Patients on hospital trolleys all over the country are to be moved into beds as part of a major initiative aimed at tackling the over-crowding crisis in accident and emergency units, writes Martin Wall.
The Health Service Executive will write to hospital managers on Tuesday instructing them to move patients from trolleys into additional beds to be placed in existing wards, The Irish Times has learned.
The HSE is also to seek greater flexibility in work practices from doctors and nurses in hospitals as part of its plan for dealing with A&E overcrowding.
Where there is more than one consultant in accident and emergency medicine in a hospital, the HSE will ask them to voluntarily agree to work new rosters which would see a senior doctor present in the unit until later in the evening.
The new HSE plan is supported by Minister for Health Mary Harney.
The plan was discussed and supported by senior Ministers at a Cabinet subcommittee meeting on health in recent days.
The move is set to be opposed by the Irish Nurses' Organisation and hospital consultants.
Secretary general of the Irish Hospital Consultants' Association Finbarr Fitzpatrick said last night that the issue of rosters could only be dealt with as part of negotiations on a new contract for consultants.
Consultants have refused to participate in talks on a new contract until a protracted row over medical insurance cover has been settled.
Under the plan hospital managers will be asked to move one additional bed into wards.
They will be instructed to carry out a "mapping exercise" from next week to determine which wards are suitable to accommodate an additional bed.
It is not known how many additional places will be provided under the plan. However, sources said last night it could make significant inroads into dealing with the overcrowding crisis.
A spokesman for the HSE confirmed to The Irish Times last night that the letter initiating the plan would be sent to hospital mangers on Tuesday.
He said it was the view of the HSE that no union should have a blanket veto over the movement of patients from accident and emergency units to hospital wards.
The spokesman said that the only criteria governing the transfer of patients from A&E units to wards should be clinical need and health and safety issues.
Liam Doran, chief executive of the Irish Nurses' Organisation, said last night that the plan to transfer patients to additional beds in wards was an indication that health management now accepted the Tánaiste's proposals to deal with the accident and emergency crisis were not working.
Mr Doran accused the HSE of seeking to hide the extent of the problem in accident and emergency units. The INO chief said that similar measures had been tried in hospitals in the 1990s but had been abandoned by management at the time as being a failure.
Mr Doran said the plan to place additional beds in existing wards would impact on patient care, lead to greater risk of infection and pose potential health and safety problems.
He said that under the plan increased numbers of patients would be squeezed into existing space leading to a great risk of infections being transmitted and a loss of dignity for everyone.
However, Department of Health sources last night dismissed the criticisms by the INO and said that the Health and Safety Authority in its report on A&E services earlier this month had suggested that more beds should be placed in wards.
This week Minister for Finance Brian Cowen appealed for more co- operation from the medical profession in acute hospitals to deal with the problems in A&E units.
He told the Dáil that resources were not the only issue in dealing with the problems. "It also involves co-operation from consultants throughout the hospital, particularly with elective surgeries that are taking place," he said.
