A leading consultant in emergency medicine has accused the Health Service Executive of being seriously dysfunctional in its handling of the trolley situation in hospitals.
Communications Officer for the Irish Association for Emergency Medicine Fergal Hickey said the HSE speaks about the issue as if the solution lies in someone else’s hand.
Speaking on RTÉ's Morning Ireland, Dr Hickey said the situation is particularly bad because the HSE has failed to meet its own targets outlined in the Winter Initiative.
The latest trolley count showed 528 people waiting for admission to a hospital bed around the country yesterday.
Overcrowding was worst yesterday at Letterkenny and Cork University Hospitals, with both having 45 people on trolleys or in wards awaiting beds, while University Hospital Galway had 43.
CUH issued a statement yesterday saying that between Monday and Tuesday this week, 411 people attended its emergency department, and of those, 166 required inpatient admission.
It appealed to people not to attend the ED unless absolutely necessary and to go to their GP or out-of-hours doctor service where possible, due to the level of overcrowding.
Irish Nurses and Midwives Organisation General Secretary Liam Doran said more funding is needed.
Speaking on RTÉ's Drivetme, Mr Doran said that unless there is sustained investment, beyond the €40 million earmarked for the Winter Initiative, problems will continue.
"The simple reality is the funding provided is inadequate to meet demand," said Mr Doran.
He said the health system cannot "meet the demand on emergency departments and, at the same time, maintain the required level of elective admissions".
This morning, Dr Hickey said that the numbers are going to get worse through the winter and people are going to die as a result.
He said the problem is not confined to winter, but the "winter surge is more significant in December, January, and February and into March, so if it is bad now it is going to get significantly worse.
"And unfortunately significant numbers of people are going to die. And that isn’t scaremongering, that is a prediction of what is going to happen."
He accused Minster for Health Simon Harris of being "unambitious in his planning" and that this sends out a message to the HSE that this does not matter.
Mr Hickey said the Department of Health has had ample time to prepare for the increase in numbers who get sick during the winter and that there is very little discussion about the patients who do really badly.
All of us who work in emergency departments have seen people die, let’s not talk the problem away or suggest it is not real.
"The evidence is there that if you are over 75 and on a trolley for over 12 hours you do badly in terms of recovery. You are much less likely to return home to an independent existence. There is a cost not only to humanity but money. We are wasting money."
He said Mr Harris has said he accepted that there are bad outcomes as a result of the situation.
Dr Hickey added that the problem will only be fixed by providing enough medical beds, so when someone needs to be admitted from the emergency department a bed is available for them.
In response to calls for more pay for nurses, Dr Hickey said the reality is that "if we can't pay, we can't recruit".
He said Irish nurses are hugely sought after in the UK and other parts of the world and they have no choice at the moment "in so far as they don't see a future in nursing and medical care in Ireland.
They see an extremely dysfunctional HSE, which is the reality that we are describing and they see other systems which value them and their qualification is sought after elsewhere. So they are voting with their feet."
Government accused over Winter Initiative
Meanwhile, Fianna Fáil's health spokesman Billy Kelleher has said the Government's Winter Initiative to tackle overcrowding in EDs had failed.
During Leaders' Questions in the Dáil, Mr Kelleher raised the comments made by Dr Hickey.
Mr Kelleher said the HSE was carrying out a bed capacity review, but he queried the independence of the review.
He said there was very low morale across the health service, but particularly in Emergency Departments.
The Fianna Fáil TD said there had been a consistent downgrading of services. and he asked the minister if he would commit to ensuring the HSE bed capacity review was independent.
Minister for Public Expenditure and Reform Pascal Donohoe said the issue was of great concern to the House and he said Budget 2017 gave a substantial rise in health funding, a €900m increase compared to a year ago.
On bed capacity, Mr Donohoe said the level of current investment was capable of a new 75-bed ward in Galway, the construction of a new Emergency Department in Kilkenny, and the same investment in Our Lady of Lourdes Hospital in Drogheda.
This was in addition to a new ward in the Mater Hospital in Dublin, which has had to deal with extra pressure, he said.
The minister said the levels of investment by this Government was facilitating these improvements and he said he had confidence in the HSE to do the Bed Capacity Review, but would pass on Mr Kelleher's concerns to Minister for Health Simon Harris.
Mr Kelleher said the Winter Initiative was meant to address the overcrowding during winter months, but if in November there are 500 people on trolleys already then, he said, the initiative had failed.
Mr Donohoe said the Winter Initiative was being reviewed on a continual basis and there would be 55 acute beds and 18 step-down beds as part of the programme.
