A dispute over patient overcrowding levels at University Hospital Limerick rumbled on Friday as the Taoiseach described the number of patients on trolleys at the hospital as “a crisis”.
Last Wednesday nurses reported 92 patients languishing on trolleys at UHL - the worst overcrowding ever recorded at an Irish hospital.
Professor Paul Burke, chief clinical director of the UL Hospitals Group, disputed the nurse’s figures, and told the RTE News at One programme that, in his view, the situation was “not a crisis”.
“It’s something we deal with all the time,” he said.
INMO trolley figures on the day showed that at 8am on Wednesday there were 81 patients on trolleys at UHL. This, they said, rose to 92 by midday that day.
The HSE’s official TrolleyGAR figures stated there were 52 patients on trolleys.
A UHL spokesperson later clarified this figure was the total number of people on trolleys in the ED, and did not include trolleys numbers on wards.
When asked if he shared Prof Burke’s view it was not a crisis, Mr Varadkar replied:
Well, I think overcrowding is a crisis, and certainly for those who experience it; whether it’s the patients on trolleys or their relatives, or the staff - it is a crisis.
The Taoiseach said hospitals which continue to experience high levels of overcrowding, such as in Limerick, Cork, and Galway, could learn from areas in the north east, which he said have seen record low overcrowding levels.
The country’s largest emergency department, costing €25m, was opened at UHL in June 2017, replacing a not fit for purpose A&E unit.
However, following decentralisation of 24-hour emergency departments at Ennis and Nenagh and St John’s Hospital to UHL, the new ED has struggled to cope with the extra demand.
Mr Varadkar said UHL has received “a lot of investment already”, and described the new ED as “the newest, most modern emergency department in the country”.
He said the solution to overcrowding “requires a combination of things”, and was more than just “more resources, more staff, and more beds”.
“We’ve had that for four years now in Limerick, so clearly that is not enough.”
He said a “different approach” was needed at UHL, “which involves better use of other facilities like Nenagh and Ennis, primary care, and also better management of patient pathways, making sure that we don't have patients in a hospital bed waiting weeks and months for a nursing home or home care; making sure that when a patient is admitted on a Friday that they don’t wait until Monday or a Tuesday to have the treatment or scan they need.”
“It doesn't matter how many beds you have - if you don't get those things right, it’ll never be enough,” added the Taoiseach.
A spokesman for UHL said:
UL Hospitals Group is meeting the national target of 5 days average length of stay for surgical patients and is the best performing group for average length of stay for medical patients.
"In addition, UL Hospitals Group is within target for and has the lowest rate of medical and surgical readmissions of any hospital group in the country.”
They added UHL has continually taken “measures to relieve pressure on the ED” including “the transfer of suitable patients to other hospitals within our group; to community care settings; and maximising access to Homecare packages and Transition care; as well as working closely with Community Intervention Teams; and communication with GPs to ensure patients are referred to ED only where appropriate.”
They added: “Overall bed capacity remains considerably below comparable hospitals in Ireland and UL Hospitals continues to use its existing bed stock efficiently.”
“In addition, the annual audits of hospital mortality published by the National Office of Clinical Audit demonstrate that UHL continues to provide safe, quality services for its patients in spite of the challenges it faces.”