Hospital overcrowding - A&E debate necessary for change

DR AIDAN GLEESON stirred a veritable hornet’s nest last week when he suggested that the immediate overcrowding in A&E departments could easily be resolved by transferring just one or two patients on trolleys to each ward in the hospital.

The Irish Nurses Organisation (INO) has refuted the suggestion indignantly, contending that this was tried in the 1990s but it did not resolve the problem. The INO has warned strongly against the danger of overcrowding in inpatient ward facilities, as this increases the risk of infection to vulnerable patients, and is therefore contrary to best practices.

The arguments made by the INO apply even more forcefully to A&E departments, where the overcrowding is many times greater. Dr Gleeson’s suggestion was not put forward as an ideal solution, but as an interim remedy. The proposal has served a very useful purpose, if only in sparking a debate that has highlighted the need for immediate action.

Nobody was seriously suggesting that moving a couple of trolleys into each ward would be a long-term solution. It was proposed merely as a remedy to resolve the immediate problem, while effective durable measures are being implemented in line with the Tánaiste’s ten-point plan to resolve the chronic overcrowding problem.

The INO is justified in demanding a timetable to ensure the 10-point plan is implemented as promised. Complaints that certain administrative reforms in matters of hygiene have not been implemented certainly undermines confidence in relation to the other promises.

The overcrowding in A&E is the most immediate problem. To resolve it requires a team effort on the part of hospital administrators, doctors and nurses, working in the interest of patients.