Hospital overcrowding: Overcrowding problem is ‘more political than management’

The medical consultant charged with tackling overcrowded black spot University Hospital Limerick (UHL) yesterday blamed politicians.

And Paul Burke, chief clinical director of the UHL Limerick group of hospitals, warned that their new emergency department due to open in May, will not reduce the numbers on trolleys.

“We just don’t have the money and that essentially is a significant component of it [overcrowding],” said Dr Burke. “There is a fundamental issue in how we fund the health service. That’s a political issue and we have to deal with it.

“In our country, we have made a certain decision that there is going to be a certain amount of money spent on healthcare and we have to manage within the confines of that. So we are forced into the situation we are in because of the fact that there is only so much money available.

“I believe the problem is more political than management. This is a political matter. Our funding this year for this region [Mid-West] is almost €100m less than it was in 2007. We are where we are and we have to deal with it.”

While the numbers on trolleys at UHL dropped from a high of 66 on Wednesday to 22 yesterday, Dr Burke said the hospital is not yet out of the woods with regard to the current overcrowding crisis. The hospital, he warned, could hit “another blip” if there is a further flu outbreak in the next month.

“If that happened it might put more demand on the service,” he said. “But I think in that scenario you wouldn’t see it quite as dramatically as you saw it this week. A lot has to do with the flu and the weather. Undoubtedly, we haven’t had our most severe cold snap yet.

“So from the point of view of our acute orthopaedics department, they haven’t probably had their blip yet. So if we have snow over coming weeks that will put pressure on the orthopaedic services.

“In terms of the flu and the increase in incidents of respiratory illnesses, we probably are likely to have another blip in relation to that within the next month. But the last week or 10 days have been quite unique.

“Every year after the holiday, because people in the primary care services [GPs and public health nurses] are only working on a skeleton service over the Christmas period and you tend to get a rebound.

“We are not out of the woods yet. It’s only early January and winter always puts huge pressure on the system and if we get a cold snap that in terms of flu and old people living on their, that tends to put huge pressure on the system. But if that happens we are not likely get the same huge rebound effect which we got over the past few days.”

Dr Burke said UHL, which has 400 beds, ideally needs an additional 150 over the next five years.

He said the new €18.25m emergency department will not change hospital capacity, or numbers on trolleys. However, he said it will prevent the current situation of trolleys “on top of each other”.