The Taoiseach Leo Varadkar has acknowledged that hospital overcrowding happens all year round but spikes “pretty much” every Tuesday and after a run of bank holidays.
This is largely, he says, because hospitals are run on a Monday to Friday basis.
“So patients admitted on a Friday or during a holiday period regularly don’t get the tests, scans, or procedures they need until the Monday or even Tuesday or Wednesday after they are admitted. They take up a bed for days, just waiting, which means others end up on trollies,” he said.
Mr Varadkar was responding to a query from The Irish Times asking him to detail his own experience, as a junior doctor, of hospitals at Christmas time after comments he made in the Dáil earlier this week caused a furore among doctors and nurses.
As the Dáil debated plans to deal with overcrowding in hospitals this winter he said nurses and hospital consultants should not take holidays in early January. He said a new HSE winter plan is needed where hospitals are not effectively closed for seven of the 12 days of Christmas and new year. In such a plan “consultants would not be on holidays in the first week of the year, particularly those who work in emergency departments and nurses will not be on leave in the first two weeks of January”.
He also said radiology departments and laboratories should be open and operating “at full whack” over Christmas and new year.
Mr Varadkar, in an article in Saturday's Irish Times, says his experience working in various hospitals helped form his views on the problems in our hospitals.
He said he had worked as a hospital doctor for four years between 2003 and 2007. "This included the Christmas and January period in St James's on the wards, Beaumont, Blanchardstown and Crumlin in the emergency department, and Blanchardstown in Medicine for Older People. I also worked in Tallaght, Navan, Wexford and Holles Street, though not at Christmas or in January," he said.
“The experience in each hospital was different and has certainly helped form my views on the problems in our hospitals”, he added.
‘Over-stretched’
The Taoiseach noted that all staff who are on duty over Christmas work very hard. But “because there aren’t enough people rostered for those periods in hospitals, the staff are over-stretched and patients have their treatment delayed. And when social and medical community services aren’t available, the hospital becomes the default option.”
Acknowledging overcrowding happens all year round, he said “it spikes pretty much every Tuesday with a peak or ‘crisis’ period after a bank holiday or a run of bank holidays. These peaks occur because we largely run our hospitals on a Monday to Friday, 9am-5pm basis with a limited emergency only or on-call service the rest of the time, or most of the time, especially when it comes to diagnostics.”
Mr Varadkar said he found the intractable nature of the problem frustrating. “During years of cutbacks it didn’t get any worse. During three years now of extra staff, extra beds and extra financial resources, it’s not got any better.”
Meanwhile there were 483 patients waiting for beds in hospitals across the State on Friday morning, the Irish Nurses and Midwives Organisation said.
Last month the IMO predicted Ireland’s hospitals face another chaotic winter with the number of patients on trolleys set to exceed 1,000 in a single day.
And earlier this week details emerged of a HSE review of how hospitals coped last winter. It found a sustained surge in the numbers attending hospitals, insufficient bed capacity, staff recruitment and retention problems as well as a prolonged flu season and extreme weather all contributed to unprecedented overcrowding.
The HSE analysis, completed in recent days, said special funding to address the pressures effectively came too late in the year to be of optimal use.
While the review by the HSE said special funding for dealing with winter pressures in the health service should be agreed in the summer, the executive’s final plan for this winter will only be submitted to the Department of Health in coming days. It was when the Dáil was discussing the review that Mr Varadkar made his remarks about hospital staff needing to work over the extended Christmas period.
