Four suspected cases of the winter vomiting bug were being treated at a Dublin hospital last night which was already struggling to cope with overcrowding in its accident and emergency department.
The patients with symptoms have been isolated in a 16-bed ward at Beaumont Hospital.
The other 12 beds in the ward have had to be kept empty to avoid transmission of the highly infectious bug to other patients. Meanwhile, 17 patients were on trolleys in the hospital's A&E department last night waiting for beds.
As the A&E crisis continues, it has emerged that a large number of patients who were due to be admitted to Dublin hospitals for elective procedures this week have had their treatment postponed. The Mater Hospital, which was one of the worst affected by A&E overcrowding, said it had to cancel "a considerable number" of elective or planned procedures over the past two days.
Beaumont said it postponed at least 20 patients over the past two days while James Connolly Memorial Hospital in Blanchardstown confirmed it had cancelled elective work for yesterday and today. The cancellations will have a knock-on effect on hospital waiting lists.
Urgent elective work is, however, taking place.
Last evening the Irish Nurses' Organisation (INO) claimed the situation at Dublin A&E units was still critical. It said there were 25 patients on trolleys in James Connolly Memorial Hospital, 24 in Tallaght, and 13 in St James's. The situation at the Mater, where there were still 16 patients on trolleys last evening, had improved significantly since Monday, when the figure was 33. At that stage the hospital, along with Beaumont, had to stop taking patients and ambulances were diverted to hospitals in the south of the city.
The improvements followed a meeting between hospital management, the Eastern Regional Health Authority (ERHA) and the INO, at which it was agreed that urgent steps would be taken to find accommodation in the community for more than 90 patients blocking acute beds in the hospital because they have nowhere else to go.
The INO's general secretary, Mr Liam Doran, blamed the health authority for the crisis and accused it of withholding funds which could be used to free up more beds. To date only a handful of patients inappropriately occupying acute beds have been moved out into the community with the €3.8 million which the Minister for Health, Mr Martin, announced he was giving to the ERHA for this purpose last July.
The ERHA said, however, yesterday that the beneficial impact of the funds was "beginning to be felt".
The Irish Nursing Homes Organisation also blamed the ERHA for current difficulties. Its chief executive, Mr Paul Costello, said the ERHA had effectively reduced the amount it was willing to pay towards the cost of caring for elderly persons in nursing homes and as a result many were remaining in acute hospital beds while over 400 private nursing-home beds in the greater Dublin area remained vacant. Yet the cost of care in a nursing home was half that of a hospital, he said.
Meanwhile, Dr Aidan Gleeson, secretary of the Irish Association of Emergency Medicine, said something serious would happen to some patient if the A&E problems weren't sorted out. "On a daily basis emergency departments are flying by the seat of their pants," he said. There was lots of talk about what needed to be done but little action. The Department of Health and the ERHA had been told repeatedly of the need to adequately fund nursing home beds, he said.