Staff cuts mean services in Waterford hospital are suffering

UNDER-STAFFING to the tune of up to 60 nurses has “severely curtailed” activities at one of the country’s busiest hospitals, as a surge in emergency admissions and the ongoing HSE moratorium hits waiting lists and services.

Elective surgery is down to less than half of normal levels at Waterford Regional Hospital (WRH) in recent weeks, while up to 30 inpatient beds remain closed as management do not have the nurses to staff them.

Meanwhile, surgeons can’t keep all eight operating theatres in the hospital at optimum activity levels because of under-staffing. The increase in demand in emergency services means staff are having to use beds which would normally be reserved for elective procedures and, as a result, patients waiting for the likes of eye surgery, varicose vein surgery, and other relatively minor, non-urgent activities are being pushed back.

“What is true is that elective activity has been severely curtailed,” a senior hospital source told the Irish Examiner.

“The hospital is not currently meeting its targets as laid down by the minister’s special delivery unit... It’s not true that none of it [elective surgery] is being done. We’re doing a bit of it, but not half as much as we should be doing.”

Emergency admissions have hit unusually high levels since March at WRH, with a “significant impact” on elective activities. The difference between now and the situation a few years ago is that there’s no longer any flexibility within the system, said the source, as the hospital can’t just go out and hire more staff or take on agency staff as the funding isn’t there to do so.

“We’ve closed wards or beds because we don’t have the staff to open them. It’s a staffing issue. In the old days we had more staff and we could go out and hire more agency staff to deal with this. It comes down to under-staffing and the effect of the [recruitment] moratorium.”

He estimated that WRH is down about 60 whole-time or equivalent nursing positions, from the level it should be at. “If we had those back we could open beds to ease the stress.”

For the last 18 months, only about five of the hospital’s eight operating theatres have been fully utilised.

The issue was highlighted last week at Waterford City Council by Fianna Fáil’s Gary Wyse, who has spent time visiting the hospital and observing activity levels. “The people didn’t walk on the streets for this,” he said, referring to the marches which took place in recent months by campaigners anxious to retain all existing services at WRH.

“The staff out there are brilliant but they can’t keep going like this,” he said yesterday. “They’re keeping the place together but the waiting lists are growing and growing.”

He pointed out that the adoption of the Higgins Report, which recommended WRH be paired with Cork University Hospital earlier this year, was meant to herald an improvement in services. “They promised us that they would give us a proper, structured service with all the supports that go with that. But what they’ve given us is a big building.”

In a statement, the HSE said it “apologises for the inconvenience caused” and reassured the public that, while the hospital is “very busy”, patients are seen and cared for appropriately.

An “unseasonably high demand” has been experienced at the emergency department in the last two months, the HSE said. “Due to this increased level of activity, in order to meet the emergency and urgent care requirements, it has been necessary on a number of occasions recently to utilise all available bed capacity in WRH. This includes those beds normally reserved for day services usage. Inevitably, this has led to the postponement and rescheduling of day procedure appointments and a number of selected inpatient procedures.”

Staff work particularly hard to minimise any inconvenience to the public, the statement said. “WRH is currently working through these issues and developing a number of options through which services can return to normal levels. In times of increased demand, as currently experienced, the maximum potential from staffing arrangements is applied and all emergency and urgent care requirements are being met, including cancer services.

“In relation to waiting lists, the HSE is currently implementing a national ‘Outpatients Department Improvement Programme’, the overall aim of which is to ensure timely, appropriate access to outpatient services in line with the target maximum waiting times, so that the right patient is seen by the most appropriate member of the clinical team at the right time.”