Dáil debates
Thursday, 15 February 2024
Saincheisteanna Tráthúla - Topical Issue Debate
Hospital Overcrowding
3:00 pm
Paul Donnelly (Dublin West, Sinn Fein)
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It is clear Connolly Hospital is in crisis. Everybody will be shocked by some of the reports that have come out in the past week alone. I raised this matter with the Tánaiste some weeks ago when a concerned member of staff contacted me about the closure of the endoscopy unit in Connolly Hospital, which had been under serious pressure. I wrote to the hospital and received an email in reply stating, "As part of the HSE Winter Unscheduled Care Planning in Connolly Hospital, elective procedures have been temporarily reduced for the month of January." I sent the email from Connolly Hospital to the person who contacted me and who had obviously listened to the exchange between the Tánaiste and me on the day in question. The individual in question wrote:
It needs to be addressed that Connolly does not have enough beds for the population it is serving [the Minister of State should bear in mind that this was several weeks ago]. The ED department is under huge pressure all the time and the numbers being returned are not reflecting the true situation. The hospital are using the line that procedures have been cancelled due to the winter initiative if that is the case the winter has been going on since last winter. They are outsourcing procedures to other hospitals ... However there are still large numbers waiting and referrals still coming in.
That was two weeks ago. We have since had other reports.
Speaking on the radio the other morning, the INMO's Phil Ní Sheaghdha described the conditions in Connolly Hospital as "inhumane". She said: "When the HSE does not plan knowing what happens every winter this is the type of immediate reactionary solutions that hospitals are trying to find because there simply isn’t enough capacity.”
A member of staff put their neck on the line by saying there is a serious crisis in the endoscopy unit and also mentioned the emergency department. The nurses organisation has said the conditions in Connolly Hospital are inhumane. Another nurse, who contacted Dublin Live, described the situation there as “chaotic” and a danger to patients. She said:
Moving patients into these totally inappropriate areas is not fair on patients or staff. This room has been set up as a ward but there’s no bell if someone becomes ill and there’s no extra staff allocated.
There’s no toilet or shower facilities and there’s also a very long walk down a corridor to the nearest toilet. This area was never in a million years for people to stay over[night], never mind use it as a ward.
They have recently repurposed it in the hope to get around 12 patients in there. It means there are no physiotherapy facilities for people recovering ...
They have repurposed a physiotherapy gym to deal with the overcrowding in Connolly Hospital. This is really serious. We know that people die in emergency departments if they are on trolleys and not getting appropriate care. I do not know how anyone could not feel shocked listening to the stories from the staff, the people who work there. It is utterly shocking.
3:10 pm
Kieran O'Donnell (Limerick City, Fine Gael)
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I am taking this matter on behalf of the Minister for Health, Deputy Stephen Donnelly. I thank Deputy Paul Donnelly for raising the question of overcrowding at Connolly Hospital, Blanchardstown. Connolly Hospital, Blanchardstown, is a major teaching academic hospital within the RCSI Hospitals Group. It has a catchment population of upwards of 331,000 people and serves a mixed urban and rural catchment, including Finglas west, Lucan, Dublin 15, north Kildare and south Meath. In addition to 24-hour emergency care, scheduled services include acute medical and surgical care, acute psychiatric services and outpatient diagnostic, therapeutic and support services. It is recorded that there has been a significant increase in demand for emergency care nationwide in 2024, with approximately 122,000 emergency department attendances in January. This is an increase of 10% compared with the same periods in 2022 and 2023.
The Department of Health has been in communication with the RCSI Hospitals Group and understands that Connolly Hospital, Blanchardstown, experienced a surge in emergency department attendance in early February. Having done my own checks, that surge occurred on 7 and 8 February. In response to this surge and following a risk assessment, on the night of 7-8 February, some suitable patients were transferred from the emergency department to an appropriate ward area while awaiting discharge. The priority was to reduce clinical risk and relieve pressure on the emergency department. I checked this and the area in question is a physiotherapy department, not formally a gym, and it is not longer in use as a ward area for the emergency department.
The Minister's officials have been in ongoing contact with the RSCI Hospitals Group on this issue. I understand how difficult this has been for patients and staff. The priority was to reduce clinical risks and relieve pressure on the emergency department at that time. The area is no longer in use for that purpose.
Urgent and emergency care pressures are no longer just experienced during winter periods and prolonged levels of high daily presentations and congestion are now being experienced throughout the year. Presentations to emergency departments of those aged 75 years and older were up 33% and 26% nationally compared with the same period in 2022 and 2023, respectively. As of 9 February, 1,126 non-ICU acute beds have been provided nationally over the number available in January 2020. This includes 78 beds in Connolly Hospital.
The Government is committed to the development of large hospitals such as Connolly Hospital, Blanchardstown. A number of key projects are under way at various stages at Connolly Hospital. The Taoiseach met hospital management in December to discuss the developments at the hospital.
The new Connolly education and research centre aims to transform the educational programmes and enhance the student experience for graduate entry medicine students and clinical placement students based at the hospital. This new building is well on the path to completion, with all structural works completed and internal works progressing. Construction is due for completion in May 2024 and the building should welcome the first intake of students later this year. A dental education centre, including endocrinology, rheumatology and an infusion suite, is also planned for Connolly Hospital, Blanchardstown, and a second CT scanner will be provided for diagnostics services at the hospital.
This investment underlines this Government’s commitment to improving services for the people of Blanchardstown and the surrounding area. The Government recognises the valuable work done by the staff in Connolly Hospital and aims to support the ongoing development of services at the hospital.
While I recognise the difficulties caused to patients, the physiotherapy unit used to relieve pressure on 7 and 8 February is no longer in use for that purpose.
Paul Donnelly (Dublin West, Sinn Fein)
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I thank the Minister of State for his answer. I expected statistics, including the extra 78 beds, to be mentioned. It is completely understandable that there will be emergencies and pressures at times. There will be times when the hospital is overcrowded due to certain circumstances, whether it be a flu epidemic or respiratory issues. However, this is not something that happened in January or February 2024 or December 2023. In 2018, in an article in the Irish Independent, the current Minister of State, Deputy Jack Chambers, raised exactly the same questions as those I am asking today. He stated that hospitals should not have to suspend vital screening of patients that may show up cancer. He also stated:
These day wards and beds are inappropriate to be used as a spillover for seriously ill inpatients being admitted to overcrowded A&Es. It is particularly troubling when this surge in emergency departments' admissions was entirely predictable.
That was in 2018. The INMO warns year after year that this crisis will happen - not that it has happened but that it will happen. Staff who are working in these departments are telling us that this is not just a problem in the winter of 2023 or 2024 but is an annual winter issue. In fact, winter does not stop in some of these hospitals.
While I understand that some work has been done and a limited number of extra beds have been provided, it is clear that what is being done is not enough when we have people in completely inappropriate places, there are no alarms, no extra staff and no way for people to shower or access toilet facilities. This is in a modern hospital in this day and age. The Minister of State, Deputy Chambers, made those comments in 2018, so this is not something new. It happens year after year. I guarantee, if we are here this time next year, that I will probably seek a Topical Issue debate on exactly the same issue unless we get to grips with it.
Kieran O'Donnell (Limerick City, Fine Gael)
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I appreciate the Deputy’s contribution and his genuine sentiments on the surge in attendance at Connolly Hospital, Blanchardstown. I also thank him for raising this important topic and acknowledge that he has raised other issues.
The Government understands how important it is to make quality patient services available to people in Blanchardstown and everyone across the country. As I outlined, Connolly Hospital experienced a surge in attendance at the emergency department on the night of 7-8 February. It took the decision to reduce clinical risk to patients by transferring some suitable patients to an appropriate ward. It was a physiotherapy ward. It is not formally a gym but part of the physiotherapy department. As stated, the hospital's priority was to reduce clinical risk and relieve pressure on the emergency department. This ward is no longer being used for that purpose.
The increase in numbers of attendees is also being felt on a national scale, with emergency department attendances in January 2024 up by 10% compared with the same periods in both 2022 and 2023.
There are a number of capital developments in train at Connolly Hospital designed to improve patient experience, including the education and research centre and laboratory transfer, a second CT scanner and a dental education centre including an endocrinology, rheumatology and infusion suite.
The Government and the Minister for Health are committed to the ongoing development of services and care in Connolly Hospital and will continue to support the hospital in developing its valuable services into the future.