EDITORIAL: December target for task force

WITH the number of people being accommodated on trollies in emergency departments across the country, as they await hospital beds to meet their medical needs, not having been reduced significantly so far, one has to question the HSE Emergency Department Task Force’s rate of progress. Its most recent meetings were in May and September and its next one was not due until early December, which hardly reflects the level of urgency that is necessary as the winter months set in.

It’s two years this month since then Minister for Health Leo Varadkar first convened the Emergency Service Task Force to adopt a whole health system approach to tackle the excessive numbers suffering unnecessarily on hospital trollies and its progress has been painfully slow with most of the pain being inflicted on those who have had to endure the indignity of being sick in very public places in hospital corridors in inhumane conditions that must make it difficult to comply with basic health and safety regulations.

The numbers on trollies in emergency departments throughout the country have been hovering above or below the 500 mark daily for the month of November and we haven’t been hit by the worst excesses of the winter weather yet. The all-time record was 601 people on trollies on a day in January 2015.

It seems that, once again, we are stuck with the perennial problem of acute hospital beds being occupied by mostly elderly people who should either be in nursing homes or being looked after through home care packages.

This is particularly frustrating in the context of up to 1,000 beds said to be available in nursing homes across the country, but according to Drimoleague man Tadhg Daly, chief executive of Nursing Homes Ireland, the HSE has been reluctant to engage with them on the matter and, curiously, NHI is not even represented on the Emergency Department Task Force. Mr Daly claimed that, back in July, the Department of Health and current Minister for Health Simon Harris’s office committed to engage with NHI ‘in a timely manner’ as part of its winter planning process, but that this had not happened. 

The weekly average cost of a nursing home bed is €1,000 as opposed to about €900 for an acute hospital bed. While it seems a no-brainer that this option should be part of the overall solution to the overcrowding of emergency departments, it will inevitably incur extra costs. 

Simon Harris announced last month that he had made €50m available to the HSE for this year’s Winter Initiative and they need to ensure that they get value for that money. Most attempts to solve the myriad problems besetting the public health service over the years have involved throwing money at them to achieve stopgap quick fixes, rather than coming up with the type of sustainable solutions that are needed for the longer term.

The Health Minister has set a target, as part of the Winter Initiative, to have the number of people on trolleys reduced to 236 in a day by early this month. If it is not met – and, with the way numbers have been stacking up in recent weeks, it is difficult to see this happen – what will Mr Harris do about it? 

But even if they do meet this ambitious target, it cannot be just a one-day wonder. The only sustainable solution remains the same – quite simply, provide enough acute hospital beds to meet the demands for admissions through emergency departments.