Averil Power (Independent) | Oireachtas source

On 22 October last, the Irish Nurses and Midwives Organisation, INMO, called for Beaumont Hospital to go off-call as the accident and emergency department was dangerously overcrowded. By the early evening, there were 41 admitted patients in the accident and emergency department awaiting a hospital bed and numbers were set to rise as the night went on. As the Minister will be aware, the department is also short of nurses and doctors and staff are concerned that it is impossible to provide a safe level of care to patients in these conditions. Almost half of those awaiting a bed on the night to which I refer night were over the age of 75 and many of them had been forced to spend days on trolleys and chairs in frantic, bright and noisy conditions waiting for beds to become available. Waiting on a trolley in such degrading and inhumane conditions is unacceptable for people of any age but it is particularly cruel for frail older individuals in their 70s, 80s and 90s.

Accident and emergency overcrowding also creates an unacceptably stressful working environment for staff and is exacerbating the problem with emigration of nurses and doctors from Ireland to other countries where they can work in better conditions. I appreciate that the problems at Beaumont accident and emergency did not just appear on this Government's watch but they seem to be getting worse. According to the INMO, overcrowding at Beaumont increased by 40% in the first nine months of this year compared with 2014. There is a major concern that the position will deteriorate further and that Beaumont Hospital may well be facing its worst winter ever.

As the Minister will recall, the CEO of the hospital, Mr. Liam Duffy, described Beaumont as unsafe during last year's similar overcrowding crisis. The former clinical director of the hospital, Professor Shane O'Neill, resigned over patient safety concerns. I recently met the CEO, Mr. Duffy, and accident and emergency staff to discuss the accident and emergency crisis, and particularly what can be done to address it. A number of things need to happen. First, we need to reduce the number of people presenting at the accident and emergency department by improving primary care and out-of-hours services. D-Doc was a great service when it started but it is suffering from a lack of resources. I obtained figures from the HSE last year which show that some people classified by D-Doc as urgent had been waiting over 13 hours to see a doctor. The rational course of action in such a circumstance is to go to accident and emergency and yet the service is supposed to prevent those who use it from having to do so. Second, there is an urgent need for more convalescent and nursing home beds in the area. Often Beaumont has up to 100 patients awaiting discharge for whom it cannot secure nursing home or convalescent home beds. Some even have been there for over a year. As the CEO explained to me, the average time in Beaumont is three or four days and in those circumstances - where there are particularly difficult cases and a place cannot be found for someone - 100 others are denied places because 100 patients could go through that bed in the same amount of time. Third, even with these measures, improving out-of-hours services and reducing those presenting to accident and emergency, there will still be a crisis at Beaumont because of the older demographic relating to the area. Beaumont has one of the most elderly populations in the country. Given that the people who live in the area are going to continue to age, there will always be a need for acute accident and emergency medical services at Beaumont far more advanced than those currently provided there.

The accident and emergency department was built for only 35 patients and is often home to 100. Work is ongoing in respect of designs for a new accident and emergency department on the Beaumont campus and the authorities there are in discussions with the HSE about the matter. However, the Government has not yet committed to building that new facility. I raised this matter in order to urge the Minister to ring-fence the necessary funding and give a solid commitment that funding will be available as soon as those plans are finalised to build a new accident and emergency facility at Beaumont Hospital.