus on hospital needs, the Health Service Executive (HSE) is not providing the necessary number of “senior decision makers” to units.

According to the group – led by emergency medicine consultants Dr Fergal Hickey, Dr James Binchy, and Dr Niall O’Connor – there are just 54 “substantive consultants in emergency medicine” for Ireland’s 32 hospitals with 24-hour emergency units.

The group, which described the figure as “woefully inadequate”, said the situation is compounded by a growing “under-provision of locum cover to replace consultants who are on annual leave, study leave or who have retired”.

In addition, it has claimed that at the start of March there were 34 unfilled senior house officer positions out of 200 in Irish hospitals and a further 23 unfilled registrar posts out of 130.

As a result, the IAEM has warned that emergency department staff are continually over-stretched.

“As all consultants in emergency medicine are on onerous rotas, the necessity for there to be adequate locum cover is particularly important. In the absence of a consultant who is on leave, the already limited number of senior decision makers is further reduced with there being nights and weekends without a consultant available.

“The IAEM is calling on the HSE to bring forward urgently a comprehensive programme of consultant expansion to increase the number of senior decision makers in the country’s emergency departments,” the group said.

A HSE spokesperson said health service managers are seeking to develop emergency department services through the emergency department forum. These groups include representatives of “all emergency department stakeholders” to ensure all views are represented.

The IAEM’s comments came after Dr Colm Quigley, former Medical Council president and clinical lead in the HSE’s south east hospital group, said Ireland could face EU financial penalties if the health service continues to fail to meet new hospital working time directives.

The directives state that non-consultant doctors should not be rostered to work more than 48 hours per week.

However, Dr Quigley, who is also clinical director of Wexford General Hospital, said a large number of physicians are working far in excess of this figure to ensure patient needs are met.

Since November, when the European Commission sent the Department of Health formal notification that it was failing to comply with the directive, Irish officials have been in correspondence with their continental peers over the issue.

Greece has already been referred to the European Court of Justice (ECJ) over the working hours of its junior doctors, while Belgium and Portugal have received warnings similar to those sent to Ireland.