Acute trolley crisis shows no signs of abating

The Irish Nurses and Midwives Organisation (INMO) has recorded a 103% rise since 2007 in the number of patients on trolleys at a time when 2,279 hospital beds remain closed.

The perennial overcrowding crisis in emergency departments shows no signs of abating with the number of patients on trolleys already up 25% this year.

The ongoing increase flies in the face of the work of the Government’s special delivery unit (SDU) set up in 2011 to cut patient waiting times, but tasked with prioritising a reduction in emergency department overcrowding.

Last night, the Department of Health blamed the ongoing emergency departments crisis on the increased number of presentations, particularly among the elderly, with respiratory and “more complex problems” — which affected patient flow in the hospitals.

In addition, the department said, “in January and February, there was also growth in the number of elderly patients awaiting discharge to a more appropriate care setting which particularly affected the Dublin Academic Teaching Hospitals”.

Last month, Cork University Hospital cancelled scheduled surgery for a week, affecting more than 120 procedures, because of pressure on the emergency departments. The department said the emergency departments trolley crisis continues to be a major focus for the SDU.

The INMO trolley figures, circulated at the organisation’s annual delegate conference in Donegal, show between Mar 11 to May 3, 2007, there were 7,067 patients on trolleys, compared to 14,343 for the same period this year.

The 2013 figures include the number of trolleys taken out of emergency departments and placed on wards. This policy of placing extra beds on wards, described by INMO general secretary Liam Doran as “a creeping phenomenon, is meant to be a last resort.

However Mr Doran said yesterday that five hospitals — MidWest Regional Hospital in Limerick, Wexford General, Tallaght, Connolly in Dublin and Mullingar Regional — continually do so as they are always pressurised.

Mr Doran said while the special delivery unit had done great work with some hospitals, the fact was others simply had too few beds.

INMO president Claire Mahon said for every additional bed placed on a ward, the risk to every patient increased.

The INMO is seeking a minimum staffing ratio of one nurse for every four patients to “set a floor” on five successive years of cutbacks, Mr Doran said.

“The biggest concern our organisation has at the moment, is where’s the floor?” Mr Doran said

“We’ve gone below the floor. There isn’t a person in the hall that won’t argue that we have gone below what is an acceptable standard. The abnormal has become the normal. What breaks our heart is that the professional nurse on the ward, her professional opinion is being ignored by people who could be 100 miles away in an office,” Mr Doran said.

He said management never accept any staffing situation is dangerous and staffing levels were particularly low in maternity units. The INMO is seeking an independent review with recommendations on what is best practice.

The conference continues in Letterkenny today and tomorrow, with health minister James Reilly due to address delegates at noon tomorrow.

Pay cuts would lead to nurses taking strike action

Any attempt by the Government to impose pay cuts on nurses is likely to trigger strike action as part of a wider public sector campaign of action, warned the Irish Nurses and Midwives Organisation (INMO) yesterday.

INMO president Claire Mahon said there was an appetite for strike among members who weren’t “high earners in the grand scheme of things” and a lot of whom were “under pressure in their home lives” because of poor pay and pressurised working conditions.

“I think they have reached the floor and are very willing to take action,” said Ms Mahon at a press conference prior to the start of the organisation’s three-day annual delegate conference in Letterkenny, Co Donegal.

INMO general secretary Liam Doran said despite the fact nurses had endured pay cuts of up to 14% in the past three-and-a-half years — meaning, for example, that a staff nurse at midpoint on the salary scale would have seen pay reduced from €47,061 to €40,473 — the Government was continuing to press ahead with legislation to unilaterally cut pay.

Mr Doran said if it came to industrial action, they would be “taking it collectively, with other public sector unions” and while they would protect essential services, elective procedures were likely to be hit.

Mr Doran said they had formed a close relationship with doctors’ union the Irish Medical Organisation (IMO) and that together, they were looking at making savings in ways that would protect pay. These included clever rostering and reductions in the use of agency staff and overtime. Use of agency nurses alone cost the HSE in excess of €100m last year. The INMO has repeatedly claimed the cost of hiring agency staff is a third higher than filling the post with permanent staff, because of the 30% Vat charge on agency staff and the payment to the agency.

Mr Doran said they were “prepared to work with IMO to reduce that... but the quid pro quo of that has got to be pay protection”.

Since the recession began, more than €3.3bn and 11,268 staff have been cut from the health service, including “a disproportion number of nurses and midwives” Mr Doran said.

Further staff will be lost through a new discretionary career break scheme, in which successful applicants will receive €12,000 annually over a three-year break.

However, INMO industrial relations director Phil Ní Sheaghdha said many nurses would be precluded from the scheme due to the vital nature of the service they provide and the ban on recruitment making their replacement impossible.