Overcrowding crisis: HSE must reflect on why some hospitals ‘doing far better’ than others, says McGrath

The Minister for Finance said those involved in the HSE at an operational level need to “reflect and understand why some hospitals are doing far, far better than others” regarding the overcrowding crisis, given the levels of public money being put into the system.

Michael McGrath said the scenes being witnessed at hospitals around the country were “unacceptable” and acknowledged that capacity issues persisted – but added that the Government was doing what it could to address historic underinvestment.

“I don’t think we could be accused of [underinvestment] with €23.5 billion almost – it’s a record amount of investment.

“We are seeing a significant increase in capacity, that needs a lot more beds in our hospitals, 16,000 more staff over the last three years, a further 6,000 recruited this year – but that said, the scenes we’ve witnessed are not acceptable and should not be happening.

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“We are adding to the number of beds, so between acute beds and community beds, you’re looking at over 1,300 In the last three years,” Mr McGrath said on RTÉ's News at One.

“We’re seeing some hospitals perform really well and have no patients on trolleys but I think at an operational level the HSE need to reflect and understand why some hospitals are doing far, far better than others,” said Mr McGrath.

“But there is an issue with capacity. We are addressing that as a Government and we will be doing all that we can to accelerate that investment to build up that capacity.”

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Minister for Health Stephen Donnelly said the pressure on hospitals from the wave of Covid-19 infections and flu was a “perfect storm” that was hitting healthcare systems across Europe.

“What we’re seeing this year doesn’t happen every year. So what we’re seeing this year was a combination of flu, Covid and RSV – we haven’t had that before,” Mr Donnelly said.

“The first two winters we had Covid, if you like, there wasn’t really a flu season, so the system was able to manage,” he said.

“Nobody wants to see this ... it’s not acceptable to me or Government. And it’s not something that we should see. It’s not something anybody wants to see,” he said.

Mr Donnelly said the past three days had seen a 50 per cent drop in the numbers waiting on trolleys, but noted that the start of a week was always busier.

The health service was focused on increasing the number of patients discharged over the weekends, to free up beds, he said.

The plan was to have more “senior decision-makers” working in hospitals over the weekend. “They’ll be looking for access to things like radiology. Critically they’ll also need access to community services so that we can discharge patients home,” he said.

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Mr Donnelly said stories of elderly patients waiting for nearly 60 hours on chairs or trolleys in emergency departments was “not acceptable”. Hospital staff were already working “above and beyond” and were dealing with “immense pressure” in recent weeks and years, he said.

However, the HSE felt there was an “opportunity” for some more senior staff to work during weekends where possible, he added. “A lot of the consultants, a lot of the nursing staff, the radiology staff, a lot of them are coming in at the weekends anyway.”

The HSE put the trolley numbers at 8am on Friday morning at 398, with 94 patients said to have waited at least 24 hours.

The figure is 66 per cent up on the same date a year ago. While it’s down from 469 on Thursday, the HSE’s interim chief executive, Stephen Mulvany, said some reduction was to be expected in the normal course of events, with Monday and Tuesday usually the worst two days of the week. He said a substantial effort had been made by staff across the service to move patients through the initial part of the system over the past couple of days.

The emergency departments at Letterkenny University Hospital, St James’s Hospital and Cork University Hospital were listed as the most overcrowded in the country on Friday, while University Hospital Waterford was reported not to have had any patients waiting on trolleys at 8am.

Asked how it had eliminated overcrowding in the emergency department, a Waterford hospital spokesman said management were “too busy” to explain.