INMO: Hospitals should be fined for failing to deal with A&E overcrowding

Hospitals should be fined for failing to deal adequately with the recent surge in emergency department overcrowding, the Irish Nurses and Midwives Organisation has said.

INMO general secretary Liam Doran said there was no doubt that hospitals were under pressure but in the last 10 days there had been some “avoidable” overcrowding.

Hospitals can be fined €10,000 each time they fail to deal adequately with emergency department overcrowding under a framework to tackle the problem. The framework gives effect to a directive issued by Health Minister Leo Varadkar and HSE officials last November aimed at cutting trolley numbers.

INMO emergency department members have raised a number of difficulties in implementing the emergency department agreement.

Mr Doran said that while improvements had been made in a number of hospitals, there had also been a “relapse” in managing overcrowding in some facilities. There had been “avoidable breaches” of the ministerial directive because management or, in some situations, a small number of consultants, were not prepared to recognise that the emergency department has to be managed above all other areas in the hospital in the interests of patient care.

On Tuesday there were 554 patients recorded on trolleys across the State — the second highest figure recorded this year. On the same day last year there were 438.

Yesterday, there were 511 patients on trolleys and University Hospital Limerick had the highest figure at 47, according to figures from the INMO.

St Vincent’s University Hospital in Dublin had the second highest figure, at 45, but the hospital was not in a position to provide a ward figure for patients still waiting to be admitted to a bed.

The highest trolley figure so far this year was 558, recorded on January 5, while the highest ever figure, 601, was reached in January 2015.

Mr Doran said there had been an 8% reduction in trolley figures last month, compared to February 2015, but the situation had gone “backwards” in recent days.

He pointed out that while University Hospital Limerick had recorded the highest trolley figure yesterday, management were engaged in implementing the agreement.

“The hospital is overwhelmed but there has been no lessening in management’s efforts to deal with the situation. If they were not doing what they were doing. the situation would be twice as bad,” said Mr Doran.

However, INMO members believed management at Midland Regional Hospital, Mullingar, Letterkenny General Hospital and University Hospital Galway were not doing enough. They also complained that management at St Vincent’s Hospital were not engaging with staff and had cancelled meetings in the last week.

Mr Doran said he would be raising the difficulties reported by emergency department members at a meeting of the HSE emergency department taskforce implementation group today.

He will also be meeting with the HSE and the Department of Health under the Workplace Relations Commission on Monday.