‘Varied response’ to call for health staff to work over bank holiday weekend, says HSE boss

The HSE’s call for staff to volunteer for working over the bank holiday weekend in order to alleviate hospital overcrowding has met with a varied response, according to its chief executive, Bernard Gloster.

He said there has been a good response in community services, and parts of the hospital system, and significant additional capacity is available in the ambulance service and “some aspects” of diagnostics service this weekend.

Mr Gloster stressed the call “wasn’t for everyone” but was intended to increase the amount of “purposeful” activity in the health services at the weekend so that decisions on patients can be made and enabled in hospitals in relation to scans and discharges.

“This isn’t just about the June bank holiday weekend. This is going to be successive over the coming weeks and months,” Mr Gloster said, adding that he intends to bring formal proposals to trade unions for more seven-day working.

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Admissions fall by 20 per cent going into a bank holiday weekend, he pointed out, but discharges fall by 66 per cent.

“Those two variables don’t add up,” he said.

The Irish Medical Organisation (IMO) warned on Friday that the HSE’s intention to introduce seven-day working rosters “will not make any meaningful difference if the underlying crises of capacity and doctor recruitment and retention are not urgently addressed”.

“The HSE’s plan to introduce seven-day rosters is a fine idea in theory, but in practice it is unworkable given our ongoing crises in bed capacity and doctor numbers,” said Prof Matthew Sadlier, chair of the IMO’s consultant committee.

[ HSE to investigate how hospital activity levels can be raised at weekends ]

“If implemented, we will only see negative outcomes as already burnt-out healthcare staff will be asked to work even harder... We have become focused on patient discharges rather than patient outcomes. Doctors must remain free to make the best clinical decisions for patients and not be concerned with notional discharge targets.”

Mr Gloster dismissed this criticism as “a bit binary”.

“It’s a bit disappointing to say deploying the health service beyond an on-call system on the days of the weekend wouldn’t make any difference. I believe it will make a fundamental difference. Even with current resources, the distribution across the week could be better,” he said on RTÉ radio.

“Our hospital and healthcare system does not function at the same rate as it does during the week. The level of discharges in our hospitals and admissions is fundamentally different.”

Mr Gloster said the HSE has received several hundred “expressions of interest” in the new public-only consultant contract, but only “a small number” had signed up so far. He said it takes time for people to consider whether to accept the offer, so this was not surprising.

The HSE will shortly begin an international recruitment campaign to fill hundreds of vacant consultant posts, he added.

There were 239 patients waiting for admission on Friday morning, one of the lowest figures recorded this year and an indication that hospitals have been discharging patients at very high levels to make room for increased demand over the weekend.

Asked about the level of interest from staff in volunteering to work this weekend, a HSE spokeswoman said it “varies from place to place” and only after the weekend will “the overall picture” become clear.

“Additional measures to transfer patients from acute hospitals to appropriate care – ie delayed transfers of care – have been implemented in advance of the weekend to maximise patient flow through the healthcare system.”