Mary Butler (Waterford, Fianna Fail) | Oireachtas source

Emergency department and hospital overcrowding has become the norm. We hear in the news every day of trolley numbers representing the number of sick patients who cannot access a medical bed in a hospital but who may instead have to wait on a trolley, in some cases for days. They have to stay on a corridor with the lights glaring, without privacy and without bathroom facilities, other than the public bathroom in the emergency department. They have nowhere to put their personal belongings.

As of October, 13,466 people aged over 75 endured waits of more than 24 hours for a bed. Never before have so many elderly people waited on trolleys for longer than 24 hours. The latest figures are devastating. Last year's figure of approximately 10,000 has skyrocketed by 35% this year. Many elderly people have told me they are afraid to go to hospital because they fear they will be left on a trolley on a corridor for days, with no privacy as people pass by. They are afraid they will die alone and would prefer to stay in the comfort of their homes, regardless of how ill they are.

The way forward is to tackle the issue of delayed discharges. We need timely transfer of care to the home or, with the correct wraparound supports, to a community respite bed or nursing home through the fair deal scheme. There are 451 patients awaiting approval for that scheme. There were 680 cases of delayed discharge at the end of October. In 2014, the former chairman of the emergency department task force warned that delayed discharges were putting lives at risk. At the time he wrote his analysis, there were 703 delayed discharge patients in the acute hospital system, which he said represented 30 wards at capacity. Frail elderly patients risk hospital acquired infections, falls, pressure ulcers and medication errors while being nursed in busy acute hospital settings for months on end.

As my colleague, Deputy Donnelly, said, I visited University Hospital Waterford on Monday and was advised that there were 21 delayed discharges currently in the hospital. On the same day, there were 23 patients on trolleys. Today, there are 20 patients on trolleys in the hospital and 577 patients on trolleys nationwide. The point I have been making all year is that if we allow 21 delayed discharges at one end of the system while there are 20 people on trolleys in the emergency department, the problem will never be resolved. The dramatic increase in lost bed days in our acute hospitals demands a direct intervention from the Minister.

I am calling for a task force on delayed discharges to co-ordinate timely discharge. We need a centralised, co-ordinated approach to delayed discharges. Each hospital group should have a task force specifically allocated to identify where issues are occurring and to design a plan to ensure timely access to step-down care for these patients. We could vastly reduce trolley overcrowding if we got serious about delayed discharges. I understand that, in some complex cases, this is not always possible but direct intervention is required. I ask the Minister to give serious consideration to that request.

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