Measures to halt child patients on trolleys urged

A major surge in the number of children forced to wait on emergency department trolleys for up to a day could be halted without increasing budget costs, it has been claimed.

Professor Ronan O Sullivan, emergency medicine consultant at Our Lady’s Hospital for Sick Children in Crumlin, Dublin, said the situation could be resolved by altering where certain medics work and opening some closed beds on a short-term basis.

He was speaking after a new Irish Association of Emergency Medicine report found that the number of children waiting on trolleys in Crumlin has increased by 700% in just three years.

While the figure now relates to 13 or 14 patients on average each night, some are still waiting up to 24 hours for treatment.

The situation is not as problematic at Temple St, where last year 90% of children in emergency departments were seen within six hours. However, it is being repeated to a lesser extent at Tallaght Hospital.

Hitting out at the trolley count surge before a hastily arranged meeting between the three hospitals, HSE clinical director, Dr Colm Costigan, and Irish Association for Emergency Medicine officials next week, Prof O’Sullivan said child emergency department overcrowding was an “escalating problem”.

He said the rates were at “historically high and dangerous levels”, with seriously ill children taking up “every physical space”.

However, he said the problems could be significantly reduced if simple measures, which would not increase costs, were implemented.

This, he said, would be possible by opening some previously closed inpatient beds on a short-term basis to reduce pressure and to re-allocate certain staff from within departments.

Prof O Sullivan — who dismissed Department of Health claims the issue is due to a “seasonal increase” in cases as this is “eminently predictable” — said overcrowding must be tackled quickly as “this is how adult [emergency department] overcrowding started”.

He said the problems were first raised with then health minister Mary Harney in December 2008. Ms Harney told the Dáil at the time that child emergency department units were in fact over-staffed at night.

A Department of Health spokesperson said last night that “with regard to the problems experienced in the last 24 hours, we are advised there is a surge in influenza and respiratory problems”.

She said “the very young and older people are the most vulnerable to infection and this is affecting our emergency departments across the State”.

The surge in child emergency department waits emerged on the same day as the Department of Health confirmed it was planning to fine all hospitals €25,000 for every patient left on any kind of waiting list for more than a year from April 1.

The HSE’s most recent performance monitoring report, for December, shows 330 people were waiting over a year for day case and inpatient procedures.

Hospitals have raised concerns that such a policy will cripple already struggling facilities.

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