HSE accused of ‘fudging’ times for emergency care

Executive misleading public on waiting times for admissions, IMO conference hears

Former IMO president Dr Mick Molloy said there was no clarity on when the clock started ticking for a patient’s wait in hospital. Photograph: Bryan O’Brien

Doctors have accused the HSE of misleading the public by “fudging” the way waiting times for patients are measured in emergency departments.

Delegates at the Irish Medical Organisation’s annual conference called for agreement on a standard definition of “waiting time” for admissions.

Former IMO president Mick Molloy said there was no clarity on when the clock started ticking for a patient's wait in hospital. Yet different approaches could add hours to a patient's journey while allowing the health system "wriggle room" when publishing figures. Each hospital handled the issue differently, he said.

Dr Peadar Gilligan, an emergency medicine consultant, said the HSE begins counting wait times from when the admitting team requests a bed for a patient, which is often four or five hours after the patient has arrived in the hospital.

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Six hours

Dr Gilligan said this amounted to fudging. “So it needs to be very clear – from the time the patient arrives until the time the patient goes to the ward or goes home. That’s the metric that should be used and it should not be more than six hours.”

There is no reason an Irish patient should wait significantly longer than a patient in the NHS or in Australia, he said.

“We just need to resource our system so we can do that,” he said. “In the hospital I work in, it is often about 16 hours after we request a bed before a bed is made available to the patient. So a patient requiring emergency admission that day waits until tomorrow until a bed becomes available to actually get into a ward.”

In the UK, the target waiting time is four hours, which is achieved 95 per cent of the time. In Australia, the target is six hours. In Ireland it is nine hours, and this is frequently breached.

Realistic budget

Any incoming government must ring-fence a realistic and fair budget for the health services, according to the incoming president of the IMO.

Dr John Duddy said there was real concern that the necessary investment and leadership will be beyond the scope of what is likely to be an unstable, short-term administration.

The current budget process for health was “simply not credible,” Dr Duddy told the conference in Sligo.

“Nobody really believes the figures when the budget is announced,” he said, “and within weeks stories are planted about potential overruns and problems.

“The process has no credibility, largely because the figures proposed are insufficient to enable the health service to operate on an appropriate basis.”

Dr Duddy, a non-consultant hospital doctor in Beaumont Hospital, criticised political commentary that characterised health as a political problem, "when in fact it is everything to do with real life".

“It’s about people receiving life-changing treatments, people on trolleys and on endless waiting lists for urgently needed surgery, people in emergency departments desperately waiting for help.”

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.