Minister declines to say whether targets for lowering trolley numbers can be reached

The numbers waiting on trolleys in our hospitals have reached an all time high.

Health minister Stephen Donnelly said it is very difficult to predict the impact of policies against hospital overcrowding and declined to say whether targets for lowering trolley numbers can be reached.

This comes as new waiting list data for non-urgent treatment shows while hospitals are treating far more patients this winter so many new patients need help targets are slipping here too.

Earlier this year, the HSE said the winter emergency care target is to have no more than 320 patients waiting for a bed on trolleys on any one day.

This stood at 589 on Friday according to the Irish Nurses and Midwives Organisation and 405 on the HSE’s system.

Recent research from France indicated for every 21 older adults who spend a night in an emergency department, there is an extra death as highlighted by emergency medicine doctors.

However, when the Irish Examiner asked Minister Donnelly if he is confident hospitals can sustain 320 this winter, he declined to answer directly.

“The number of patients on trolleys today is too high, we know it is too high on an ongoing basis. There is a comprehensive plan in place,” he said on Wednesday. 

He later said: “They are going to do everything they can.

“I think it is very difficult to predict what the impact is going to be. We are doing some things which are entirely new, there are some new protocols in place, it is difficult to predict where exactly it is going to go.” 

Data consistently shows “a relatively small number of hospitals is accounting for a very sizeable portion of the people on trolleys," he said. 

Special interventions are in place, he said, naming as examples university hospitals Limerick, Cork, Galway and Kerry. 

Some 106 people were without a bed in UHL yesterday. The corresponding figure at CUH was 47, according to the INMO.

When asked why numbers are still going up at these sites, the minister said: “The reality is right now through the winter we are going to see a very high level of demand.” 

Looming over this week’s figures is the memory of 931 patients without a bed on just one day in January.

Responding to his comments, General Secretary Phil Ni Sheaghdha said persistent overcrowding will not be solved without investment in hospitals and community including nursing homes.

“There is no point in pretending any other proposed solutions will solve the trolley crisis in the long-term without additional capacity,” she said.

“Since the HSE announced their target to reach 320 people on trolleys a day, the INMO TrolleyWatch figures have not dipped below 360.

“The average number of people on trolleys a day since August has been 492 according to INMO figures.” 

She also sees variation between sites, saying “lessons must be learned” from hospitals which focused on lowering trolley numbers.

They have prioritised capacity and transfers to long-term facilities, she said, adding: “This is good for patients and good for staff.” 

She welcomed the growing development of community services. 

Meanwhile, some 687,621 people are waiting as out-patients, needing to be admitted or for GI Scopes.

The Department of Health said: “Against the 2023 Waiting List Action Plan, the total waiting list position is c.7.1% (46,000) behind target, as a result of additions being c.6.8% (102,000) higher than projected.” 

Reductions are being seen but overall the number of patients added to the lists is a startling 284,000 or 21.6% higher than during the same time in 2019. The data also shows 187,000 more people removed from waiting lists than by this time last year.