Dr. Mick Molloy:

As a consultant in emergency medicine in a busy emergency department, I can tell the Deputy exactly what the impact of waiting and trolley times is. It is death. That is what the impact is. A seminal paper was published earlier this year by the ex-president of the Royal College of Emergency Medicine in the UK. Two years of admissions in the UK were studied, along with 430,000 deaths in the UK system. Researchers were able to show that for every 82 people who were delayed in getting to a bed on a ward for longer than six hours from the time of presentation to an emergency department, one extra person died because of the delay. It is fairly simple. The study was carried out very scientifically over a huge population. It showed that people who got a bed on a ward more quickly were less exposed to – I do not use this phrase lightly – the torture of being in an emergency department. It is a 24-hour operation. The lights are on. When people are sick they want the lights turned off and a place with peace and quiet. There are many staff moving around and there is a lot of noise. The Geneva Convention recognises that not allowing a person to sleep and exposing him or her to loud noise is a form of torture, and that is what is happening to these people in emergency departments. People tolerate that for short durations. We know that people who have been exposed for 24 or 48 hours are not getting sleep for that period which dramatically affects their ability to survive an illness.

With respect to workforce planning, quite a lot of work went into this in recent years in the national doctors training programme which identified the numbers required in each specialty over the next ten years in order to staff the service. That is great, if people have confidence in working in the service. People are choosing to work elsewhere because they cannot see the level of investment in the service to guarantee them the ability to do their job. Surgeons are appointed to hospitals without any operating time. That makes no sense. Why appoint a surgeon if he or she cannot operate? People are appointed to community health organisations where there is no base from which to run clinics. Again, that makes no sense.

A lot is required in the service. I draw the attention of the committee to a report from the Department of Health from 20 years ago on acute bed capacity. At that time, it recognised the need for 5,000 extra beds. At that time, there were 11,862 inpatient acute beds. We now have less than that. We had a population of 3.5 million then, but the population now is over 5 million and is growing on a week-to-week basis. Sitting and talking about strategies and plans are great, but they are only good intentions unless we actually generate the hard work needed to implement them.