Are people being served properly in emergency departments?

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SPEAKER_2 (0:28)

That's fieldmaps.ie The Hard Shoulder, with Ciara Kelly and Shane Colman. On Newstalk, with Ciara.

Ciara Kelly (0:39)

Now new figures from the HSE show more than 70,000 people did not wait or left before completing their treatment in emergency departments during the first 7 months of this year. Chairperson of the Oireachtas Committee on Health Social Democrats, TD. Pádraig Rice, obtains the figures and he joins me now. About 10,000 a month is a huge amount, Pádraig, but do we know why? Like how much is this people getting fed up of waiting? How much is it that people have been maybe seen initially and don't think anyone's going to follow up with them and just walk out? Do we have any more of that granular detail?

Pádraig Rice (1:12)

Unfortunately not. The detail the HSE gave to us was just the absolute numbers. So there could be a myriad of reasons there. People could have got fed up waiting because we do know that over 32,000 people waited longer than 24 hours to be either admitted or discharged. And so there could be a variety of reasons why people left. People could have left and came back the next day. We don't know, but what we do know is that 70,000 people have left without being seen or having their treatment completed. So it's a huge number. And I think it's just a symptom of a bigger problem in our health service. Like we have a pipeline problem in the health service where people end up in HNE and that's the sharp end of things. And I think there are a number of things that need to be done to solve this. There are a number of solutions.

And in the first instance, we need to substantially increase the hospital capacity.

According to Eurostat, Ireland has the fifth lowest number of beds per capita across Europe.

So we have 290 beds per 100,000. The EU average is over 500 So we don't have enough hospital beds in which people can get admitted into and then staffed and treated. And the EFRI told us we need 300 per year because of our ageing population and demographic changes. Last year, the government fell 100% of even that target. So serious lack of ambition here on behalf of both government to build up the capacity we need in our acute hospitals. And that's one of the reasons why we have a huge pressure on our A&E services despite our staff working incredibly hard every day.

Ciara Kelly (2:36)

Yeah. How difficult though, sorry to cut across you there, how difficult though is that actually to reach? Because I've had occasion to be with family members in A&Es and it's not like there's a whole pile of space to put extra beds in. Many people are crammed on top of each other. They're on trolleys like it's not necessarily just a question of add the beds in and the staff, but also the infrastructure. You need a physical place to put them.

Pádraig Rice (2:55)

No, absolutely. Like we need to be building wings onto hospitals to have beds and staff to treat patients. And that is crucial. And we need to at least get to the EU average. But all of the solutions here can't just be found in the acute hospitals. The solutions have to be found in the community and we need to invest in community services because people are struggling to access the GP service, particularly in rural areas, commuter belts, urban deprived areas. And when people are waiting over two weeks to see a GP, or when they have to pay huge amounts out of pocket, the most expensive GP care in Europe, then sometimes people end up going to A&E instead. So we need to invest in those community services to try and ensure that people who don't need to go to A&E can have access to a GP.

I know people who travel inter-county to see a GP because they can't get on a list. So it's crucially important. But we also know that there's 100,000 bed days lost because of delayed discharges. So a huge number of people who are in hospital, who don't need to be there any longer, but they can't go home because they can't get home care. You can't get a step down facility. We need to ensure that people are discharged in a timely way to make the maximum use of our really expensive acute hospitals that are there. So there are those solutions to be found in the community if we invest in those services.