A&E medics deny sending patients home early

Doctors working in emergency medicine have rejected claims that they are sending patients home who should be in hospital.

Last weekend, Dr Conor McGee, president of the National Association of General Practitioners, said the practice of discharging patients “who should be admitted” was increasing pressure on family doctors.

However the Irish Association for Emergency Medicine (IAEM) rejected the accusation, arguing that changes in healthcare delivery means a significant number of conditions traditionally treated in hospital are now treated in an outpatient or GP setting.

IAEM spokesman Fergal Hickey, a consultant in emergency medicine at Sligo General Hospital, said hospital admission was “not without its own risks”.

“Unless there is a clear benefit to a patient being admitted to hospital then this shouldn’t happen just because it might be a more convenient solution for other healthcare professionals,” said Dr Hickey.

He said the IAEM rejected the inference made at the NAGP conference that the practice of sending home patients who required hospitalisation was systemic.

“The public can be assured that the decision to discharge a patient home from ED is only made after careful medical assessment (often including a suite of investigations) to ensure that it is safe to do so. To suggest that patients are routinely sent home without adequate assessment is unfair and misleading to patients, their families and the public.”

However, he admitted that problems “can arise in certain circumstances” such as when patients are sent by their GP to an ED with a clinical problem — such as long-term back pain — for which the ED has no solution.

“In these cases the ED may have nothing further to offer the patient,” Dr Hickey said.

He also rejected Dr McGee’s suggestion that patients with chronic conditions such as diabetes or heart failure, needed to be automatically admitted, saying this “flies in the face” of modern medical thinking.

Separately, the Irish Medical Organisation (IMO) said talks are progressing on the introduction of free GP care for the under-sixes.

Ray Walley, chairman of the IMO GP committee told RTÉ radio yesterday that there were no sticking points, but he declined to put a timeframe on its introduction.

“I don’t want to be giving dates, I don’t want to be changing where we are with things, but basically it is a professional engagement and we are progressing,” he said.