The Chief Executive of the HSE has said that there are a number of key challenges contributing to increased pressures at an earlier point in the winter period, which is resulting in a high level of unscheduled care activity.

Stephen Mulvany said that so far this year, 304,814 patients have been admitted to beds from emergency departments, which is up 3.4% on the same period in the pre-Covid year of 2019.

He told the Oireachtas Committee on Health that for patients aged 75 years and older, emergency department admissions are up over 10% on the same period in 2019.

Mr Mulvany said that new issues are being faced in maintaining and opening additional bed capacity related to infection prevention and control requirements, recruitment and staff retention challenges.

He said that while currently Covid-19 hospitalised cases are stable at 317 patients, including 11 patients in ICU, there remains the potential of a high incidence of seasonal illnesses this winter.

The HSE chief added that influenza and Respiratory Syncytial Virus (RSV) were also adding to pressures and that in the week to 5 November there were 117 influenza cases and 439 RSV cases notified.

Mr Mulvany said there are particular demands for primary and community care services in responding to and supporting the health needs of those seeking international protection.

These increasing demands are compounded by a shortage of healthcare workers both nationally and internationally to address and deliver the staff required for core and new service developments.

Fine Gael TD Colm Burke told the committee that some consultants cannot hold clinics because they do not have the nursing staff available.

He also said that some theatres are not being allowed operate after 4pm.

Mr Mulvany said that hospital clinics can proceed with healthcare assistants and that consultants who need access to theatre should get access, but there may be issues about the complexity of an operation.

Social Democrats co-leader Roisin Shortall critcised the Health Service Executive for what she said was the failure to provide for any new beds in its recent Winter Plan.

She told the committee that 1,228 extra beds had been promised in recent years, but according to the HSE, just 924 had been delivered to date.

The HSE told the committee that in order to put more beds in place, there were significant construction projects to progress and 119 extra beds are due to be opened before the end of the year, plus 184 beds in the first quarter of next year.

Meanwhile, the Irish Nurses and Midwives Organisation said there were 626 admitted patients waiting for a hospital bed this morning.

According to the INMO's TrolleyWatch figures, 521 patients were waiting in emergency departments, while 105 were waiting in other wards.

University Hospital Limerick has 87 patients waiting, with 58 at Cork University Hospital, 47 at LetterKenny University Hospital and 43 at St James's Hospital in Dublin.

The figures also show that 37 children are waiting for hospital beds, with 21 of these at Children's Health Ireland, Crumlin.