Medic warns winter will be 'hell on earth' for patients and hospital staff 

Emergency departments have become 'warehouses for admitted patients'.

Winter will be “hell on earth” for both patients and hospital staff if projections for hospital and ICU admissions are correct.

That is according to Dr Fergal Hickey, president of the Irish Association of Emergency Medicine, who said winter would be an “Armageddon” type situation.

Dr Hickey repeated his often made warning about the state of the healthcare system due to the lack of acute beds, the lack of critical care beds and the difficulty in recruiting staff who were “voting with their feet” and emigrating to work in Australia and Asia, where work conditions were better.

Staff did not want to work in a broken system, he said, and as a result, the system was “haemorrhaging” healthcare workers.

The lack of acute beds had been an issue for many years, he told RTÉ radio. The issue had not been addressed despite many years of “agitation” on the issue.

Emergency departments have become “warehouses for admitted patients”, he added. 

“Our acute beds capacity is 2.8 acute hospital beds per 1,000 of the population, the OECD average is 4.3, so we're going into this with one hand tied behind our back and the reality is that our emergency departments have been left to become warehouses for admitted inpatients.” 

A report for Monday's meeting of the Emergency Department Task Force shows there were 40,398 breaches of waiting times, when patients were left waiting over 24 hours in the period from January to August this year.

Dr Hickey said the 40,000 patients waiting over 24 hours for admission were patients who had already been treated in the emergency department and were waiting to be moved to a hospital ward.

Because they remain in the emergency departments, they completely negate the emergency department's capacity to act as an emergency department, so we can't deal with the next group of incoming patients. 

“We can't cope safely. We have no hope of coping in the winter if these numbers prove to be the case.”

Dr Hickey described the HSE’s annual winter initiative as “completely stupid” and said the healthcare system problems were an ongoing issue.

“This is a 12 month of the year, a 365 days of the year problem. The only time that there seems to be either political interest in this, or health service management interest is in the winter, and yet we set records all through the year.” 

The system continued to be short “a few thousand beds”, he said, but nothing was being done. Dr Hickey added the bed shortage would also have an impact elsewhere in the system as patients could not be released home in the depths of winter to a cold home. This was going to make the situation much worse, he said.

Meanwhile, Phil Ní Sheaghdha, general secretary of the Irish Nurses & Midwives Organisation (INMO) has warned hospitals that are already overcrowded, will not be able to cope this winter with the twin threats of Covid and flu.

Ms Ní Sheaghdha told Newstalk Breakfast the INMO was seeking an early agreement with private hospitals to ensure acute services were not overwhelmed and procedures subsequently cancelled.

The system could be better managed, she said. Private hospitals must be asked to be part of the overall health service this winter with a view to making sure that elective admissions were not cancelled.

Ms Ní Sheaghdha said the crisis was predictable given the already stretched nature of the health service and the graduate brain drain from the HSE was exacerbating the problem.