Ireland ends 2023 on record high for hospital overcrowding

Ireland’s main nursing organisation has slammed the Irish government after hospitals finished the year with overcrowding, long delays, and inadequate bed space, citing chronic underfunding and unsafe staffing levels.

According to the Irish Nurses and Midwives Organisation (INMO), more than 121,526 patients were admitted to hospitals without a bed, and more than 3,450 children were treated on hospital trolleys instead of beds in 2023 – an increase of 24% on the previous year.

The INMO said this crisis was predictable and unnecessary – though it is just the latest in a series of protracted funding battles that have dogged Irish health authorities, accompanied by high-profile funding and recruitment struggles played out in bitter public feuds.

Ireland’s Minister for Health Stephen Donnelly eventually secured stop-gap funding for 2024, though medical associations say it is too little to meet minimum care obligations.

In addition, as part of a long-term plan to increase efficiency and modernise Ireland’s creaking health system, the health minister has launched a series of projects to upgrade integrated systems and to streamline care structures, including the spring 2024 roll-out of ‘virtual wards’ designed to shift some patient categories from hospital care to home care.

Hospital bed capacity

INMO General Secretary Phil Ní Sheaghdha underlined the impact of a recruitment freeze on the health workforce:

“Instead of coming forward with plans to drastically improve the lot of our members and patients who find themselves in emergency departments, the HSE [Health & Safety Executive] has instead decided to implement a recruitment freeze which will further demoralise a burned out, exhausted workforce. We know from past experience that it can take a long time to reverse the impact of any recruitment freeze,” she said.

“There are several factors impacting the tight hospital bed capacity, one of which is the spike in respiratory illnesses in the young – this has clearly added pressure,” said Billy Kelleher, a member of the European Parliament for the centrist Renew group.

Speaking with Euractiv, Kelleher said: “When it comes to training and hiring more specialist consultants, a ‘whole of government’ approach is needed. We simply don’t have enough consultants and other front-line staff.”

“We need the right incentives for doctors to stay in the health service, and we need effective government policies to attract international talent to fill the gaps in health service roles.”

Virtual Wards

At the end of November, Health Minister Donnelly announced that an Acute Virtual Ward (AVW) programme will commence in early 2024 in both Limerick University Hospital and St. Vincent’s University Hospital, Dublin.

A spokesperson for the Department of Health (DoH) told Euractiv that the Virtual Ward programme builds on remote monitoring, which is already in place, and aims to provide services for respiratory and cardiology patients, treating approximately 600 patients a year in each site.

According to the DoH, this has the potential to save over 8,000 bed days per year in each acute hospital. Additional virtual wards are planned for 2024, which will include care for patients with a broader range of illnesses as part of a phased roll-out.

Commenting on the announcement, MEP Kelleher said: “Virtual wards have a long-term role, and this is increasingly possible because of modern communications, allowing a systemic shift which will help prevent some people with chronic illness from the need to be hospitalised.”

A spokesperson for Ireland’s Health Service Executive confirmed to Euractiv that the initial two AVWs will scale to be 25-bedded wards with Cardiology and Respiratory specialties included in the initial deployment.

The Phase 1 implementation will provide an opportunity for the programme to evaluate performance, safety, and value for money, which will influence planning for implementation in future sites.

Community Pharmacy

In addition to virtual wards, enhancing the role of community healthcare specialists, such as pharmacists, is part of the government’s strategy to reduce pressure on hospitals, free-up limited bed space, and reduce the workload of local doctors.

The DoH said: “It will still be necessary for people to see GPs in a community setting for medicines prescription, for example, but the role of the community pharmacist can be expanded for repeat prescriptions – this would free up GP resources.”

Long-term preventive medicine

However, despite policy innovation and technology deployment, Kelleher said that “one of the great challenges for Ireland is preventive medicine – it’s a long-term investment, which makes it less attractive politically, as politicians tend to be incentivised by short-term considerations.”

“However, the EU can help because it can take a long-term policy perspective with health impacts such as alcohol consumption, early diagnostics, and very importantly, DNA testing.”

He explained there is “an opportunity to prepare our health service for the future.”

“Simple data gathering from birth using neonatal heel pricks is one way we can help predict the impact of the genetic likelihood for some diseases – and this can allow the health service to plan and prepare accordingly,” he explained.

[By Brian Maguire, Edited by Vasiliki Angouridi/Zoran Radosavljevic | Euractiv.com]

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